Sangrado uterino anormal como manifestación de hipotiroidismo severo: reporte de un caso

Abstract

Introduction: Thyroid dysfunction causes a wide spectrum of reproductive disorders, including menstrual disorders. Hypothyroidism has been associated with heavy and prolonged menstrual bleeding. The mechanism by which hypothyroidism causes abnormal uterine bleeding is multifactorial and includes alterations in hemostasis and neuroendocrine dysfunction. Clinical case: A 27-year-old female patient, 0 pregnancies, 0 deliveries, 0 abortions, with a personal history of hypothyroidism diagnosed in 2017, without thyroid hormone replacement treatment. She was admitted to the emergency department due to a history of abnormal uterine bleeding. Hemoglobin 4 g/dl and hypovolemic shock. Therefore, fluid resuscitation and blood transfusion were started. Thyrotropin stimulating hormone and free thyroxin became available and were 102.12 mUI/ml (0.38-5.33 mUI/ml) and 0.19 ng/dl (0.58-1.64 ng/dl) respectively. Treatment was started with oral levothyroxine loading dose of 400 mcg for 3 days. Conclusion: Severe hypothyroidism can lead to abnormal uterine bleeding and must be considered as an important etiological factor in the context of menstrual disorders.