P. Jain, Anuja Bhalerao, Sakshi Aggarwal, J. Malhotra
{"title":"迟发性先天性肾上腺增生或早发性多囊卵巢综合征:一个临床困境","authors":"P. Jain, Anuja Bhalerao, Sakshi Aggarwal, J. Malhotra","doi":"10.5005/JP-JOURNALS-10006-1513","DOIUrl":null,"url":null,"abstract":"Aim: To differentiate nonclassical congenital adrenal hyperplasia (NCCAH) from polycystic ovarian syndrome (PCOS) in a 13-year-old girl. Introduction: Hirsutism and virilization are effects of hyperandrogenism by ovaries and adrenal glands. It has a marked psychological and social impact affecting the quality of life. About 75% of premenarchal girls have hyperandrogenism due to PCOS but late-onset CAH cannot be ruled out, and this leaves the clinician in a quandary regarding the diagnosis and management. Case report: A 131⁄2-year-old girl presented with excessive facial hair, hoarseness of voice, and darkening of elbow pits since past 2 months, which was increasing in severity. The patient had not yet attained menarche but had pubarche 1 year earlier. Examination revealed presence of acanthosis, underdeveloped breasts, and clitoromegaly >3 cm. Levels of 17-hydroxyprogesterone were normal but higher levels were reported poststimulation. Fasting insulin levels were also high. Appropriate treatment was started, which led to improvement in patient’s symptoms. Conclusion: There is significant overlapping between PCOS and NCCAH, which warrants accurate diagnosis based on hormonal analysis to institute early and appropriate therapy. Clinical significance: Early therapy can prevent infertility and androgenic complications later in life.","PeriodicalId":53559,"journal":{"name":"Journal of SAFOG","volume":"9 1","pages":"280-282"},"PeriodicalIF":0.0000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Late-onset Congenital Adrenal Hyperplasia or Early-onset Polycystic Ovarian Syndrome: A Clinical Dilemma\",\"authors\":\"P. Jain, Anuja Bhalerao, Sakshi Aggarwal, J. Malhotra\",\"doi\":\"10.5005/JP-JOURNALS-10006-1513\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: To differentiate nonclassical congenital adrenal hyperplasia (NCCAH) from polycystic ovarian syndrome (PCOS) in a 13-year-old girl. Introduction: Hirsutism and virilization are effects of hyperandrogenism by ovaries and adrenal glands. It has a marked psychological and social impact affecting the quality of life. About 75% of premenarchal girls have hyperandrogenism due to PCOS but late-onset CAH cannot be ruled out, and this leaves the clinician in a quandary regarding the diagnosis and management. Case report: A 131⁄2-year-old girl presented with excessive facial hair, hoarseness of voice, and darkening of elbow pits since past 2 months, which was increasing in severity. The patient had not yet attained menarche but had pubarche 1 year earlier. Examination revealed presence of acanthosis, underdeveloped breasts, and clitoromegaly >3 cm. Levels of 17-hydroxyprogesterone were normal but higher levels were reported poststimulation. Fasting insulin levels were also high. Appropriate treatment was started, which led to improvement in patient’s symptoms. Conclusion: There is significant overlapping between PCOS and NCCAH, which warrants accurate diagnosis based on hormonal analysis to institute early and appropriate therapy. Clinical significance: Early therapy can prevent infertility and androgenic complications later in life.\",\"PeriodicalId\":53559,\"journal\":{\"name\":\"Journal of SAFOG\",\"volume\":\"9 1\",\"pages\":\"280-282\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of SAFOG\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/JP-JOURNALS-10006-1513\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of SAFOG","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/JP-JOURNALS-10006-1513","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Late-onset Congenital Adrenal Hyperplasia or Early-onset Polycystic Ovarian Syndrome: A Clinical Dilemma
Aim: To differentiate nonclassical congenital adrenal hyperplasia (NCCAH) from polycystic ovarian syndrome (PCOS) in a 13-year-old girl. Introduction: Hirsutism and virilization are effects of hyperandrogenism by ovaries and adrenal glands. It has a marked psychological and social impact affecting the quality of life. About 75% of premenarchal girls have hyperandrogenism due to PCOS but late-onset CAH cannot be ruled out, and this leaves the clinician in a quandary regarding the diagnosis and management. Case report: A 131⁄2-year-old girl presented with excessive facial hair, hoarseness of voice, and darkening of elbow pits since past 2 months, which was increasing in severity. The patient had not yet attained menarche but had pubarche 1 year earlier. Examination revealed presence of acanthosis, underdeveloped breasts, and clitoromegaly >3 cm. Levels of 17-hydroxyprogesterone were normal but higher levels were reported poststimulation. Fasting insulin levels were also high. Appropriate treatment was started, which led to improvement in patient’s symptoms. Conclusion: There is significant overlapping between PCOS and NCCAH, which warrants accurate diagnosis based on hormonal analysis to institute early and appropriate therapy. Clinical significance: Early therapy can prevent infertility and androgenic complications later in life.
期刊介绍:
Journal of South Asian Federation of Obstetrics and Gynaecology is the aim of this journal to provide platform for members to have access to scientific and peer-reviewed clinically oriented guidelines for practice and professional updating of subject of obstetrics and gynecology. The scope of South Asian Federation of Obstetrics and Gynaecology (SAFOG) journal is to cover the broad subject of obstetrics and gynecology and give out articles, information, and practice guidelines. The journal has fixed format of review articles, presentations as original studies by members and readers, operative skill reviews, case reports, and midwifery peer-reviewed practice guidelines. In addition, call upon experts and clinical authorities among member countries of SAFOG region to give out editorials on policy formulating topics such as maternal mortality, abortions, contraceptives, reproductive health preservation of women, etc. As well as to tabulate reproductive health country specific data to create awareness regarding the enormity of maternal and neonatal problems. To give out reader specific information for forthcoming professional events in the region. It remains a platform for better communication and exchange of reproductive indices among member countries. Also to amalgamate with world bodies, recommendations for practice guidelines for members. Brief of the journal: The SAFOG journal is the official organ and publication of South Asia Federation of Obstetrics and Gynecology. This is a scientific and peer-reviewed platform of exchange of professional activities, clinical practice guidelines, operative skill updates, and nursing midwifery practices among member countries.