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Infiltrative neurosarcoidosis presenting as secondary amenorrhea case report and review of the literature.
MedLine Citation:
PMID:  23942474     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In this report, we describe abrupt onset of secondary amenorrhea in a woman with history of chronic systemic sarcoidosis. Endocrinologic evaluation of her hypothalamic-pituitary axis revealed abnormally low levels of follicle-stimulating hormone, luteinizing hormone, and insulinlike growth factor 1 and elevated prolactin. Urine osmolality was low, and serum osmolality was high. Magnetic resonance imaging revealed diffuse extensive leptomeningeal enhancement, with involvement of the hypothalamus, pituitary stalk, and the optic chiasm. Clinical diagnosis was consistent with neurosarcoidosis with hypothalamic-pituitary infiltration resulting in clinical hypogonadotropic hypogonadism, hyper-prolactinemia, and diabetes insipidus. In our report, we provide an overview of basic reproductive neuroendocrinology and discuss salient concepts of the pathogenesis, clinical manifestations, evaluation, and management of hypogonadotropic hypogonadism. The current literature on neurosarcoidosis with involvement of the hypothalamic-pituitary axis is summarized. The possibility of infiltrative process should be considered in patients with new diagnosis of hypogonadotropic hypogonadal amenorrhea.
Authors:
Lusine Aghajanova; Robert B Jaffe; Christopher N Herndon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrical & gynecological survey     Volume:  68     ISSN:  1533-9866     ISO Abbreviation:  Obstet Gynecol Surv     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-08-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401007     Medline TA:  Obstet Gynecol Surv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  482-8     Citation Subset:  IM    
Affiliation:
Resident, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA.
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