Document Detail

Ovarian hyperstimulation syndrome in newborns--a case presentation and literature review.
MedLine Citation:
PMID:  19039238     Owner:  NLM     Status:  MEDLINE    
Preterm ovarian hyperstimulation syndrome (POHS) is a rare condition in which immaturity of the gonadal axis is accepted as the cause. Based on our case and 8 cases from the literature, we made an attempt to specify the mechanisms underlying the syndrome and its pathognomonic signs. All POHS newborns were born between 24 and 31 weeks postconception age (WPCA) and developed vulvar, hypogastric and upper leg swelling, and ovarian follicular cyst/cysts (10-40 mm in diameter) with mildly or considerably elevated E(2) concentrations (80-5,300 pmol/l) between 35 and 39 WPCA. The GnRH test, performed in 5 cases, confirmed gonadal axis activation. In our case the observed normalization of elevated gonadotropin values by 43 WPCA, accompanied by a simultaneously increasing E(2) value (approximately 800 pmol/l), could correspond with the maturation of the gonadal steroid-dependent negative-feedback mechanism. The continuously increasing E(2) levels after this period (maximum 1,300 pmol/l) suggest its autonomous secretion. In all the cases, including 3 neonates treated with medroxyprogesterone and surgery, the swelling resolved by 6 months. Conclusions: A pathognomonic sign of POHS is swelling which develops around 37 +/- 3 WPCA, and the syndrome is only infrequently diagnosed when the swelling is profound. The direct etiologic factor here is not E(2). POHS does not require therapy as long as there is no danger of cyst torsion.
Jerzy Starzyk; Małgorzata Wójcik; Joanna Wojtyś; Przemysław Tomasik; Zofia Mitkowska; Jacek J Pietrzyk
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-11-27
Journal Detail:
Title:  Hormone research     Volume:  71     ISSN:  1423-0046     ISO Abbreviation:  Horm. Res.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-20     Completed Date:  2009-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366126     Medline TA:  Horm Res     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  60-4     Citation Subset:  IM    
Copyright Information:
Copyright 2008 S. Karger AG, Basel.
Department of Pediatric and Adolescent Endocrinology, Jagiellonian University, Collegium Medicum, Kraków, Poland.
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MeSH Terms
Estradiol / blood
Follicle Stimulating Hormone / blood
Infant, Newborn
Luteinizing Hormone / blood
Ovarian Hyperstimulation Syndrome / blood,  etiology*
Reg. No./Substance:
50-28-2/Estradiol; 9002-67-9/Luteinizing Hormone; 9002-68-0/Follicle Stimulating Hormone

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