ECE2017 Eposter Presentations: Reproductive Endocrinology Clinical case reports - Pituitary/Adrenal (5 abstracts)
Congenital adrenal hyperplasia: case series, describing results of initial dexamethasone therapy
Dragan Tesic 1 , Edita Stokic 1 , Milica Medic-Stojanoska 1 , Milena Mitrovic 1 , Dragana Tomic-Naglic 1 , Tijana Icin 1 , Ivana Bajkin 1 , Djordje Popovic 1 , Vuleta Dusan 2 & Jovan Vlaski 3
1Clinic of Endocrinology, Diabetes and Metabolic Diseases, Novi Sad, Serbia; 2Obstetrics and Ginecology Clinics, Novi Sad, Serbia; 3Institut for Child and Youth Health Care, Novi Sad, Serbia.
Introduction: Congentital adrenal hyperplasia (CAH) comes to adult endocrinologist wheather as transition from pediatritian (Case 3) or as still without diagnosis (Case 1, 2, 4). The aim of this work is to describe typical forms of CAH initially sucessfuly treated with dexamethasone therapy.
Case descriptions: Case 1: female, 1972y., presented in 1995y. (23y.) as severe hirsutism and infertility managed by team of gynecologists. She refused any additional investigations and was severily depressed. Ex iuvantibus 0.5mg dexamethason therapy was followed with pregnancy. Case 2: female, 1990.y, presented in 2008.y.(18y.). Non-classic CAH. Hirsutism, primary amenorrhoea. Dexamethasone therapy 0.5 mg at night. After 4 month estabished menstruation, after 18m. became pregnant with healthy male baby born. Case 3: female, 1994y, presented 2012.y. (18y.) Classic CAH, salt wasting form. At birth classical low sodium, high potassium. Established therapy with fludrocortison and hydrocortison, at night dexamethason 0.5 mg. Still primary amenorrhoea. On CT sevear vaginal stenosis. Case 4: male, 1980y, presented in 2014.y.(34y. old), when he was diagnosed for the first time! Classic CAH, simple virilising form and glucocorticoid-remediable aldosteronism, suprarenal hyperplasia on one gland and incidentaloma on the other. Unilateral testicular adrenal rest tumour (TART), azoospermia. Therapy hydrocortisone and dexamethasone at night. Soon he normalised aldosterone, ACTH, 17-OH progesterone but lowered testosterone. After 2y. CT of testes confirmed enlargement and the regression of TART.
Discussion: We have described two cases of CAH which solved the problem of fecundity (Cases 1 and 2). One treatment confirmed the need for additional surgical treatment of developmental abnormality on external genitalia(Case 3). Finally the problem of TART has been solved without any invasive intervention (Case 4), wheather diagnostic or therapeutic, which are not the rare case even in these years.
Volume 49
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Endocrine Abstracts
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