ECE2023 Eposter Presentations Reproductive and Developmental Endocrinology (48 abstracts)
Primo-secondary amenorrhea: When autoimmune polyendocrine syndrome divert the course of a Rathke’s cleft cyst
Nabila Zeryouh 1 , Yousra Laalaoua 1 , Hamdane Chaymae 1 , Salma Derbel 1 , Siham Rouf 1 & Hanane Latrech 2
1Faculty of Medicine and Pharmacy, University of Mohammed 1st, Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Oujda, Morocco; 2Faculty of Medicine and Pharmacy, University of Mohammed 1st, Department of Endocrinology-Diabetology and Nutrition, Mohammed VI University Hospital Center, Morocco
Introduction: Secondary or primo-secondary amenorrhea suggests central damage of the hypothalamic-pituitary axis or peripheral damage of the reproductive system. It must be carefully investigated with an essential hormonal workup to determine the etiology and initiate the appropriate treatment.
Observation: We report the case of a 21-year-old patient, admitted for exploration of a primo-secondary amenorrhea associated with a pituitary tumor syndrome made of retro-orbital headaches, without vomiting nor visual acuity decrease, with sometimes hot flashes. Clinically, the patient had a good development of secondary sexual characteristics. She was in clinical euthyroidism without dysmorphic syndrome. Biologically: 17 B Estradiol was less than 12 pg/ml with elevated gonadotropins, collapsed AMH and normal karyotype. Anti-TPO antibodies were positive with normal TSHus. Radiologically: Hypothalamic-pituitary MRI revealed of a Rathke’s cleft cyst of 6 mm and uterus was hypoplasic on Pelvic ultrasounds. Finally, Eye examination and Goldman’s visual field were normal.
Discussion-Conclusion: This observation reflects the complexity of the etiological diagnosis of primo-secondary amenorrhea while two disorders at different levels of the hypothalamic-pituitary-ovarian axis are associated: Rathke’s cleft cyst and primary autoimmune ovarian insufficiency as part of a type 2 autoimmune polyendocrine syndrome. Thus, although the diagnosis may be obvious, further investigation should be required to support the diagnosis and to avoid misinterpretation of a true underlying etiology.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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