Levothyroxine Replacement In Management Of Ovarian Hyperstimulation Syndrome Associated With Hypothyroidism In Two Members Of A Family | 13276
Clinical Pharmacology & Biopharmaceutics
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Ovarian hyperstimulation syndrome (OHSS) is usually iatrogenic and potentially life-threatening complication
of ovulation induction. It can occur rarely following hypothyroidism. We report this syndrome in two members of a family with
hypothyoidism and describe the effects of levothyroxine replacement in the management of it.
A 15 years Old girl presented with abdominal pain and distention for a few months. On examination, she had classic
features of hypothyroidism. Abdominal ultrasound revealed enlarged ovaries with multilobulated ovarian cysts (Right ovary:
150?75mm, volume: 454cc; Left ovary: 130?70 mm, volume: 340cc).The second patient, a 14.5 years old girl (the cousin of the
patient1) presented to the emergency unit with acute abdominal pain, nausea and vomiting after a minor trauma. she had also
classic features of hypothyroidism. Abdominal ultrasound revealed enlarged ovaries with multilobulated ovarian cysts(Right
ovary: 110? 65 mm, volume: 279cc; Left ovary: 118? 58 mm, volume: 285cc). Both patients,started on levothyroxine 100 μg per
day regarding their thyroid function test.hypothyroid features resolved and thyroid function test became normal after 2 months.
Follow-up ultrasound of the first patient, showed significantly smaller ovaries after 6week and became normal with complete
resolution of cysts after 4 months. The second patient who was less compliant with her treatment also showed improvement, but
in longer duration.
In OHSS associated with hypothyroidism, patients could benefit from levothyroxine replacemnet not only for
treatment of hypothyroidism but also for achieving normalization of ovary size with regression of cysts within a few months.
Fatemeh.Ghazanfari Amlashi obtained her medical diploma at Guilan University of Medical Sciences in 2009; she delivered a unique thesis about the
role of biomarkers in diffuse axonal injury and published it in a reputed journal. After graduation, she worked for 2 years in a rural clinic to improve her
practical talents. Then, she has started collaboration with Guilan Endocrinology and Metabolic Research Center and presented one of their works in
ICE/ECE 2012 as a poster. She has published one article in an omicsgroup-related journal. As a young general practitioner, she would like to pursue
her studies as both medical researcher and specialist, particularly in the field of internal medicine.
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