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Abstract
RÉSUMÉ
Le syndrome des ovaires polymicrokystiques (SOPMK) est la cause la plus fréquente de troubles de l'ovulation et d'hyperandrogénie. Bien qu'étant très fréquent, il doit rester un diagnostic d'élimination, ce qui impose d'écarter toutes les autres causes de troubles du cycle et/ou d'hyperandrogénie Les auteurs décrivent un cas de SOPMK associé à une hypothyroïdie périphérique. Il s'agissait d'une patiente âgée de 29 ans ; sans antécédents médico-chirurgicaux et gynéco-obstétricaux, venue en consultation externe d'endocrinologie pour une aménorrhée évoluant depuis un an. L’association d’arguments biologiques (dosages hormonaux) et radiologiques (échographie thyroïdienne et pelvienne) a permis de retenir le diagnostic de SOPMK associé à une hypothyroïdie. L'aménorrhée est un motif fréquent de consultation dont la complexité du diagnostic étiologique constitue la hantise du spécialiste. La nécessite d'une investigation plus approfondie s'impose telle que le dosage de la testostéronémie, de la prolactinémie, de la TSHus
ABSTRACT
Polymicrocystic ovary syndrome (PCOS) is the most common cause of ovulation disorders and hyperandrogenism. Although very frequent, it must be a diagnosis of elimination, which means ruling out all other causes of cycle disorders and/or hyperandrogenism The authors describe a case of PCOS associated with peripheral hypothyroidism. The patient was 29 years old, with no previous medical, surgical or gynecological-obstetrical history, and came to the endocrinology outpatient clinic with amenorrhea that had been progressing for one year. A combination of biological (hormone assays) and radiological (thyroid and pelvic ultrasound) findings led to the diagnosis of PCOS associated with hypothyroidism. Amenorrhea is a frequent reason for consultation, and the complexity of the etiological diagnosis is the specialist's main concern. The need for a more in-depth investigation, such as testosteronemia, prolactinemia, TSHus, etc., is emphasized.
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References
- Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007 ; 370 (9588) : 685 – 97.
- Vendola KA, Zhou J, Adesanya OO et al. Andro-gens stimulate early stages of follicular growth inthe primate ovary. J Clin Invest 1998 ;101 :2622-9.
- Rotterdam ESHRE/ASRM-Sponsored PCOS consen-sus workshop group. Revised 2003 consensus on dia-gnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004 ; 19 (1) : 41 – 7.
- Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935 ; 29 : 181 – 91.
- Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome : the complete task force report. Fertil Steril 2009 ; 91 (2) : 456 – 88.
- Strauss III JF, Dunaif A. Molecular mysteries of poly-cystic ovary syndrome. Mol Endocrinol 1999 ; 13 (6) : 800 – 5.
- Nelson V L, Qin K N, Rosenfield R L, Wood J R, Penning T M, Legro R S, et al. The biochemical basis for increased testosterone production in theca cells propagated from patients with polycys-tic ovary syndrome. J Clin Endocrinol Metab 2001 ; 86(12) : 5925 – 33.
- Thessaloniki ESHRE / ASRM - Sponsored PCOS Consensus Workshop Group. Consensus on inferti-lity treatment related to polycystic ovary syndrome. Hum Reprod 2008 ; 23(3) : 462 – 77.
- Kase N, Kowal J, Perloff W, Soffer L J. Invitro production of androgens by a virilizing adrenal adenoma and associated polycystic ovaries. Acta Endocrinol (Copenh) 1963 ; 44 : 15 –9.
- Hughesdon PE. Morphology and morphogenesis of the Stein-Leventhal ovary and of so-called « hyperthe-cosis» . Obstet Gynecol Surv 1982 ; 37 (2) : 59 – 77.
- Catteau- Jonard S, De wailly D. Physiopathologie des perturbations de la folliculogenèse dans le SOPK. Médecine de la reproduction, gynécologie, endocrinologie 2009 ; 11(3) :191-7.
- Das M, Djahanbakhch O, Hacihanefioglu B, Saridogan E, Ikram M, Ghali L, et al. Granulosa cell survival and proliferation are altered in polycystic ovary syndrome. J Clin Endocrinol Metab 2008 ; 93 (3) : 881 – 7. http://www.ncbi.nlm.nih.gov/pubmed ? term=%22Raveen-dran%20M%22%5BAuthor%5D.
- Webber L J, Stubbs SA, Star kJ, Margara R A, Trew GH, Lav ery SA, et al. Prolonged survival in culture of preantral follicles from polycystic ovaries. J Clin Endocrinol Metab 2007 ; 92 (5) : 195 – 8.
References
Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007 ; 370 (9588) : 685 – 97.
Vendola KA, Zhou J, Adesanya OO et al. Andro-gens stimulate early stages of follicular growth inthe primate ovary. J Clin Invest 1998 ;101 :2622-9.
Rotterdam ESHRE/ASRM-Sponsored PCOS consen-sus workshop group. Revised 2003 consensus on dia-gnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004 ; 19 (1) : 41 – 7.
Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935 ; 29 : 181 – 91.
Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome : the complete task force report. Fertil Steril 2009 ; 91 (2) : 456 – 88.
Strauss III JF, Dunaif A. Molecular mysteries of poly-cystic ovary syndrome. Mol Endocrinol 1999 ; 13 (6) : 800 – 5.
Nelson V L, Qin K N, Rosenfield R L, Wood J R, Penning T M, Legro R S, et al. The biochemical basis for increased testosterone production in theca cells propagated from patients with polycys-tic ovary syndrome. J Clin Endocrinol Metab 2001 ; 86(12) : 5925 – 33.
Thessaloniki ESHRE / ASRM - Sponsored PCOS Consensus Workshop Group. Consensus on inferti-lity treatment related to polycystic ovary syndrome. Hum Reprod 2008 ; 23(3) : 462 – 77.
Kase N, Kowal J, Perloff W, Soffer L J. Invitro production of androgens by a virilizing adrenal adenoma and associated polycystic ovaries. Acta Endocrinol (Copenh) 1963 ; 44 : 15 –9.
Hughesdon PE. Morphology and morphogenesis of the Stein-Leventhal ovary and of so-called « hyperthe-cosis» . Obstet Gynecol Surv 1982 ; 37 (2) : 59 – 77.
Catteau- Jonard S, De wailly D. Physiopathologie des perturbations de la folliculogenèse dans le SOPK. Médecine de la reproduction, gynécologie, endocrinologie 2009 ; 11(3) :191-7.
Das M, Djahanbakhch O, Hacihanefioglu B, Saridogan E, Ikram M, Ghali L, et al. Granulosa cell survival and proliferation are altered in polycystic ovary syndrome. J Clin Endocrinol Metab 2008 ; 93 (3) : 881 – 7. http://www.ncbi.nlm.nih.gov/pubmed ? term=%22Raveen-dran%20M%22%5BAuthor%5D.
Webber L J, Stubbs SA, Star kJ, Margara R A, Trew GH, Lav ery SA, et al. Prolonged survival in culture of preantral follicles from polycystic ovaries. J Clin Endocrinol Metab 2007 ; 92 (5) : 195 – 8.