Funda Gungor Ugurlucan, Omer Demir, Cenk Yasa, Suleyman Akhan

Slides:

Advertisements

Similar presentations

ASSESSMENT OF A CASE OF AMENORRHEA

Advertisements

MEN: feedback loop.

 Produced by endocrine glands  Male endocrine glands = Testes  Female endocrine glands = Ovaries.

TEMPLATE DESIGN © An Unusual Case of Uterine Fibroid I Adibah, K Norhayati, KC Liew Department of Obstetrics and Gynaecology,

MRI findings in Kallmann syndrome H. ZAGHOUANI BEN ALAYA, Z. ACHOUR, M.BHOURI, M. LIMEME, S. MAJDOUB, H. AMARA, D. BAKIR, CH. KRAIEM HN27.

Amenorrhea Dr.F Mehrabian MD

EVALUATION AND MANAGEMENT OF AMENORRHEA Assistant Professor at JUH

CASE PRESENTATION (4)(6)(7)

Lecture outline I. Puberty & Development of Secondary Sexual Characteristics A. Establishing the ovarian cycle B. Breast development C. Pubic and Axillary.

Reproductive System. Disorders Infertility ► Infertility in males : - pretesticular or secondary hypogonadism due to hypothalamic or pituitary lesions.

The Gynaecology Clinic Michaelmas term year 2. This session will: Cover definitions of amenorrhoea and oligomenorrhoea Explain the genetic, anatomical.

Ambiguous genitalia Sukanya MD..

ENDOCRINE PROJECT By: Katie Glaeser Melanie Olmedo 8 th January 13, 2014.

AMENOREA PUTRI SRI LASMINI.

Emily Bartlett Katrina Bush

Testis By: Kyle Nagel, Amada Stewart, Matthew Whyte.

The Reproductive System

AMENORRHEA Obstetrics & Gynecology Hospital of Fudan University

Ku č era, E..  Normal menstrual cycle  21 – 36 days interval between bleeding  duration of bleeding is 2 – 8 days  average is 5 days  blood loss.

PUBERTY It is a physiological phase lasting 2 to 5 years, during which the genital organs mature.

AMENORRHEA Paul Beck, MD, FACOG, FACS. Incidence of Primary Amenorrhea Less than.1% Puberty Breast: / yrs. Pubic Hair:11.0 +/ yrs. Menarche12.9.

Biology Seminar Testosterone.

Precocious puberty:.

POLYCYSTIC OVARY SYNDROME A COMMON FEMALE ENDOCRINE DISEASE SBI4U-01 Mr. Gajewski Bashour Yazji Jason Antrobus Narayan Wagle.

Precocious puberty Dr. Mahtab Ordooei. Precocious puberty Defined as the onset of secondary sexual characteristics before 8 yr age in girls and 9 yr in.

Amenorrhea (and Dysfunctional Uterine Bleeding)

Amenorrhea DI WEN M.D., Ph.D., DI WEN M.D., Ph.D., Professor & Chairman Professor & Chairman Department Of Obstetrics & Gynecology Department Of Obstetrics.

Reproductive and endocrine disease Shujun Gao. Individual Each in normal position Each keeps normal activity Each has normal reaction.

Amenorrhea Dr Nadia algantary Associated proffessor Faculty of medicine.

MD.Trần Thị Bích Huyền Children hospital 1 Endocrine department

Amenorrhea Dr Jack Biko.

CASE SERIES IN CONGENITAL UTERO-VAGINAL ANOMALIES

Amenorrhea & Anovulation Andrea Chymiy, MD Swedish Family Medicine.

Amenorrhea - classification Anatomic Defects Ovarian Failure Chronic anovulation with estrogen present Chronic anovulation with estrogen absent.

APPROACH TO PATIENTS WITH AMENORRHEA Enrico Gil C. Oblepias, MD, FPOGS Associate Professor University of the Philippines Philippine General Hospital.

Investigating infertile couple

A boy with tall stature and delayed puberty

Emad R. Sagr, MBBS, FRCSC, FACOG Consultant Obstetrics & Gynecology and Gynecology Oncology Security Forces Hospital.

Precocious puberty A case

Wendy Vitek, MD University of Rochester LaTasha B Craig, MD University of Oklahoma Health Sciences Center.

Investigations of infertility

Primary Amenorrhea.

Girl, 13-4/12 years old, with constitutional delay in growth and puberty. History revealed a normal growth rate but short stature at all ages. Physical.

Osteopenia in Sheehan’s Syndrome

Current Management of Amenorrhea

Ghufran S. Babar,MD MSc, Associate Professor of Endocrinology,

Intravascular leiomyomatosis (A rare case report)

Precocious or early puberty in patients with

Primary AmenorrhoeaPrepared by Professor Dr.Lilyan Sersam

Reproduction-Related Disorders

Myomectomy over forties

Precocious Puberty due to an hCG-secreting tumor in Klinefelter syndrome Sasigarn A. Bowden¹, Carlos R Suarez² and John A. Germak¹ ¹Department of Pediatrics,

HYPOGONADOTROPIC HYPOGONADISM IN A PATIENT WITH VANISHING TESTIS SYNDROME – CASE REPORT Zsuzsanna Szántó1, Annamária Nagy2, Monica Beldean2, Igor Calancea3,

Reproduction-Related Disorders

Copyright © 2015 by the American Osteopathic Association.

Chronic Bilateral Slipped Capital Femoral Epiphysis as an Unusual Presentation of Congenital Panhypopituitarism due to Pituitary Hypoplasia in a 17 year-old.

PUBERTY AHMED ABDULWAHAB.

Amenorrhea Dr Ferdous Mehrabian Professor of Isfahan university

Herlyn Werner Wunderlich Syndrome Diagnosed Through Pelvic Abscess

DELAYED PUBERTY & HYPOGONADISM

PUBERTY IT IS THE TIME IN LIFE WHEN A BOY OR GIRL

Adult-Onset Hypogonadism

Diagnosis of Acromegaly

Anatomy and Physiology Overview

Adult-Onset Hypogonadism

Regulation of the Reproductive System

Amenorrhea Dr. Maysa’ Khadra

Radioloksabha spotters series- VII

Presentation transcript:

Funda Gungor Ugurlucan, Omer Demir, Cenk Yasa, Suleyman Akhan Concomitant Mullerian Agenesis and Hypogonadotropic Hypogonadism in a Girl Presenting with Primary Amenorrhea Funda Gungor Ugurlucan, Omer Demir, Cenk Yasa, Suleyman Akhan Istanbul University Istanbul Faculty of Medicine Department of Obstetrics and Gynecology

Introduction and Objective Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare disorder characterized by aplasia or hypoplasia of the uterus and vagina due to arrest in the development of the Müllerian ducts. Women with this syndrome have the normal 46 XX karyotype, normal female secondary sexual characteristics, and present with primary amenorrhea.

Introduction and Objective Hypogonadotropic hypogonadism (central hypogonadism) is associated with a decrease in gonadotropin releasing hormone (GnRH) or a hypophysis unresponsive to GnRH stimulation and leads to anovulation. Idiopathic hypogonadotropic hypogonadism is presumptive, however, and can only be confirmed by normal radiologic studies of the hypothalamic-pituitary region. Testing of other anterior pituitary endocrine function should also be undertaken to assure that the defect in gonadotropin secretion is isolated.

Here we present a rare case of concomitant Mayer Rokitansky Küstner Hauser syndrome and hypogonadotropic hypogonadism.

Case A 17 year-old girl applied to our clinic with the complaint of primary amenorrhea. Her medical history was unremarkable. Physical examination revealed Tanner Stage 2 breast development and a short vagina of 3 cm in length on the vaginal examination. Uterus could not be visualized by transabdominal and transrectal ultrasonography and the ovaries were not clearly distinguishable, either.

Case Laboratory results revealed FSH: 3.62 mIU/ml LH: 2.79 mIU/ml, E2: 5 pg/ml. Magnetic resonance imaging of the pelvis showed a narrow fibrotic vagina. Uterus could not be visualized and Müllerian agenesis was confirmed. The right ovary was measured as 2.1x7.5 mm and the left ovary was measured as 2.7x7.7 mm.

Case The patient was diagnosed as Müllerian agenesis coexisting with hypogonadotropic hypogonadism. Cranial Magnetic Resonance Imaging was obtained and was normal. Bone mineral density was measured by DEXA method and vertebra T score was -3.6 and Z score was -3.4. Estrogen and calcium+ vitamin D treatment was ordered and the patient was referred to physical therapy and rehabilitation specialists for osteoporosis management.

Cranial MRI

Cranial MRI

Cranial MRI

Conclusion Rarely, multiple causes of primary amenorrhea may coexist in the same patient. It is prudent to follow algorithms in the diagnosis of these complicated cases as well as using advanced imaging techniques when needed.