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  • Iran, Islamic Republic of x
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Roghieh Molaei Langroudi Diagnostic Radiology Department, Poursina Hospital, Guilan University of Medical Sciences, Guilan, Iran

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Fatemeh Ghazanfari Amlashi Guilan Endocrinology and Metabolism Research Center, Razi Hospital, Rasht, Guilan, Iran and

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Mohammad Hassan Hedayati Emami Department of Endocrinology, Guilan Endocrinology and Metabolism Research Center, Razi Hospital, Rasht, Guilan, Iran

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Summary

Background: Spontaneous ovarian hyperstimulation syndrome (sOHSS) can occur following hypothyroidism. Ultrasonography facilitates diagnosis and monitoring of this syndrome. We describe ovarian sonographic changes in a hypothyroid patient with sOHSS after treatment with levothyroxine (l-T4).

Case presentation: A 15-year-old girl presented with abdominal pain and distension for a few months. On examination, she had classical features of hypothyroidism. Abdominal and pelvic ultrasound revealed enlarged ovaries with multiple thin-walled cysts and mild ascitic fluid. On follow-up, abdominal ultrasound showed significant reduction of ovary size after 6 weeks of initiation of l-T4. Normal ovary size with complete regression of ovarian cysts was seen after 4 months.

Conclusion: Serial ultrasound in sOHSS associated with hypothyroidism showed regression of ovarian cysts and ovarian volume after 4 months whereas in other studies, it is reported to happen in various durations, presumably according to its etiology.

Learning points

  • OHSS can rarely occur due to hypothyroidism.

  • This type of OHSS can be simply treated by l-T4 replacement, rather than conservative management or surgery in severe cases.

  • Ultrasound follow-up shows significant regression of ovarian size and cysts within 6 weeks of initiation of l-T4.

  • Ultrasound follow-up shows normal ovarian size with complete resolution of ovarian cysts 4 months after treatment.

Taxonomy:
Clinical Overview, Gland/Organ, Ovaries, Thyroid, Topic, Gynaecological endocrinology, Thyroid, Hormone, HCG, Condition/ Syndrome, Ovarian hyperstimulation syndrome, Patient Demographics, Age, Adolescent/young adult, Gender, Female, Ethnicity, Asian - other, Country of Treatment, Iran, Islamic Republic of, Diagnosis and Treatment, Signs and Symptoms, Abdominal distension, Abdominal pain, Investigation, Ultrasound scan, Medication, Levothyroxine, Related Disciplines, Gynaecology, Radiology/Rheumatology, Publication Details, Case Report Type, New disease or syndrome: presentations/diagnosis/management
DOI:
https://doi.org/10.1530/EDM-13-0006
Volume/Issue:
Volume 2013: Issue 1
Open access