DIAGNOSIS OF HYPERANDROGENISM: DIFFICULTY AND THE CONSEQUENCES
https://doi.org/10.21886/2219-8075-2017-1-44-50
Abstract
Objective: to evaluate the prescription of drug treatment of hyperandrogenism according to the diagnostic algorithm by endocrinologists in clinical practice.
Materials and methods: retrospective analysis of 15 case reports of women with established diagnosis of hyperandrogenism. The following parameters were analyzed: clinical manifestations of hyperandrogenism, laboratory studies, prescribed drugs and complications of the treatment.
Results: despite of absence of any clinical indications laboratory examination was performed, the diagnosis of hyperandrogenism was established in all cases and glucocorticoid treatment was prescribed to all patients. Because of long-term drug intake signs of drug overdose were assessed: iatrogenic hypercortisolism was observed in 4 women. The abolition of glucocorticoid treatment was performed in all patients because of absence of any indications. Nevertheless, chronic adrenal insufficiency developed in 2 women, which required lifelong replacement glucocorticoid treatment.
Conclusions: noncompliance of the diagnostic algorithm of hyperandrogenism has led to iatrogenic hypercortisolism.
About the Authors
N. I. Volkova
Rostov State Medical University
Russian Federation
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
Russian Federation
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
I. U. Davidenko
Rostov State Medical University
Russian Federation
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
Russian Federation
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
S. A. Kanaeva
Rostov State Medical University
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
K. D. Shemyakina
Rostov State Medical University
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
29 Nakhichevanskiy st., Rostov-on-Don, 344022 Russia
References
1.
2. Hirshfeld-Cytron J, Barnes RB, Ehrmann DA, Caruso A,Mortensen MM, Rosenfield RL. Characterization of functionally typical and atypical types of polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94(5):1587–94. doi: 10.1210/jc.2008-2248
3. Volkova NI, Dimitriadi TA. Diagnosis of hyperandrogenism in clinical practice (retrospective analysis). Pharmateka endocrinologii. 2009;17:48-51. (In Russ).
4. Costello MF, Chapman M, Conway U. A systematic review and meta-analysis of randomized controlled trials on metformin coadministration during gonadotrophin ovulation induction or IVF in women with polycystic ovary syndrome. Hum Reprod. 2006;21(6):1387–1399. doi: 10.1093/humrep/dei501
5. Volkova NI. Hyperandrogenism as an interdisciplinary problem: modern approaches to the diagnostics. Problemi jenskogo zdorovya. 2009;4(4):46-55. (In Russ).
6. Bouchard Ph. Hyperandrogenism: Hopital Saint Antoine and University Pierre et Marie Curie. Hirsutism. European NeuroEndocrine Assosiation Congress. 22-25 September, 2010.
7. Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL et al. Evaluation and Treatment of Hirsutism in Premenopausal Woman: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(4):1105-20. doi: 10.1210/jc.2007-2437
8. Carruthers M, Trinick TR, Wheeler MJ. The validity of androgen assays. Aging Male. 2007;10(3):165-72. doi: 10.1080/13685530701483738
9. Jameson JL, De Groot LJ. Endocrinology: Adult and Pediatric. Seventh Edition. Elsevier Inc.; 2016.
10. Speiser PW, Azziz R, Baskin LS, Ghizzoni L, Hensle TW, Merke DP et al. Congenital Adrenal Hyperplasia Due to Steroid 21-hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010;95(9):P.4133- 60. doi: 10.1210/jc.2009-2631, 2010.
11. National guidelines on endocrinology. Ed. by Dedov II. Moscow; 2008. (In Russ).
12. Volkova NI, Rymashevsky AN, Dimitriadi TA. Clinical application of method diagnostics hyperandrogenism syndrome on women of reproductive age. Mat` i Ditya v Kuzbasse. 2011;1:28- 30. (In Russ).
13. Endocrinology. Ed. by Nicholas A. Boon, Nicki R. Colledge, Brian R. Walker, John A.A. Hunter; translation from English under the editorship Melnichenko GA, Fadeev VA. Moscow: Read Elsevier; 2009. (In Russ).
14. Kenneth GS, Furst DE. Major side effects of systemic glucocorticoids. Uptodate; 2015. Available from: http://www.uptodate.com/contents/major-side-effects-of-systemic-glucocorticoids. Accessed on November 08, 2016
Review
For citations:
Volkova N.I., Davidenko I.U., Kanaeva S.A., Shemyakina K.D. DIAGNOSIS OF HYPERANDROGENISM: DIFFICULTY AND THE CONSEQUENCES. Medical Herald of the South of Russia. 2017;(1):44-50. (In Russ.) https://doi.org/10.21886/2219-8075-2017-1-44-50
Views:
6469
Email this article 