Cases reported "Hypothalamic Diseases"

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1/3. MURCS association and hypothalamic anovulation.

    A new case of MURCS association (mullerian duct aplasia, renal aplasia and cervicothoracic somite dysplasia) in an 18 year old patient is reported. In addition to other minor phenotypical features, hypothalamic chronic anovulation was documented. Basal concentrations of PRL, TSH, GH, F and E were within reference values for adult women. Challenges with TRH and ACTH evoked normal responses in terms of TSH and F respectively. Basal levels of LH and FSH and a LHRH stimulation test demonstrated dissociation of both gonadotrophins. Persistent progesterone values within follicular phase levels led us to the diagnosis of hypothalamic chronic anovulation which was confirmed by the induction of ovulation by clomiphene citrate. This finding shows the importance of a detailed endocrinological evaluation in patients with the MURCS association in order to prevent secondary disorders due to endocrinological impairment.
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ranking = 1
keywords = ovulation
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2/3. LHRH treatment of hypothalamic amenorrhoea.

    Chronic intermittent intravenous administration of 13 micrograms LHRH every 88 minutes for 28 days, was successful in inducing ovulation in two patients with 3a type secondary hypothalamic amenorrhoea. A catheter phlebitis was the only side effect of the treatment and it could be easily prevented by more flexible, thin venous catheters. The minimum laboratory need for monitoring the treatment, and the absence of hyperstimulation of the ovaries suggested the superiority of this substance to hMG for ovulation induction in clomiphene negative patients.
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ranking = 0.28571428571429
keywords = ovulation
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3/3. Hypothalamic hypopituitarism in a patient with a basal encephalocoele--treatment with luteinizing hormone-releasing hormone.

    A 20-year-old patient presented with primary amenorrhoea and growth hormone deficiency caused by a basal encephalocoele. She was found to have developed diabetes insipidus in the 8 years following diagnosis. Gonadotrophin release in response to bolus injection of luteinizing hormone-releasing hormone (LHRH) was normal, as was thyrotrophin and adrenocorticotrophin (ACTH) secretion. Pulsatile administration of LHRH by the subcutaneous route resulted in normal ovulation and subsequent menstruation. The investigation and management of patients with basal encephalocoeles are discussed in the light of these findings.
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ranking = 0.14285714285714
keywords = ovulation
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