PakMediNet Discussion Forum : Medicine : Is it pregnancy related condition?
Is it pregnancy related condition?24 year old lady presents wid amenorrhea, recurrent UTI. She is overweight and have spider nevi. Hb 11.7 g/dl, TLC 4300, Platelet 120000, Ca 2.2 mmol/l, phosphate 1.1mmol/l, Albumin 32g/dl, Bilirubin 90 umol/l, ALT 500 iu/l, Alkaline phosphatase 500iu/l. Please give 1 diagnosis and 4 Differentials. Thank u
Posted by: omesam Posts: 13 :: 05-03-2008 :: | Reply to this Message
Re: Is it pregnancy related condition?
I would think of:
Autoimmune Hepatitis with Primary or secondary hypogonadism leading to amenorrhea. Platelets are low, associated ITP can be a possibility. PBC is unlikely at this age group.
Posted by: yasir Posts: 90 :: 06-03-2008 :: | Reply to this Message
Re: Re: Is it pregnancy related condition?
quote:
Primary or secondary hypogonadism leading to amenorrhea.
Posted by: imtiazk Posts: 56 :: 06-03-2008 :: | Reply to this Message
Re: Is it pregnancy related condition?Amenorrhea means the patient has hypogonadism which can be primary or secondary or tertiary. Primary hypogonadism is likely in this patient because of associated autoimmune hepatitis. One autoimmune condition can be linked to other autoimmune conditions as well. The patient needs workup for amenorrhea using : FSH, LH, Estradiol, Prolactin and TSH / FT4. The results of these tests would tell us more about the cause of the amenorrhea (secondary).
Posted by: yasir Posts: 90 :: 07-03-2008 :: | Reply to this Message
Re: Re: Is it pregnancy related condition?
I have asked omesan if any other clinical featre of hypogonaism are present or not.
Posted by: imtiazk Posts: 56 :: 07-03-2008 :: | Reply to this Message
Re: Re: Re: Is it pregnancy related condition?No features of hypogonadism. it is secondary amenorrhea
Posted by: omesam Posts: 13 :: 08-03-2008 :: | Reply to this Message
Re: Is it pregnancy related condition?
Seems like none of you guys know what "hypogonadism" means. Hypogonadism means "Inadequate functioning of the testes or ovaries as manifested by deficiencies in gametogenesis or the secretion of gonadal hormones".
Amenorrhea is a symptom of hypogonadism. Primary hypogonadism is the problem in the ovaries resulting in the lack of mensturation (amenorrhea). Since the patient has features of autoimmune disease, premature ovarian failure can be a possibility. This can be checked using Lab tests of "FSH, LH, Prolactin and Estradiol". High FSH and LH with low Estradiol would be seen in the primary ovarian failure resulting in amenorrhea.
Dr. Yasir
Endocrinologist
[Edited by docosama on 09-03-2008 at 06:57 AM GMT]
Posted by: yasir Posts: 90 :: 09-03-2008 :: | Reply to this Message
Re: Is it pregnancy related condition?whats the reason of recurrent UTI.
Posted by: sade Posts: 9 :: 17-03-2008 :: | Reply to this Message
Re: Re: Re: Is it pregnancy related condition?
quote:
Seems like none of you guys know what "hypogonadism" means. Hypogonadism means "Inadequate functioning of the testes or ovaries as manifested by deficiencies in gametogenesis or the secretion of gonadal hormones".
Amenorrhea is a symptom of hypogonadism.
Posted by: imtiazk Posts: 56 :: 24-03-2008 :: | Reply to this Message
Re: Re: Re: Re: Is it pregnancy related condition?
Well .. if you read my earlier postings, amenorrhea is ONE of the symptom of hypogonadism. There are other symptoms / signs (in adults) also which include loss of libido and atrophy of breasts.
I wanted to know what could be the cause of recurrent UTI in this patient. Is it related to the current condition or a separate entity?
Posted by: yasir Posts: 90 :: 24-03-2008 :: | Reply to this Message