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Background: This study was aimed at determining the frequency of thyroid autoimmunity and subclinical hypothyroidism in patients with hyperprolactinemia due to prolactinoma compared to well-matched healthy controls. Methods: This was a cross-sectional study wherein 78 treatment naïve prolactinoma patients and ninety-two healthy control subjects were recruited. Serum prolactin (PRL), thyroid-stimulating hormone (TSH), total thyroxine (T4), circulating anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti-Tg) antibody levels were measured in all study subjects. Progression of the antibody-positive population to subclinical hypothyroidism was determined. Results: The median PRL level among patients was 166 ng/ml (IQR 85-467) compared to 11.4 ng/ml (IQR 8.5-15.9) in controls (P < 0.001). There was no significant difference in levels of T4 (P = 0.83) and TSH (P = 0.82) between the cases and controls. Overall, 25% of patients had the presence of anti-thyroid antibodies as compared to 20% of controls (P = 0.56). SCH was more common in antibody-positive hyperprolactinemia subjects compared with antibody-positive controls. Conclusion: We did not find an increased prevalence of thyroid autoimmunity among untreated prolactinoma patients compared to healthy controls. At the same time, subclinical hypothyroidism was more common in thyroid antibody-positive patients with hyperprolactinemia than positive controls.
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To report the clinical, hormonal, and genetic features of a female with multiple endocrine neoplasia type 1 (MEN1) with multiple uterine leiomyomas. The study was conducted at a tertiary care endocrinology unit. A 27-year-old female was diagnosed with prolactinoma, primary hyperparathyroidism (PHPT), and multiple uterine leiomyomas. In view of prolactinoma and PHPT, a clinical diagnosis of MEN1 syndrome was made. She also had multiple uterine leiomyomas for which myomectomy was done. Genetic analysis revealed a novel mutation c.1763C>T, p.S588L of MEN1 gene. The association of uterine leiomyomas with MEN1 is exceptionally rare. This is the first report of multiple uterine leiomyomas in a patient with MEN1 from our country and the first report of this mutation in the MEN1 gene in the world. We conclude that in the presence of multiple uterine leiomyomas and endocrine tumor, clinical examination and laboratory evaluation may uncover the diagnosis of MEN1 syndrome in these patients.
RESUMO
OBJECTIVE: To estimate the prevalence of polycystic ovary syndrome (PCOS) among women of reproductive age across educational institutions in the Kashmir valley. METHODS: A cross-sectional study was conducted from May 2013 to May 2015. Eligible girls and women aged 15-40 years were included using a multistage random selection process from five out of 12 districts in turn housing 14 educational institutions. They were screened through a brief questionnaire in a staged manner. After obtaining consent, women underwent detailed clinical, biochemical, hormonal, and sonographic evaluation to satisfy Rotterdam 2003 criteria. The participants were also evaluated using NIH and AE-PCOS criteria. RESULTS: Out of a total of 3300 eligible women, 964 women were evaluated using a structured questionnaire. Among these, 446 (46.4%) were identified as "probable PCOS" cases. Out of 171 probable PCOS women who completed all biochemical, hormonal, and sonographic assessment, 35.3% qualified for a diagnosis of PCOS using Rotterdam criteria. The prevalence of PCOS was 28.9% by NIH criteria and 34.3% by AE-PCOS criteria. CONCLUSION: The prevalence of PCOS is high among Kashmiri women and is probably the highest in a published series globally. A countrywide systematic prevalence study is warranted to reconfirm the findings.