Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies

Background. Preterm ovarian hyperstimulation syndrome (POHS) is an uncommon disorder characterized by prematurity, hypogastric and upper leg swelling, high serum estradiol and gonadotropin levels, and ovarian cysts. Immaturity of the gonadal axis is accepted as the cause. But still, other eti...

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Main Authors: Elvan Bayramoğlu, Şenay Savaş Erdeve, Betül Emine Derinkuyu, İstemi Han Çelik, Semra Çetinkaya, Zehra Aycan
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2020-12-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/553
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author Elvan Bayramoğlu
Şenay Savaş Erdeve
Betül Emine Derinkuyu
İstemi Han Çelik
Semra Çetinkaya
Zehra Aycan
author_facet Elvan Bayramoğlu
Şenay Savaş Erdeve
Betül Emine Derinkuyu
İstemi Han Çelik
Semra Çetinkaya
Zehra Aycan
author_sort Elvan Bayramoğlu
collection DOAJ
description Background. Preterm ovarian hyperstimulation syndrome (POHS) is an uncommon disorder characterized by prematurity, hypogastric and upper leg swelling, high serum estradiol and gonadotropin levels, and ovarian cysts. Immaturity of the gonadal axis is accepted as the cause. But still, other etiological factors are suspected. Case. A preterm baby who was born at 24 gestational weeks was referred to our clinic for ambiguous genitalia on day 118 of life. Labia majora and clitoris was edematous. Clitoris length was 1.5 cm. On laboratory evaluation: 17OH-Progesterone: 1.84 ng/ml, dehydroepiandrosterone sulphate (DHEA-S): 139 μg/dl, total testosterone (T.T): 88 ng/dl, luteinizing hormone (LH): 22.5 mIU/l, Follicle stimulating hormone (FSH): 15.7 mIU/l, estradiol (E2): 447 pg/ml. Karyotype analysis was 46, XX. There was a 25x14x12 mm ovarian cyst detected on ultrasound. On follow-up, E2 levels and cyst size increased, and there was 4 mm pericardial effusion on echocardiography at the time. Conclusion. In this paper, we present a case with POHS and to discuss possible pathophysiological mechanisms and treatment. This is the first case of POHS developing pericardial effusion.
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spelling doaj-art-c9e73a8dd16e44c590401960f52482cf2025-08-20T03:01:10ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212020-12-0162610.24953/turkjped.2020.06.022Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babiesElvan Bayramoğlu0Şenay Savaş Erdeve1Betül Emine Derinkuyu2İstemi Han Çelik3Semra Çetinkaya4Zehra Aycan5Clinics of Pediatric Endocrinology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Clinics of Pediatric Endocrinology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Clinics of Radiology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Clinic of Neonatology, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.Clinics of Pediatric Endocrinology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.Clinics of Pediatric Endocrinology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey. Background. Preterm ovarian hyperstimulation syndrome (POHS) is an uncommon disorder characterized by prematurity, hypogastric and upper leg swelling, high serum estradiol and gonadotropin levels, and ovarian cysts. Immaturity of the gonadal axis is accepted as the cause. But still, other etiological factors are suspected. Case. A preterm baby who was born at 24 gestational weeks was referred to our clinic for ambiguous genitalia on day 118 of life. Labia majora and clitoris was edematous. Clitoris length was 1.5 cm. On laboratory evaluation: 17OH-Progesterone: 1.84 ng/ml, dehydroepiandrosterone sulphate (DHEA-S): 139 μg/dl, total testosterone (T.T): 88 ng/dl, luteinizing hormone (LH): 22.5 mIU/l, Follicle stimulating hormone (FSH): 15.7 mIU/l, estradiol (E2): 447 pg/ml. Karyotype analysis was 46, XX. There was a 25x14x12 mm ovarian cyst detected on ultrasound. On follow-up, E2 levels and cyst size increased, and there was 4 mm pericardial effusion on echocardiography at the time. Conclusion. In this paper, we present a case with POHS and to discuss possible pathophysiological mechanisms and treatment. This is the first case of POHS developing pericardial effusion. https://turkjpediatr.org/article/view/553clitoromegalyovarian cystpericardial effusionpreterm ovarian hyperstimulation syndrome
spellingShingle Elvan Bayramoğlu
Şenay Savaş Erdeve
Betül Emine Derinkuyu
İstemi Han Çelik
Semra Çetinkaya
Zehra Aycan
Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies
The Turkish Journal of Pediatrics
clitoromegaly
ovarian cyst
pericardial effusion
preterm ovarian hyperstimulation syndrome
title Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies
title_full Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies
title_fullStr Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies
title_full_unstemmed Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies
title_short Clitoromegaly caused by ovarian stimulation in a preterm newborn: ovarian hyperstimulation syndrome of preterm babies
title_sort clitoromegaly caused by ovarian stimulation in a preterm newborn ovarian hyperstimulation syndrome of preterm babies
topic clitoromegaly
ovarian cyst
pericardial effusion
preterm ovarian hyperstimulation syndrome
url https://turkjpediatr.org/article/view/553
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