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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors present the case of a young woman who had Hodgkin's disease when she was 29 years of age. This was treated with 5 courses of M.O.P.P. (Mustard (nitrogen mustard), Oncovin, Procarbazine, Prednisone). These courses were followed by radiotherapy and the patient was given the combined oestrogen-progesterone pill while under treatment. After 20 months following treatment the patient was clinically and biologically menopausal. She was treated with hormone replacement therapy on alternate months. 10 months later, she started a twin pregnancy (there was no family history of twins) and after 37 weeks of amenorrhoea she delivered twins weighing 2,180 g and 2,300 g. The review of the literature shows that the ovaries are affected by this type of treatment, which causes ovarian fibrosis and failure of maturation, with disappearance of follicles. The effects of such treatment are variable and may leave the patients with normal ovarian function, or with a menopause from the outset. The essential prognostic feature is the age of the patient at the time of treatment. The dose of the antimitotic drugs used does not seem to have a great effect on ovarian function. The role of giving oestrogens and progestogens is disputed. The fact that twins occurred in this case could be explained by the fact that twin pregnancies do occur more often in the pre-menopause because the higher levels of gonadotrophins ripen several follicles.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Twin pregnancy after iatrogenic menopause]. 366 87

This paper emphasized the syndrome of anovulation and infertility following oral contraceptive therapy in patients with previously regular menses. Case histories of 2 successfully treated patients are given. The first was 22-years-old, gravida 0, and had taken Enovid for almost a year following marriage. Physical and histological findings were normal. Withdrawal flow but not ovulation followed oral administration of 10 mg of 6-alpha methyl 17-acetoxyprogesterone daily for 5 days. Ovulation began after prednisone, 5 mg twice daily, was given for 1 month. Several months later she conceived and has had a normal delivery. The other patient, a 23-year-old gravida 0, used Enovid for 2 years. After cessation her previously regular menstrual periods became very irregular and complete amenorrhea had lasted 4 months. Prednisone, 5 mg twice a day, restored ovulation in 1 month. She conceived the following month. Relative frequency of anovulation following oral contraception is believed greater than suspected. Patients who have not yet completed their families should be warned of the risk and contraceptives should not be used to treat infertility to produce a "rebound" effect.
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PMID:The oral contraceptives and infertility. 521 29

A case report is presented of the need for both bromocriptine and human menopausal gonadotropin (hMG) for induction of ovulation in a patient who developed partial hypopituitarism and persistent hyperprolactinemia even after a transsphenoidal pituitary microadenectomy. The patient, a 27-year old white female, initially presented in 1979 with a history of amenorrhea and galactorrhea after discontinuing oral contraceptives (OCs). Her menstrual cycles had been regular since her menarch at age 13 until she began taking OCs at age 20. Preoperative endocrine evaluation in 1979 revealed serum luteinizing hormone (LH), 9.1 mIU/ml; serum follicle stimulating hormore (FSH), 6.4 mIU/ml; serum thyroid stimulating hormone (TSH), 3.8 mIU/ml; serum prolactine (PRL), 300 ng/ml; serum thyroxine (T4), 6.4 mcg/dl; and an attenuated PRL response to thyrotropin releasing hormone (TRH). Radiographic studies revealed a pituitary tumor of approximately 1 cm in diameter. In July 1979 a transsphenoidal hypophysectomy was performed. Pathologic examination revealed a pituitary adenoma with a monomorphic basophilic cell population with fibrosis and chronic inflammation. The patient required prednisone therapy postoperatively for 3 months secondary to compromised adrenal status. Prednisone therapy was discontinued in October 1979 after a normal cortisol (F) response to induced hypoglycemia was documented. The patient's serum PRL levels remained elevated at 111 ng/ml in August 1979 and 269 ng/ml in October 1979. Her amenorrhea and galactorrhea persisted. Bromocriptine therapy, 2.5 mg 3 times daily, was instituted in October 1979. She became normoprolactinemic, with a serum PRL of 6 ng/ml, and the galactorrhea disappeared but the amenorrhea persisted. In February 1981 she was referred for further consultation on her fertility status. Bromocriptine therapy was discontinued. In April 1981 she underwent a thorough endocrine evaluation. The results indicate that GnRH stimulation was unable to elicit a pituitary gonadotropin response anywhere near normal levels of FSH and LH, thus suggesting pituitary hypogonadotropism. Growth hormone release was subnormal in response to the insulin induced hypoglycemia and L-dopa ingestion. Hyperprolactinemia was obvious but the patient's serum TSH, T4, and adrenocorticotropin (ACTH) levels were normal. A diagnosis of hyperprolactinemia with partial hypopituitarism and gonadotropin deficiency was made. Bromocriptine therapy was reinstituted at 2.5 mg twice daily in June 1981, with good results. In November 1981 her serum PRL was normal, and as she was desirous of pregnancy, ovulation induction with bromocriptine and Pergonal was carried out. The patient is now 6 months pregnant and doing well. This case illustrates the poor functional results for surgery for pituitary microplactinomas.
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PMID:Partial hypopituitarism and hyperprolactinemia: successful induction of ovulation with bromocriptine and human menopausal gonadotropins. 681 37

Satoyoshi syndrome (OMIM 600705) is a rare disorder of unknown cause characterized by progressive painful intermittent muscle spasms, amenorrhea, alopecia, malabsorption, and skeletal abnormalities mimicking a skeletal dysplasia. In this report, we describe a Caucasian 12-year-old girl that presented with characteristic manifestations, including alopecia, muscle cramps, and short stature with onset at age 7. Prednisone 60 mg/m(2) every other day and amytriptiline 25 mg QD were administered. After 2 months, alopecia had significantly improved and muscle cramps had almost disappeared, so that glucocorticoid treatment was tapered. Follow-up, 9 months later, showed a normal looking and asymptomatic girl.
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PMID:Satoyoshi syndrome in a Caucasian girl improved with glucocorticoids--a clinical report. 1260 41