Sultan A, Velaga M R, Fleet M, Cheetham T
Department of Paediatrics, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Arch Dis Child. 2006 Jun;91(6):509-10. doi: 10.1136/adc.2005.088443.
Ovarian hyperstimulation is a recognised complication of longstanding hypothyroidism. A 12 year old girl with atrophic thyroiditis who presented with abdominal pain and distension is reported. She was noted to have bruising in the vicinity of the umbilicus (Cullen's sign). She had pronounced ovarian enlargement on ultrasonography and it was hypothesised that this profound phenotype might reflect an abnormal FSH receptor. However sequencing of the FSH receptor was normal. The ovarian enlargement resolved with thyroxine replacement. Physicians and surgeons should consider longstanding hypothyroidism in patients presenting with Cullen's sign.
卵巢过度刺激是长期甲状腺功能减退症的一种公认并发症。本文报告了一名12岁患有萎缩性甲状腺炎的女孩,她出现腹痛和腹胀。她被发现脐周有瘀斑(库伦氏征)。超声检查显示她有明显的卵巢肿大,据推测这种严重的表现型可能反映了促卵泡激素(FSH)受体异常。然而,FSH受体测序结果正常。卵巢肿大在补充甲状腺素后消退。对于出现库伦氏征的患者,内科医生和外科医生应考虑长期甲状腺功能减退症。