Foer Dinah, Buchheit Kathleen M
Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA.
Immunol Allergy Clin North Am. 2017 Nov;37(4):773-784. doi: 10.1016/j.iac.2017.07.006. Epub 2017 Aug 23.
Heterogeneous presentations of disease pose particular diagnostic and management challenges to the clinician. Progestogen hypersensitivity (PH) classically consists of hypersensitivity symptoms to endogenous progesterone during the luteal phase of the menstrual cycle. However, with the rise of assisted fertility and the exponential growth in the use of exogenous progestins for contraception, PH's prevalence and symptom heterogeneity have increased. In this article, we focus on the clinical approach to PH diagnosis with an emphasis on key elements of the history, physical, and testing modalities. We also review the current evidence for successful management and treatment across a broad range of patients.
疾病的异质性表现给临床医生带来了特殊的诊断和管理挑战。孕激素超敏反应（PH）传统上是指在月经周期的黄体期对内源性孕酮产生超敏症状。然而，随着辅助生殖技术的兴起以及外源性孕激素在避孕方面的使用呈指数级增长，PH的患病率和症状异质性都有所增加。在本文中，我们重点关注PH诊断的临床方法，强调病史、体格检查和检测方式的关键要素。我们还回顾了目前针对广泛患者成功管理和治疗的证据。
