Van Voorhis B J, Neff T W, Syrop C H, Chapler F K
Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City.
Obstet Gynecol. 1994 May;83(5 Pt 2):885-7.
Primary hypothyroidism is known to be associated with multicystic ovaries in juvenile females, but this association has been reported only once previously in an adult. This report describes an unusual case of bilateral multicystic ovaries occurring in an adult patient with profound hypothyroidism.
A 26-year-old woman presented with an acute abdomen and bilateral adnexal masses. An emergency exploratory laparotomy revealed bilateral enlarged multicystic ovaries with torsion of the right ovary. Because this ovary was necrotic, it was removed; pathology revealed multiple hemorrhagic follicular cysts. Laboratory studies to evaluate the cause of the multicystic ovaries revealed negative serum beta-hCG, LH 0.7 IU/L, FSH 15.7 IU/L, and estradiol 80 pg/mL. The TSH value was greater than 50 IU/L and serum thyroxine was undetectable, demonstrating profound hypothyroidism. Subsequent thyroid hormone replacement was associated with resolution of the cysts in the remaining ovary.
Profound hypothyroidism can cause multicystic ovaries in an adult. In the absence of ovarian torsion, surgery can be avoided, as thyroid hormone replacement leads to clinical resolution of the cysts within 3 months.
原发性甲状腺功能减退症与青少年女性的多囊卵巢有关，但这种关联此前仅在一名成年人中被报道过一次。本报告描述了一名患有严重甲状腺功能减退症的成年患者出现双侧多囊卵巢的罕见病例。
一名26岁女性因急腹症和双侧附件包块就诊。急诊剖腹探查发现双侧多囊卵巢增大，右侧卵巢扭转。由于该卵巢已坏死，故将其切除；病理显示多个出血性滤泡囊肿。评估多囊卵巢病因的实验室检查显示血清β-hCG阴性，促黄体生成素（LH）0.7 IU/L，促卵泡生成素（FSH）15.7 IU/L，雌二醇80 pg/mL。促甲状腺激素（TSH）值大于50 IU/L，血清甲状腺素检测不到，表明存在严重的甲状腺功能减退症。随后的甲状腺激素替代治疗使剩余卵巢中的囊肿消退。
严重的甲状腺功能减退症可导致成年女性出现多囊卵巢。在没有卵巢扭转的情况下，可以避免手术，因为甲状腺激素替代治疗可在3个月内使囊肿临床消退。
