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Recurrent severe hyperandrogenism during pregnancy: a case report.
1Academic Department of Diabetes and Endocrinology, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY, UK. hbholt@doctors.net.uk
Journal of Clinical Pathology
|March 26, 2005
Summary
Recurrent maternal virilization during pregnancy is rare. This case details a unique, severe ovarian condition causing hyperandrogenism in two successive pregnancies, posing potential risks to mother and child.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Gynecologic Oncology
Background:
- Recurrent maternal virilization is an exceptionally rare condition, with only seven previous cases documented.
- This case presents a unique and severe instance of virilization during two successive pregnancies.
Observation:
- A 28-year-old woman experienced rapid onset of hirsutism, increased musculature, and voice deepening in her third trimester of both pregnancies.
- Biochemical analysis revealed significant maternal hyperandrogenism (testosterone levels >20 times normal) during both pregnancies.
- Ultrasonography and fetal blood/placental assays excluded ovarian/adrenal masses and fetal aromatase deficiency.
Findings:
- The patient delivered healthy male infants in both pregnancies, with maternal androgen levels normalizing postpartum.
- The recurrent nature and severity of hyperandrogenism pointed towards a unique, possibly ovarian, etiology.
- Ovarian luteoma recurrence and hyperreactio luteinalis were considered but deemed unlikely given the pronounced androgen levels.
Implications:
- This case highlights a rare ovarian condition causing severe maternal hyperandrogenism during pregnancy.
- The condition poses potential risks to both the mother and the developing fetus.
- Further investigation into unique ovarian pathologies causing recurrent hyperandrogenism is warranted.