Preterm ovarian hyperstimulation syndrome presented with vaginal bleeding: a case report

Area of Science:

• Pediatric Endocrinology
• Reproductive Endocrinology

Background:

• Preterm ovarian hyperstimulation syndrome (POHS) is a rare condition affecting premature infants.
• It is characterized by specific physical and hormonal markers, including swelling and elevated estradiol and gonadotropin levels.

Observation:

• This case report details the first instance of POHS presenting with vaginal bleeding in a female infant born at 25 weeks gestation.
• The infant exhibited typical POHS symptoms such as breast enlargement and lower body swelling, followed by recurrent vaginal bleeding.

Findings:

• Diagnosis was confirmed by elevated gonadotropin and estrogen levels, vulvar swelling, and ovarian follicular cysts.
• The presentation of vaginal bleeding in POHS is a novel finding, occurring at monthly intervals.

Implications:

• This case expands the known clinical spectrum of POHS.
• It highlights the importance of considering POHS in premature infants with unexplained vaginal bleeding and associated symptoms.