Cystic ovaries in women affected with hereditary angioedema.
2008
Polycystic ovary (PCO) syndrome is biochemically characterized by abnormal
gonadotropin secretion and polycystic ovaries associated with increase in size
and functional activity of stromal tissue; multifollicular ovaries (MFO) are
defined by the presence of multiple cysts with no increase in stromal tissue. A
central (hypothalamic-pituitary) abnormality, including high plasma
beta-endorphin (BE) concentrations without simultaneous elevation of ACTH, was
reported for subjects with PCO syndrome. Since we have found the presence of high
plasma BE concentrations in hereditary angioedema (HANE) during attacks as well
as during symptom-free periods, we studied, by means of pelvic ultrasound
scanning employed to determine the prevalence of PCO and of MFO, 13 women of
reproductive age affected with HANE who were not on oral contraceptives. We have
found PCO in 5/13 (38.4%) and MFO in 7/13 (53.8%) HANE patients. Nine patients
had oligomenorrhoea (five with PCO, three with MFO, one with normal ovaries),
five (three with PCO, two with MFO) were hirsute and only one (with MFO) had
weight loss. No patient was obese. Mean plasma LH, testosterone, prolactin,
cortisol and ACTH concentrations were normal, while FSH was significantly reduced
and LH/FSH ratio increased. BE concentrations were significantly high in all the
patients studied. Our results clearly demonstrate that women with HANE frequently
have cystic ovaries (polycystic or multifollicular) in the presence of high BE
concentrations.
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