PDF(Pubmed)
Abstract：
Polycystic ovary syndrome (PCOS) is the leading cause of endocrine disorders among females of reproductive age and is linked with autoimmune disorders. PCOS has been associated with autoantibodies such as antinuclear antibody (ANA), anti-thyroid, and anti-Smith (anti-SM). Young patients with PCOS and systemic lupus erythematosus (SLE) have up to a 10-fold increase in stroke. We present a case of a patient with a history of PCOS (on metformin), hypothyroidism, and pulmonary embolism who presented to the emergency room with acute left-sided weakness. She was extensively investigated for risk factors and was eventually diagnosed with a cerebrovascular accident secondary to possible SLE with positive ANA (1:160, nuclear homogenous pattern). The diagnosis of PCOS, coupled with autoantibodies and recurring episodes of thromboembolic events, rendered her case management complex. She received tenecteplase and had thrombectomy done twice because of recurrent thrombotic events during her hospital stay. She passed away on the fifth day post-thrombectomy from a possible massive pulmonary embolism with hemodynamic compromise. There is a need for more research to comprehend the underlying mechanisms of SLE and PCOS to guide the proper management of patients in this situation.
摘要：
多囊卵巢综合征（PCOS）是育龄女性内分泌失调的主要原因，与自身免疫性疾病有关。PCOS与自身抗体相关，例如抗核抗体（ANA），抗甲状腺，和反史密斯（anti-SM）。患有PCOS和系统性红斑狼疮（SLE）的年轻患者的中风增加了10倍。我们介绍了一例有PCOS病史的患者（服用二甲双胍），甲状腺功能减退,和急性左侧无力出现在急诊室的肺栓塞。对她进行了广泛的危险因素调查，最终被诊断为继发于SLE的脑血管意外，ANA阳性（1：160，核同质模式）。PCOS的诊断,再加上自身抗体和反复发作的血栓栓塞事件，使她的案件管理复杂。她接受替奈普酶治疗，并因住院期间血栓事件复发而进行了两次血栓切除术。她在血栓切除术后第五天因可能的大面积肺栓塞和血液动力学受损而去世。需要更多的研究来理解SLE和PCOS的潜在机制，以指导在这种情况下对患者的正确管理。
