Polycystic ovarian syndrome

多囊卵巢综合征
  • 文章类型: Case Reports
    多囊卵巢综合征(PCOS)是一种影响育龄妇女的内分泌疾病,其特征是荷尔蒙失衡导致代谢和生殖失调。此病例报告围绕着一位30岁的丈夫和他27岁的伴侣。男性伴侣有正常精子症,女性配偶患有PCOS,根据这对夫妇的诊断评估。女性患者接受卵巢刺激专门用于辅助PCOS,然后将回收的卵母细胞在体外成熟。卵胞浆内单精子注射(ICSI)后,受精和胚胎发育成功。PCOS相关不孕症的治疗面临许多挑战,并讨论了体外成熟(IVM)及其作为有效辅助生育方法的潜力。为了优化治疗结果,结论显示了IVM和其他辅助生殖技术对不孕症的重要性.它还侧重于必要的持续研究和临床经验。通过测量血清β-人绒毛膜促性腺激素(β-hCG)水平,然后进行超声检查(USG)来确认临床妊娠,这表明胎儿的生长速度正常。
    Polycystic ovary syndrome (PCOS) is an endocrinological disorder affecting women of reproductive age, characterized by hormonal imbalance leading to metabolic and reproductive dysregulations. This case report revolves around a 30-year-old husband and his 27-year-old partner. The male partner had normozoospermia, and the female spouse had PCOS, according to the couple\'s diagnostic evaluations. The female patient received ovarian stimulation specifically to assist with PCOS, and the retrieved oocytes were then matured in vitro. After intracytoplasmic sperm injection (ICSI), fertilization and embryonic development were successful. Treatment of PCOS-related infertility presents many challenges, and in vitro maturation (IVM) and its potential as an effective assisted fertility method are discussed. To optimize treatment outcomes, the conclusion shows the importance of IVM and other assisted reproductive techniques for infertility. It also focuses on the necessary continuous research and clinical experience. Clinical pregnancy was confirmed by measuring serum beta-human chorionic gonadotropin (β-hCG) levels followed by ultrasound sonography (USG), which showed a normal growth rate of the fetus.
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  • 文章类型: Journal Article
    背景:多囊卵巢综合征(PCOS)是一种常见的生殖和内分泌疾病。PCOS可以对个体生活的许多方面产生重大影响,包括生殖健康和心理健康。这项研究的目的是评估营养状况,经前综合症,与没有PCOS的女性相比,受PCOS影响的女性的心理健康。
    方法:巴勒斯坦的病例对照观察研究包括100名PCOS患者和200名健康女性。收集的数据包括社会人口统计信息,病史,经前综合症,心理健康,营养状况,和生活方式。人体测量和地中海饮食依从性筛选器(MEDAS)用于评估营养状况。一般健康问卷(12-GHQ)用于评估心理健康状况。使用经过验证的阿拉伯经前综合征问卷评估经前综合征(PMS)的严重程度。
    结果:研究结果表明,在PCOS患者中,PMS的三个维度有统计学上的显著增加,p<0.05。同样,PCOS患者在心理健康的各个方面都表现出了较高的评分,p<0.05。就其他变量而言,据观察,PCOS患者的睡眠障碍发生率明显更高,地中海饮食依从性下降.回归分析显示,PCOS与GHQ评分较高的心理健康问题相关(OR:1.09;95%CI:1.03;1.16,p<0.05)。对MD饮食的依从性较低(OR:0.86;95%CI:0.76;0.98,p<0.05),和月经前综合症,特别是调整年龄后的身体症状(OR:1.06;95%CI:1.003;1.12,p<0.05),吸烟,腰臀比,体重指数(BMI)。
    结论:该研究将多囊卵巢综合征与负面的心理健康结果和经前期综合征(PMS)的严重程度增加联系起来。为了建立巴勒斯坦人口中多囊卵巢综合征(PCOS)与生活方式之间的因果关系,需要进行额外的调查。干预和指导研究对于研究管理策略在减轻多囊卵巢综合征(PCOS)对身心健康的影响方面的功效是必要的。
    BACKGROUND: Polycystic ovarian syndrome (PCOS) is a widely seen reproductive and endocrinological disorder. PCOS can exert substantial effects on many aspects of an individual\'s life, including reproductive health and psychological well-being. The objective of this study was to assess the nutritional status, premenstrual syndrome, and mental health of women affected by PCOS in comparison to women without PCOS.
    METHODS: A case-control observational study in Palestine included 100 PCOS patients and 200 healthy women. The collected data included socio-demographic information, medical history, premenstrual syndrome, mental health, nutritional status, and lifestyle. Anthropometric measurement and the Mediterranean Diet Adherence Screener (MEDAS) were used to evaluate the nutritional status. The General Health Questionnaire (12-GHQ) was used to evaluate the state of mental health. Premenstrual syndrome (PMS) severity was evaluated using a validated Arabic premenstrual syndrome questionnaire.
    RESULTS: The study\'s findings indicated that there was a statistically significant increase in the three dimensions of PMS among participants with PCOS, p < 0.05. Similarly, PCOS patients demonstrated elevated ratings across all aspects of mental health, p < 0.05. In terms of the other variables, it has been observed that PCOS patients have a notably greater prevalence of perceived sleep disturbances and decreased adherence to the Mediterranean diet. Regression analysis revealed that PCOS is associated with mental health problems indicated by a higher GHQ score (OR: 1.09; 95% CI: 1.03; 1.16, p < 0.05), lower adherence to the MD diet (OR: 0.86; 95% CI: 0.76; 0.98, p < 0.05), and pre-menstrual syndrome, especially the physical symptoms (OR: 1.06; 95% CI: 1.003; 1.12, p < 0.05) after adjusting for age, smoking, waist-hip ratio, and body mass index (BMI).
    CONCLUSIONS: The study has linked polycystic ovary syndrome to negative mental health outcomes and an increased severity of premenstrual syndrome (PMS). Additional investigation is required in order to establish a causal association between polycystic ovary syndrome (PCOS) and lifestyle behaviors within the Palestinian population. Intervention and instructional studies are necessary to investigate the efficacy of management strategies in alleviating the effects of polycystic ovary syndrome (PCOS) on both physical and mental well-being.
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  • 文章类型: Journal Article
    背景:多囊卵巢综合征(PCOS)是育龄妇女排卵性不孕和内分泌异常的最常见原因。尽管已经引入了MIND饮食来改善大脑功能,证据表明,MIND饮食富含有益的食物组,可以对其他代谢紊乱产生预防作用。本研究旨在研究坚持MIND饮食与PCOS之间的关系。
    方法:这项年龄和BMI频率匹配的病例对照研究是在Yazd于2018年1月至2019年3月期间对216名女性进行的。伊朗。根据鹿特丹标准诊断PCOS。采用方便抽样法选择参与者。经过验证的178项食物频率问卷用于评估通常的饮食摄入量。使用Logistic回归估计MIND饮食与PCOS之间的关联。
    结果:本研究的结果表明,在粗模型中,坚持MIND饮食与PCOS之间存在显著的负相关(T3与T1:0.12(95%CI:0.05-0.25),P值<0.001)和包括能量摄入的多变量调整模型,年龄,BMI,腰围,婚姻状况,怀孕史,吸毒史,教育和体育活动(OR为T3vs.T1=0.08(95%CI:0.03-0.19),P值<0.001)。坚持MIND饮食具有92%的保护作用。
    结论:尽管本研究的结果表明,坚持MIND饮食与PCOS的风险较低有关,未来需要更多的研究来证实这些发现。
    BACKGROUND: Polycystic ovary syndrome (PCOS) is the most prevalent cause of ovulatory infertility and endocrine abnormalities in reproductive-age women. Although the MIND diet has been introduced to improve brain function, evidence shows that the MIND diet is rich in beneficial food groups that can have a preventive effect on other metabolic disorders. The present study was conducted to investigate the association between adherence to the MIND diet and PCOS.
    METHODS: This age and BMI frequency-matched case-control study was conducted on 216 women between January 2018 and March 2019 in Yazd, Iran. PCOS was diagnosed based on Rotterdam criteria. Participants were selected by convenience sampling method. The validated 178-item food frequency questionnaire was used to assess the usual dietary intake. Logistic regression was used to estimate the association between the MIND diet and PCOS.
    RESULTS: The findings of the present study showed a significant inverse association between adherence to the MIND diet and PCOS in the crude model (OR for T3 vs. T1: 0.12 (95% CI: 0.05-0.25), P-value < 0.001) and multivariable-adjusted model including energy intake, age, BMI, waist circumference, marital status, pregnancy history, drug use history, education and physical activity (OR for T3 vs. T1 = 0.08 (95% CI: 0.03-0.19), P-value < 0.001). Adherence to the MIND diet had a protective effect of 92%.
    CONCLUSIONS: Although the results of the present study showed that higher adherence to the MIND diet is associated with a lower risk of PCOS, more studies are needed to confirm these findings in the future.
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  • 文章类型: Case Reports
    该案例研究的29岁参与者在过去的六年中一直在与不孕症作斗争。在评估了她的症状后,激素谱,和超声结果,她被诊断为多囊卵巢综合征(PCOS).PCOS是一种多方面的内分泌和代谢紊乱,以肥胖等症状为特征,胰岛素抵抗,无排卵,和多囊卵巢.各种因素,包括遗传,肠道生态失调,肥胖,环境污染物,生活方式的选择,神经内分泌异常,有助于女性对PCOS的易感性。在计划多囊卵巢刺激时,至关重要的是要考虑诸如窦卵泡计数(AFC)等参数,黄体生成素(LH),和抗苗勒管激素(AMH)。仔细计划促性腺激素剂量对于在促性腺激素释放激素拮抗剂(GnRH-ant)周期中获得最佳反应至关重要。在我们的案例中,使用了简短的拮抗剂方案,结果良好,卵巢过度刺激综合征(OHSS)的风险最小。尽管多次尝试自然受孕失败,患者在胞浆内单精子注射(ICSI)的帮助下成功受孕,导致积极的妊娠结果。除了结合机械孵化以促进植入,我们努力选择对患者最有益的药物。
    The 29-year-old participant in the case study has been grappling with infertility for the last six years. Following an assessment of her symptoms, hormone profile, and ultrasound results, she received a diagnosis of polycystic ovarian syndrome (PCOS). PCOS is a multifaceted endocrine and metabolic disorder characterized by symptoms such as obesity, insulin resistance, anovulation, and polycystic ovaries. Various factors, including heredity, intestinal dysbiosis, obesity, environmental pollutants, lifestyle choices, and neuroendocrine abnormalities, contribute to the susceptibility of women to PCOS. In planning polycystic ovarian stimulation, it is crucial to consider parameters such as antral follicle count (AFC), luteinizing hormone (LH), and anti-Müllerian hormone (AMH). Careful planning of the gonadotrophin dose is essential to achieve an optimal response during a gonadotropin-releasing hormone antagonist (GnRH-ant) cycle. In our case, the brief antagonist protocol was used, resulting in a favorable outcome with minimal risk of ovarian hyperstimulation syndrome (OHSS). Despite multiple unsuccessful attempts at natural conception, the patient successfully conceived with the help of intracytoplasmic sperm injection (ICSI), leading to a positive pregnancy outcome. In addition to incorporating mechanical hatching to promote implantation, we diligently selected the most beneficial medications for the patient.
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  • 文章类型: Case Reports
    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。
    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.
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  • 文章类型: Case Reports
    对于麻醉师来说,六胎妊娠的母亲剖腹产具有挑战性。由于子宫过度扩张和母亲的相关变化,可能有几种围手术期并发症。我们正在报告一名患有六胎妊娠的妇女来进行紧急剖腹产的情况。她也有多囊卵巢综合征(PCOS)和排卵诱导受孕的背景病史。妊娠早期并发卵巢过度刺激综合征。她在怀孕早期需要宫颈环扎术。紧急剖宫产是在她早产时进行的,6名早产儿在妊娠29周时分娩。剖宫产在脊髓麻醉下进行。子痫前期和产后出血并发围手术期。
    Cesarean section in a mother with a sextuplet pregnancy is challenging for an anesthesiologist. Several perioperative complications are likely because of the overdistended uterus and associated changes in the mother. We are reporting the case of a woman with a sextuplet pregnancy who came for an emergency cesarean. She also had a background history of polycystic ovarian syndrome (PCOS) and ovulation induction for conception. Early pregnancy was complicated by ovarian hyperstimulation syndrome. She required cervical cerclage in early pregnancy. The emergency cesarean was done as she went into preterm labor and six premature babies were delivered at 29 weeks of gestation. Cesarean was done under spinal anesthesia. Preeclampsia and postpartum hemorrhage complicated the perioperative period.
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  • 文章类型: Journal Article
    背景:多囊卵巢综合征(PCOS)是一种在育龄女性中普遍存在的生殖激素异常,巴基斯坦妇女的患病率高达52%,令人震惊。这项研究旨在比较患有PCOS的女性与生活在拉合尔的年龄匹配的健康对照的日常体力活动和饮食习惯。巴基斯坦。
    方法:使用病例对照研究设计从位于拉合尔的一家私立医院收集数据,巴基斯坦。使用研究人员管理的问卷从115名育龄(18-45岁)参与者中收集数据。人口统计变量,生殖特征,人体测量,使用国际体育活动问卷(IPAQ-Short版本)和7天的饮食摄入水平使用食物频率问卷(7天FFQ)来测量参与者的饮食习惯。Mosby的Nutritacv4.0软件用于估算常量营养素,维生素,和膳食摄入中存在的矿物质。计算血糖指数和血糖负荷,以比较两组之间碳水化合物消耗的质量和数量。
    结果:49例PCOS,使用鹿特丹标准新确定的,平均年龄24.63岁(SD±4.76),和66个健康对照,平均年龄23.24岁(SD±5.45),进行了比较。生殖特征存在显着差异(p≤0.05),日常体力活动,两组之间的多不饱和脂肪和维生素摄入量。二元logistic回归分析显示,血糖指数低(GI≤40)的食物可使PCOS的发生几率降低,OR=1.94。同样,血糖负荷低(GL≤10)的食物营养素可减少PCOS的发生,OR=1.60.
    结论:育龄妇女的日常体力活动水平和饮食习惯会影响其生殖特征和多囊卵巢形态。血糖负荷和指数低的饮食可以对育龄妇女产生有益的生殖健康影响。
    Polycystic ovarian syndrome (PCOS) is a reproductive hormonal anomaly prevalent among women of reproductive age, with an alarmingly high prevalence of 52% among Pakistani women. This study aims to compare the daily physical activity and dietary habits of women with PCOS with age-matched healthy controls living in Lahore, Pakistan.
    A case-control study design was used to collect data from a private hospital situated in Lahore, Pakistan. Data was collected from 115 participants of reproductive age (18-45 years) using a researcher-administered questionnaire. Demographic variables, reproductive characteristics, anthropometric measurements, and seven days of physical activity levels using the international physical activity questionnaire (IPAQ-Short version) and seven days of dietary intake using the food frequency questionnaire (7 days-FFQ) were used to measure the dietary habits of the participants. Mosby\'s Nutritac v4.0 software was used to estimate the macronutrients, vitamins, and minerals present in dietary intake. The glycaemic index and glycaemic load were calculated to compare the quality and quantity of carbohydrate consumption between the two groups.
    The 49 PCOS cases, newly identified using the Rotterdam criteria, mean age 24.63 years (SD ± 4.76), and 66 healthy controls, mean age 23.24 years (SD ± 5.45), were compared. A significant difference (p ≤ 0.05) was found for reproductive characteristics, daily physical activity, and polyunsaturated fat and vitamin intake between the two groups. A binary logistic regression analysis showed that food with a low glycaemic index (GI ≤ 40) reduced the odds of PCOS occurrence by OR = 1.94. Similarly, food nutrients with a low glycaemic load (GL ≤ 10) can reduce PCOS occurrence by OR = 1.60.
    The daily physical activity levels and dietary habits of women of reproductive age can influence their reproductive characteristics and polycystic ovarian morphology. A diet with a low glycaemic load and index can produce beneficial reproductive health effects among women of reproductive age.
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  • 文章类型: Journal Article
    原因不明的复发性妊娠丢失(RPL)占RPL患者的50%以上。胰岛素抵抗(IR)是原因不明的RPL的潜在原因。
    评估沙特女性胰岛素抵抗(IR)与无法解释的RPL之间的关系。
    这是一个单中心,在沙特阿拉伯东部省的一家三级医院进行的病例对照研究。研究小组由患有无法解释的RPL的沙特女性组成,而对照组的沙特女性至少有一个活产,没有RPL。采集血样以确定空腹血糖(FG)和空腹胰岛素(FI)水平。排除患有糖尿病和多囊卵巢综合征的女性。胰岛素抵抗指数(HOMA-IR)值≥3的稳态模型评估被认为是IR。
    研究组和对照组包括43名和56名女性,分别。在群体之间,平均年龄(病例:37.9±5.4岁;对照组:32.2±5.9岁;P<0.0001)和平均BMI(病例:31.5±6.0;对照组:26.1±2.8;P<0.0001)差异有统计学意义。对照组FG水平略高(90.9mg/dLvs88.7mg/dL;P=0.068)。研究组的FI水平明显较高(16.33μU/mLvs.6.17μU/mL;P<0.0001)。≥3的HOMA-IR在研究组(n=22;51.2%)明显高于对照组(4;7.1%)(P<0.0001)。在调整了年龄和BMI后,发现IR≥3与无法解释的RPL独立相关(aOR:13.2;95%CI:3.77-46.36)。
    这项研究表明,与没有RPL病史的人相比,患有无法解释的RPL的沙特女性的空腹胰岛素水平和胰岛素抵抗水平明显更高。因此,建议评估RPL女性的IR.
    UNASSIGNED: Unexplained recurrent pregnancy loss (RPL) accounts for >50% of the patients with RPL. Insulin resistance (IR) is a potential cause of unexplained RPL.
    UNASSIGNED: To evaluate the relationship between insulin resistance (IR) and unexplained RPL among Saudi women.
    UNASSIGNED: This is a single-center, case-control study conducted at a tertiary hospital in the Eastern Province of Saudi Arabia. The study group comprised Saudi women with unexplained RPL, while the control group had Saudi women with at least one live birth and no RPL. Blood samples were taken to determine the fasting glucose (FG) and fasting insulin (FI) levels. Women with diabetes mellitus and polycystic ovarian syndrome were excluded. A homeostatic model assessment of insulin resistance index (HOMA-IR) value ≥3 was considered as IR.
    UNASSIGNED: The study and control groups comprised 43 and 56 women, respectively. Between the groups, there was a significant difference in the mean age (case: 37.9 ± 5.4 years; control: 32.2 ± 5.9 years; P < 0.0001) and the mean BMI (case: 31.5 ± 6.0; control: 26.1 ± 2.8; P < 0.0001). FG level was slightly higher in the control group (90.9 mg/dL vs 88.7 mg/dL; P = 0.068). FI level was significantly higher in the study group (16.33 μU/mL vs. 6.17 μU/mL; P < 0.0001). HOMA-IR of ≥3 was significantly more common in the study group (n = 22; 51.2%) than the control group (4; 7.1%) (P < 0.0001). After adjusting for age and BMI, IR ≥3 was found to be independently associated with unexplained RPL (aOR: 13.2; 95% CI: 3.77-46.36).
    UNASSIGNED: This study showed that Saudi women with unexplained RPL had significantly higher levels of fasting insulin and insulin resistance than those without a history of RPL. Therefore, it is recommended to assess IR in women with RPL.
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  • 文章类型: Case Reports
    卵巢过度刺激综合征(OHSS)可能是辅助生殖技术期间控制性卵巢过度刺激的严重并发症。在OHSS期间,由于毛细血管渗透性的增加,流体从血管内空间转移到第三空间隔室。这会导致腹腔和胸腔中的液体积聚。患者出现严重的OHSS症状(双侧胸腔积液和肺积液),在急诊室就诊和住院期间需要双侧超声引导穿刺术和双侧胸腔穿刺术。由于毛细血管通透性增加带来的远距离影响,病人中耳出现液体,导致取卵后12天出现浆液性中耳炎。这种情况在接受抗组胺药和抗生素治疗2-3周后得到解决,鼻子,还有喉部医生.通过持续监测排卵诱导患者,可以降低OHSS风险。使用适当的促性腺激素剂量,并使用已知的其他药物来降低其风险。如果OHSS仍然发生,可能需要对症治疗和多学科专业团队来预防液体积聚并发症.与许多发表的关于OHSS及其并发症的文章相反,这是首例出现严重OHSS并发症的浆液性中耳炎患者的病例报告.
    Ovarian hyperstimulation syndrome (OHSS) may be a severe complication of controlled ovarian hyperstimulation during assisted reproductive technology. During OHSS, fluid shifts from the intravascular space to the third-space compartments as the result of an increase in capillary permeability. This can cause fluid accumulation in peritoneal as well as thoracic cavities. The patient presented with symptoms of severe OHSS (bilateral hydrothorax and pulmonary effusion), requiring bilateral ultrasound-guided paracentesis and bilateral thoracentesis during her Emergency Room visits and hospitalization. Due to distant effects from the increased capillary permeability, the patient presented fluid in the middle ear, which led to the development of serous otitis media 12 days after egg retrieval. This was resolved 2-3 weeks later after being treated with antihistamines and antibiotics given by her Ear, Nose, and Throat doctor. OHSS risk may be reduced by continuous monitoring of patients undergoing ovulation induction, using an appropriate gonadotropin dosage, and using additional agents known to decrease its risk. If OHSS still occurs, symptomatic treatment and a multidisciplinary team of professionals may be needed to prevent fluid build-up complications. In contrast to many published articles about OHSS and its complications, this is the first case report of a patient presenting serous otitis media as a complication of severe OHSS.
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  • 文章类型: Case Reports
    持续性苗勒管综合征(PMDS)是男性中发生的一种假两性畸形。它是一种常染色体隐性遗传性家族性疾病,通常与血缘史有关。我们记录了一例22岁的成年男性急性右髂疼痛,经过超声扫描和激素检查,他被诊断为多囊卵巢综合征(PCOS)。
    Persistent Mullerian Duct Syndrome (PMDS) is a type of pseudohermaphroditism that occurs in males. It is an autosomal recessive type of familial disease that is commonly associated with a history of consanguinity. We have documented this case of a 22-year-old adult male who came with acute right iliac pain; after an ultrasound scan and hormone investigations, he was diagnosed with polycystic ovarian syndrome (PCOS).
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