A 15-year-old girl presented with hirsutism, oligomenorrhea, and a Ferriman-Gallwey score of 14. Laboratory tests found elevated LH, testosterone, and prolactin levels. Ultrasound showed enlarged ovaries. She was diagnosed with PCOS and hyperprolactinemia. Treatment with lifestyle changes and Diane 35 was started.
A 15-year-old girl presented with hirsutism, oligomenorrhea, and a Ferriman-Gallwey score of 14. Laboratory tests found elevated LH, testosterone, and prolactin levels. Ultrasound showed enlarged ovaries. She was diagnosed with PCOS and hyperprolactinemia. Treatment with lifestyle changes and Diane 35 was started.
A 15-year-old girl presented with hirsutism, oligomenorrhea, and a Ferriman-Gallwey score of 14. Laboratory tests found elevated LH, testosterone, and prolactin levels. Ultrasound showed enlarged ovaries. She was diagnosed with PCOS and hyperprolactinemia. Treatment with lifestyle changes and Diane 35 was started.
A 15-year-old girl presented with hirsutism, oligomenorrhea, and a Ferriman-Gallwey score of 14. Laboratory tests found elevated LH, testosterone, and prolactin levels. Ultrasound showed enlarged ovaries. She was diagnosed with PCOS and hyperprolactinemia. Treatment with lifestyle changes and Diane 35 was started.
menarche at 10, 3-4 menstrual cycle/year since than, last period: 3 months ago Her father has diabetes mellitus type II Her mother is hypertensive, obese (BMI= 33 kg/m2)
She is the only daughter of the family,
She had low birth weight with rapid catch-up growth, No chronic medication use, no recent stress or ilness, No change in weight, diet or strenous exercise
History and physical
Her complaint was also about hirsutism with:
age of onset 11, slow rate of progression Tanner Stage 5, (B5, PH5) Ferriman Gallwey score 14, Acne vulgaris, seborrhea, hyperhidrosis,
Physical:
BMI= 23 kg/m2.( H=162 cm, W=60,5 kg) Blood presure=110/70 mmHg Waist/hip ratio= 0,80
Physical examination
Ferriman-Gallwey score Scores above 8 suggest an excess of androgen-mediated hair growth that should be confirmed by hormonal evaluation.
What laboratory tests would you order to evaluate this patient?
Lab studies
Kariotype 46,XX; PRL = 23 ng/ml , (Normal range <20 ng/ml) LH = 21 IU/ml , (Normal range 5- 20 IU/ml) FSH = 9 IU/ml , (Normal range 6- 16 IU/ml) Testosteorone (total) = 1,2 ng/mL
Normal range <0,82 ng/mL
17-hydroxiprogesteronum = 4 nmol/L
Normal range 0.6-3 nmol/L
Lab studies
DHEA-S= 203 g/dl
Normal range 120-300 g/dl
IGF-1 - normal for age Urinary free cortisol= 23 mcg/24 h
Normal range 10-100 mcg/24 h; Normal range 0,9-3,2 g/dl
