Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea
Primary amenorrhoea is defined as the failure to commence menstruation by the age of 15 years, in the presence of normal secondary sexual development. The potential causes of primary amenorrhoea extend from structural to chromosomal abnormalities. Polycystic ovarian syndrome (PCOS) is a common cause...
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Bioscientifica
2017-03-01
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Series: | Endocrinology, Diabetes & Metabolism Case Reports |
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doaj-d3acb73b0f3d4f5a94d20a2ca4d5a88c2020-11-25T02:11:06ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732017-03-01111510.1530/EDM-16-0117Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoeaS Vimalesvaran0S Narayanaswamy1L Yang2J K Prague3A Buckley4A D Miras5S Franks6K Meeran7W S Dhillo8Department of Endocrinology & Metabolism, Imperial College London, UKDepartment of Endocrinology & Metabolism, Imperial College London, UKDepartment of Endocrinology & Metabolism, Imperial College London, UKDepartment of Endocrinology & Metabolism, Imperial College London, UKDepartment of Endocrinology & Metabolism, Imperial College London, UKDepartment of Diabetes & Endocrinology, Imperial Healthcare NHS Trust, London, UKDepartment of Diabetes & Endocrinology, Imperial Healthcare NHS Trust, London, UKDepartment of Diabetes & Endocrinology, Imperial Healthcare NHS Trust, London, UKDepartment of Endocrinology & Metabolism, Imperial College London, UKPrimary amenorrhoea is defined as the failure to commence menstruation by the age of 15 years, in the presence of normal secondary sexual development. The potential causes of primary amenorrhoea extend from structural to chromosomal abnormalities. Polycystic ovarian syndrome (PCOS) is a common cause of secondary amenorrhoea but an uncommon cause of primary amenorrhoea. An early and prompt diagnosis of PCOS is important, as up to 30% of these women are predisposed to glucose intolerance and obesity, with the subgroup of women presenting with primary amenorrhoea and PCOS displaying a higher incidence of metabolic dysfunction. We describe a case of an 18-year-old female presenting with primary amenorrhoea of unknown aetiology. Although initial investigations did not demonstrate clinical or biochemical hyperandrogenism or any radiological evidence of polycystic ovaries, a raised luteinising hormone (LH) suggested a diagnosis of PCOS. If PCOS was the correct diagnosis, then one would expect intact hypothalamic GnRH and pituitary gonadotropin release. We used the novel hormone kisspeptin to confirm intact hypothalamic GnRH release and a GnRH stimulation test to confirm intact pituitary gonadotroph function. This case highlights that kisspeptin is a potential unique tool to test GnRH function in patients presenting with reproductive disorders. Chttps://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-16-0117 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
S Vimalesvaran S Narayanaswamy L Yang J K Prague A Buckley A D Miras S Franks K Meeran W S Dhillo |
spellingShingle |
S Vimalesvaran S Narayanaswamy L Yang J K Prague A Buckley A D Miras S Franks K Meeran W S Dhillo Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea Endocrinology, Diabetes & Metabolism Case Reports |
author_facet |
S Vimalesvaran S Narayanaswamy L Yang J K Prague A Buckley A D Miras S Franks K Meeran W S Dhillo |
author_sort |
S Vimalesvaran |
title |
Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea |
title_short |
Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea |
title_full |
Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea |
title_fullStr |
Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea |
title_full_unstemmed |
Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea |
title_sort |
using kisspeptin to assess gnrh function in an unusual case of primary amenorrhoea |
publisher |
Bioscientifica |
series |
Endocrinology, Diabetes & Metabolism Case Reports |
issn |
2052-0573 2052-0573 |
publishDate |
2017-03-01 |
description |
Primary amenorrhoea is defined as the failure to commence menstruation by the age of 15 years, in the presence of normal secondary sexual development. The potential causes of primary amenorrhoea extend from structural to chromosomal abnormalities. Polycystic ovarian syndrome (PCOS) is a common cause of secondary amenorrhoea but an uncommon cause of primary amenorrhoea. An early and prompt diagnosis of PCOS is important, as up to 30% of these women are predisposed to glucose intolerance and obesity, with the subgroup of women presenting with primary amenorrhoea and PCOS displaying a higher incidence of metabolic dysfunction. We describe a case of an 18-year-old female presenting with primary amenorrhoea of unknown aetiology. Although initial investigations did not demonstrate clinical or biochemical hyperandrogenism or any radiological evidence of polycystic ovaries, a raised luteinising hormone (LH) suggested a diagnosis of PCOS. If PCOS was the correct diagnosis, then one would expect intact hypothalamic GnRH and pituitary gonadotropin release. We used the novel hormone kisspeptin to confirm intact hypothalamic GnRH release and a GnRH stimulation test to confirm intact pituitary gonadotroph function. This case highlights that kisspeptin is a potential unique tool to test GnRH function in patients presenting with reproductive disorders.
C |
url |
https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-16-0117 |
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