Hyperandrogenism. Cases of Combination of Different Variants of Hyperandrogenism in Adolescent Girls with the Peripheral Form of Hyperandrogenism

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Abstract


Hyperandrogenism is a pathological process associated with an excessive effect of androgens in a female organism. In addition to the appearance changes hyperandrogenism (HA) can declare itself by some disorders of reproductive system functioning (anovulation, sterility, miscarriage). The causes of hyperandrogenism can be absolutely different by their pathogenesis conditions. Such external (peripheral) manifestations of hyperandrogenism as hirsutism can be determined by the only reason - excess of 5a-reductase enzyme. There are more cases of combined (associated) forms in the clinical practice. The article considers the cases of combinations of various forms of hyperandrogenism with peripheral forms and their influence on the change of clinical and laboratory parameters. The highest frequency of the excess of 5a-reductase enzyme was found in the group of girls with congenital adrenal dysfunction - 75 %, among the girls with a polycystic ovary syndrome the frequency of this pathology was 9,5 %, and among the girls with hypothalamic syndrome of pubertal period - 14,3 %. The combination of any hyperandrogeny form with the excess of 5a-reductase enzyme was accompanied by hirsutism increase, reduction of mammary glands in adolescents, suprarenal hormones level increase - DEA-s and 17-OHPg. In the case of combination of congenital adrenal dysfunction or hypothalamic syndrome of pubertal period with the excess of 5a-reductase enzyme the laboratory parameters of hyperandrogenism (testosterone, index of free testosterone) were expressed more intensively. In the case of the combination of the excessive production of 5a-reductase enzyme with a polycystic ovary syndrome the diagnosis was more complicated because the index of free testosterone was normal. In the case of combined forms polycystic ovary syndrome is not frequently proved by the laboratory hyperandrogenism, more often these are the cases of incomplete polycystic ovary syndrome.

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About the authors

Elena Magometovna Bogatyreva

Saint Petersburg State Pediatric Medical University

Email: Elen_bogat@mail.ru
Postgraduate Student, Department of children gynecology and women reproductology

Galiya Fettyakhovna Kutusheva

Saint Petersburg State Pediatric Medical University

Email: Galiya@chadogyn.ru
MD, PhD, Prof., Head. Dep. of Children Gyn. and Female Reproductology, Fac. of Postgraduate Education

Irina Nikolaevna Gogotadze

Saint Petersburg State Pediatric Medical University

Email: irinagogotadze@rambler.ru
MD, PhD, Ass. Prof. Dep. of Сhildren Gynecology and Women Reproductology

Anastasia Dmitrievna Zernyuk

Saint Petersburg State Pediatric Medical University

Email: zernyuk@rambler.ru
MD, PhD, Ass. Prof. Dep. of Сhildren Gynecology and Women Reproductology

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Copyright (c) 2015 Bogatyreva E.M., Kutusheva G.F., Gogotadze I.N., Zernyuk A.D.

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