2. Scenario:
A 35-year-old female presents with complaints of weight gain, fatigue and
irregular menstrual cycles for the past six months. She has a history of
Hashimoto’s thyroiditis, an autoimmune disorder that affects the thyroids
gland.
3. Diagnosed disease:
The diagnosed disease is polycystic Ovary syndrome(PCOS).
PCOS:
PCOS stands for Polycystic Ovary syndrome, which is hormonal disorder
that affects women of reproductive age. It is a condition in which the ovaries
produce high levels of androgens(male hormones).
4.
5. Causes:
The exact cause of PCOS is unknown, but it is believed to be related to a
combination of genetic and environmental factors.
Insulin resistance and high levels of androgens (male hormones) are thought
to play a role in development of PCOS.
6. Factors that may cause PCOS :
1)Insulin resistance.
Insulin is a hormone that the pancreas makes. It allows cells to use sugar, your
body's primary energy supply. If cells become resistant to the action of insulin,
then blood sugar levels can go up. This can cause your body to make more insulin
to try to bring down the blood sugar level.
Too much insulin might cause your body to make too much of the male hormone
androgen. You could have trouble with ovulation, the process where eggs are
released from the ovary.
One sign of insulin resistance is dark, velvety patches of skin on the lower part of
the neck, armpits, groin or under the breasts. A bigger appetite and weight gain
may be other signs.
7. 2)Low-grade inflammation:
White blood cells make substances in response
to infection or injury. This response is called low-grade inflammation. Research
shows that people with PCOS have a type of long-term, low-grade inflammation
that leads polycystic ovaries to produce androgens. This can lead to heart and
blood vessel problems.
8. 3)Excess androgen:
With PCOS, the ovaries may produce high levels of
androgen. Having too much androgen interferes with ovulation. This means that
eggs don't develop on a regular basis and aren't released from the follicles where
they develop. Excess androgen also can result in hirsutism and acne.
9. 4)Heredity:
Research suggests that certain genes might be linked to PCOS.
Having a family history of PCOS may play a role in developing the condition.
10.
11. Symptoms:
The symptoms of PCOS can vary from person to person, but commonly include:
Irregular menstrual cycles
Excessive hair growth on the face, chest and abdomen
Acne
Weight gain or difficulty losing weight
Infertility
Ovarian cysts
12.
13. Clinical points:
PCOS is a common endocrine disorder affecting approximately 5-10% of
women of reproductive age. It is diagnosed based on a combination of
clinical, biochemical, and imaging criteria.
14. Lab diagnosis:
Blood test can be used to evaluate hormone levels including:
1) Androgens
2) Estrogens
3) Luteinizing hormone (LH)
4) Thyroid – stimulating hormone (TSH)
5) Follicle- stimulating hormone (FSH)
Imaging studies such as:
A) Pelvic ultrasound can be used to detect ovarian cysts.
15. Tests important in chemical pathology:
Testosterone levels
Luteinizing hormone (LH)
Follicle – stimulating hormone (FSH) levels
Prolactin levels
Glucose levels
16. Gold standard test:
There is no single gold standard test for the diagnosis of PCOS, but a chemical
combination of clinical , biochemical and imaging criteria are used to make
the diagnosis.
17. Planned solution:
The treatments of PCOS depends on the individual’s symptoms and goal.
Treatment options may include lifestyle modification such as weight loss and
exercise , medication to regulate menstrual cycles and hormones levels, and
fertility treatments for those trying to conceive. Regular monitoring of
symptoms and hormones levels is important to ensure the effectiveness of
treatment.
