Serial Inhibin B Measurements in Boys with Congenital Monorchism Indicate Compensatory Testicular Hypertrophy in Early Infancy

2021 ◽  
Author(s):  
Simone Hildorf ◽  
Erik Clasen-Linde ◽  
Dina Cortes ◽  
Magdalena Fossum ◽  
Jorgen Thorup
Keyword(s):  
Diagnostic Procedure ◽  
Compensatory Hypertrophy ◽  
Reproductive Hormones ◽  
Inhibin B ◽  
Third Trimester ◽  
Ductus Deferens ◽  
Blind Ending ◽  
Testicular Hypertrophy ◽  
Unilateral Cryptorchidism

Abstract Aim Congenital monorchism is considered a condition in which an initially normal testis has existed but subsequently atrophied and disappeared due to a third trimester catastrophe (presumably torsion). Since inhibin B concentrations appear related to Sertoli and germ cells number, we evaluated pre- and postoperative inhibin B of boys with congenital monorchism to determine whether the well-known hypertrophy of the contralateral testis was reflected in inhibin B concentrations. Materials and Methods Twenty-seven boys consecutively diagnosed with congenital monorchism (median age 12 months) underwent follow-up with reproductive hormones 1 year postoperatively (median age 25 months). The results were compared with inhibin B of 225 boys with congenital nonsyndromic unilateral cryptorchidism, by converting values to multiple of the median (MoM) for age in normal boys. Results Ten boys (37%) had blind-ending vessels and ductus deferens (vanished testis) and the remaining (63%) had testicular remnants. At the time of diagnostic procedure, monorchid boys did not have significantly lower inhibin B (median 114, range 20–208) than unilateral cryptorchid boys (136, 47–393) (p = 0.27). During follow-up, MoM values of inhibin B increased in monorchid boys (median 0.59 to 0.98) and in unilateral cryptorchid boys (0.69 to 0.89) (both p < 0.0001). Compared with the concentration at surgery, an additional 44% monorchid boys had inhibin B MoM values higher than 1.0, whereas only additional 23% of unilateral cryptorchid boys exhibited such values (p = 0.04). Conclusion Generally, inhibin B MoM values were normalized during follow-up in boys with congenital monorchism, reflecting compensatory hypertrophy within the first 2.5 years of life. The compensatory capacity to increase was better in monorchism than in unilateral cryptorchidism.

Prenatal diethylstilbestrol exposure and reproductive hormones in premenopausal women

2015 ◽  
Vol 6 (3) ◽  
pp. 208-216 ◽  
Author(s):  
L. A. Wise ◽  
R. Troisi ◽  
E. E. Hatch ◽  
L. J. Titus ◽  
K. J. Rothman ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Premenopausal Women ◽  
Reproductive Hormones ◽  
Follicular Phase ◽  
Inhibin B ◽  
Reproductive Age ◽  
Endogenous Hormones ◽  
Reproductive Disorders ◽  
Early Follicular Phase

Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women in the mid-1900s, is a potent endocrine disruptor. Prenatal DES exposure has been associated with reproductive disorders in women, but little is known about its effects on endogenous hormones. We assessed the association between prenatal DES exposure and reproductive hormones among participants from the Harvard Study of Moods and Cycles (HSMC), a longitudinal study of premenopausal women aged 36–45 years from Massachusetts (1995–1999). Prenatal DES exposure was reported at baseline (43 DES exposed and 782 unexposed). Early follicular-phase concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were measured at baseline and every 6 months during 36 months of follow-up. Inhibin B concentrations were measured through 18 months. We used multivariable logistic and repeated-measures linear regression to estimate odds ratios (OR) and percent differences in mean hormone values (β), respectively, comparing DES exposed with unexposed women, adjusted for potential confounders. DES-exposed women had lower mean concentrations of estradiol (pg/ml) (β=−15.6%, 95% confidence interval (CI): −26.5%, −3.2%) and inhibin B (pg/ml) (β=−20.3%, CI: −35.1%, −2.3%), and higher mean concentrations of FSH (IU/I) (β=12.2%, CI: −1.5%, 27.9%) and LH (IU/I) (β=10.4%, CI: −7.2%, 31.3%), than unexposed women. ORs for the association of DES with maximum FSH>10 IU/I and minimum inhibin B<45 pg/ml – indicators of low ovarian reserve – were 1.90 (CI: 0.86, 4.22) and 4.00 (CI: 0.88–18.1), respectively. Prenatal DES exposure was associated with variation in concentrations of FSH, estradiol and inhibin B among women of late reproductive age.

scholarly journals Larger Testes and Higher Inhibin B Levels in Finnish than in Danish Newborn Boys

2006 ◽  
Vol 91 (7) ◽  
pp. 2732-2737 ◽  
Author(s):  
Katharina M. Main ◽  
Jorma Toppari ◽  
Anne-Maarit Suomi ◽  
Marko Kaleva ◽  
Marla Chellakooty ◽  
...  
Keyword(s):  
Sperm Quality ◽  
Genetic Difference ◽  
Reproductive Hormones ◽  
Inhibin B ◽  
Testicular Volume ◽  
Seminiferous Tubules ◽  
Testicular Development ◽  
Testis Size ◽  
University Hospitals ◽  
Prospective Longitudinal

Abstract Context: Recent studies showed that male reproductive health problems, such as cryptorchidism, hypospadias, testicular cancer, and low sperm quality, are more prevalent in Denmark than in Finland. Objectives: We hypothesized that, if fetal testicular dysgenesis contributed to these observations, differences in gonadal development and the hypothalamus-pituitary-testis axis would already be detectable perinatally. Thus, we investigated healthy newborn boys in both countries. Design: This was a prospective, longitudinal population-based study. Setting: Two primary obstetric centers were included at the University Hospitals of Copenhagen, Denmark, and Turku, Finland. Participants: The participants of the study included 633 Danish and 1044 Finnish boys, born at term with appropriate weight for gestational age. Interventions: Ultrasound determination of testis size at 0, 3, and 18 months and blood sampling (n = 727) at 3 months were analyzed. Main Outcome Measures: Testicular volume and reproductive hormones were measured. Results: Testis volume was significantly higher at all ages in Finnish than in Danish boys (medians, 98 vs. 95, 185 vs. 119, and 188 vs. 136 mm3, respectively; P &lt; 0.00001). Testis growth from birth to 3 months was larger in Finnish than in Danish boys (mean, 75 vs. 26 mm3; P &lt; 0.0001). Serum hormone levels were higher in Finnish than Danish boys for inhibin B (median, 456 vs. 385 pg/ml; P &lt; 0.0001), FSH (1.33 vs. 1.21 IU/liter; P &lt; 0.036), and SHBG (143 vs. 136 nmol/liter; P &lt; 0.022). Inhibin B was significantly positively correlated to testicular volume (r = 0.25; P &lt; 0.006). Conclusions: The larger testes and higher inhibin B levels most likely represent a bigger volume of seminiferous tubules in Finnish compared with Danish boys. Although this phenomenon may be attributable to a genetic difference between the two countries, it may also reflect environmental factors influencing testicular development.

scholarly journals Trastuzumab administration during pregnancy: un update

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angeliki Andrikopoulou ◽  
Kleoniki Apostolidou ◽  
Spyridoula Chatzinikolaou ◽  
Garyfalia Bletsa ◽  
Eleni Zografos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Growth Factor Receptor ◽  
First Trimester ◽  
Systemic Review ◽  
Third Trimester ◽  
Her2 Positive ◽  
Exact Test ◽  
Metastatic Setting ◽  
Epidermal Growth

Abstract Background Over than one third (28–58%) of pregnancy-associated breast cancer (PABC) cases are characterized by positive epidermal growth factor receptor 2-positive (HER2) expression. Trastuzumab anti-HER2 monoclonal antibody is still the benchmark treatment of HER2-positive breast tumors. However, FDA has categorized Trastuzumab as a category D drug for pregnant patients with breast cancer. This systemic review aims to synthesize all currently available data of trastuzumab administration during pregnancy and provide an updated view of the effect of trastuzumab on fetal and maternal outcome. Methods Eligible articles were identified by a search of MEDLINE bibliographic database and ClinicalTrials.gov for the period up to 01/09/2020; The algorithm consisted of a predefined combination of the words “breast”, “cancer”, “trastuzumab” and “pregnancy”. This study was performed in accordance with the PRISMA guidelines. Results A total of 28 eligible studies were identified (30 patients, 32 fetuses). In more than half of cases, trastuzumab was administered in the metastatic setting. The mean duration of trastuzumab administration during gestation was 15.7 weeks (SD: 10.8; median: 17.5; range: 1–32). Oligohydramnios or anhydramnios was the most common (58.1%) adverse event reported in all cases. There was a statistically significant decrease in oligohydramnios/anhydramnios incidence in patients receiving trastuzumab only during the first trimester (P = 0.026, Fisher’s exact test). In 43.3% of cases a completely healthy neonate was born. 41.7% of fetuses exposed to trastuzumab during the second and/or third trimester were born completely healthy versus 75.0% of fetuses exposed exclusively in the first trimester. All mothers were alive at a median follow-up of 47.0 months (ranging between 9 and 100 months). Of note, there were three cases (10%) of cardiotoxicity and decreased ejection fraction during pregnancy. Conclusions Overall, treatment with trastuzumab should be postponed until after delivery, otherwise pregnancy should be closely monitored.

Follow-Up of Boys with Unilateral Compensatory Testicular Hypertrophy

1980 ◽  
Vol 33 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Zvi Laron ◽  
Zvi Dickerman ◽  
Irena Ritterman ◽  
Haiuta Kaufman
Keyword(s):  
Testicular Hypertrophy

Gitelman Syndrome in Pregnancy: A Clinical Challenge

2021 ◽  
Author(s):  
Seval Yilmaz Ergani ◽  
Gokcen Orgul ◽  
Harun Egemen Tolunay ◽  
Mustafa Arici ◽  
Aykan Yucel ◽  
...  
Keyword(s):  
Potassium Citrate ◽  
Gitelman Syndrome ◽  
Third Trimester ◽  
Case Presentation ◽  
Early Admission ◽  
Uterine Surgery ◽  
Elective Cesarean ◽  
Gestational Week ◽  
Routine Antenatal Care

Abstract Purpose Disease progress may be affected by pregnancy-related changes, and underlying conditions may also affekt pregnancy outcomes in women with Gitelman syndrome (GS). Case presentation A 35-year-old woman with GS (gravida 2 para 1) was referred to our hospital to start routine antenatal care follow-up at 6 weeks of gestation. At the age of 31, she had been diagnosed with GS after her first uneventful pregnancy. Upon early admission, her serum Mg+level was 0.51 mmol/L and her serum K+level 2.7 mmol/L with normal kidney function tests. She was already taking oral combined potassium citrate and potassium bicarbonate supplementation once a day before pregnancy. At the eighth gestational week, the medication was changed to an oral potassium color sachet of 1.5 gram per day until labor because of the insufficient dosage to maintain optimum potassium levels. She was also taking 365 milligrams of oral magnesium oxide twice a day before and during pregnancy. In the third trimester of the pregnancy, her serum Mg+level was 0.48 mmol/L and serum K+level 2.8 mmol/L. Because of the previous uterine surgery history, she underwent an elective cesarean operation at 39 weeks’ gestation under spinal anesthesia and delivered a healthy 3090-gram female infant. Conclusion Increased need for potassium and magnesium supplementation should be the critical considerations when managing pregnant patients with GS.

CHOREA GRAVIDARUM: A RARE CASE REPORT

2021 ◽  
pp. 71-72
Author(s):  
Aswini Viswanadh ◽  
Sujata Singh ◽  
Vinnisa N. V
Keyword(s):  
Case Report ◽  
Family History ◽  
Gestational Age ◽  
Postpartum Period ◽  
Rare Case ◽  
Third Trimester ◽  
Detailed Evaluation ◽  
Rare Case Report

Chorea gravidarum is the term given to chorea occurring during pregnancy. Here, we report a case of 24 year old primigravida at gestational age 38 weeks 3days ,without any signicant past & family history who presented with chorea gravidarum for the rst time in third trimester. On detailed evaluation no etiology was identied. On follow up in postpartum period, her choreiform movements have reduced in intensity, but is still persisting pointing towards an idiopathic origin.

Paracetamol Poisoning in Pregnancy: An Analysis of the Outcomes of Cases Referred to the Teratology Information Service of the National Poisons Information Service

1990 ◽  
Vol 9 (3) ◽  
pp. 147-153 ◽  
Author(s):  
P.R. McElhatton ◽  
F.M. Sullivan ◽  
G.N. Volans ◽  
R. Fitzpatrick
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Information Service ◽  
First Trimester ◽  
Paracetamol Overdose ◽  
Structural Development ◽  
Paracetamol Poisoning ◽  
Third Trimester ◽  
Neonatal Problems

A study was carried out to investigate the outcome of pregnancy in 115 women who had been exposed to paracetamol overdose. Follow up was obtained in 48 cases. Exposure occurred in all trimesters, and the most striking feature of this series is that the majority of the pregnancy outcomes were normal. None of the mothers died. There were 39 live born infants with no malformation, 14 of whom had been exposed in the first trimester. Four babies, exposed in the third trimester had neonatal problems, but these seem unrelated to paracetamol. There were two live born infants with gross malformations (spina bifida occulta; and cleft lip and palate). However, as the overdoses occurred at weeks 26 and 28 respectively, long after the structural development of these organs, the malformations could not have been caused by the paracetamol. There were two spontaneous abortions, both in the first trimester, which occurred two weeks after the overdose which may be related to the paracetamol. The overall conclusion is that paracetamol overdose per se is not necessarily an indication for termination of pregnancy.

scholarly journals Urachal Tumor: A Case Report of an Extremely Rare Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
José Palla Garcia ◽  
Rita Sampaio ◽  
Carlos Peixoto
Keyword(s):  
Anterior Abdominal Wall ◽  
Bladder Wall ◽  
Disease Recurrence ◽  
Rare Tumor ◽  
Past Medical History ◽  
Third Trimester ◽  
Surgical Specimen ◽  
The Third ◽  
Mucosal Erosion

The urachus is a tubular structure that connects the bladder to the allantois in the embryonic development, involuting after the third trimester. The urachus carcinoma is an extremely rare tumor that accounts for <1% of all bladder cancers. We report a case of a 46-year-old woman, with no past medical history, complaining of hematuria with 6-month duration and a physical exam and an abdominal computed topographic scan revealing an exophytic mass of 6.8 cm longer axis that grew depending on the anterior bladder wall, invading the anterior abdominal wall. Cystoscopy detected mucosal erosion. The biopsy showed structures of adenocarcinoma of enteric type. The surgical specimen showed urachus adenocarcinoma of enteric type with stage IVA in the Sheldon system and stage III in the Mayo system. This case has a 3-year follow-up without disease recurrence.

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