Virilization in a pregnancy

We describe a 29-year old pregnant woman with history of primary hypothyroidism and impaired glucose tolerance presenting in her third trimester with preeclampsia and virilization. Initial investigations revealed markedly elevated serum testosterone, 17 hydroxy-progesterone and a non-suppressed serum cortisol following overnight dexamethasone. Imaging of the adrenals proved normal. At lower segment caesarean section, she had markedly enlarged ovaries with multiple haemorrhagic cysts; compatible with hyperreactio luteinalis. At two months postpartum, there was complete resolution of biochemical hyperandrogenemia with normalization of ovaries. Other causes of virilization such as late onset congenital adrenal hyperplasia, Cushing’s syndrome and placental aromatase deficiency were excluded.

DOI: http://dx.doi.org/10.4038/sjdem.v2i1.4335

Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2012; 2: 43-45