Endometriosis and concomitant hypothyroidism: a harbinger of several metabolic defects

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Ogo, E.O
Ede, O
Otesanya, A
Olopade, O.B
Odeniyi, I.A
Fasanmade, O.A
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Endocrinology and metabolism society of Nigeria
Background Endometriosis is a common and debilitating condition for women in the reproductive age group. It leads to several complications and is associated with several metabolic disorders, especially thyroid disease. This case report highlights several of the comorbid conditions endometriosis can lead to. Case Report A 39-year-old lady presented to the private wing outpatient clinic of LUTH with a history of general body pain, fatigue and recurrent fainting-like spells which were attributed to low blood sugars. She had the year previous been treated for endometriosis after presenting with cyclical abdominal pain and later dyspnoea and chest pain which were found to be due to pericardial and pleural effusion. In the course of the investigation (laparoscopy), she was also found to have endometriosis affecting her adnexa, ovaries and peritoneum. She was commenced on goserelin which she couldn’t however tolerate for long. Thereafter she started having the fainting like spells. Her abdominal scan revealed hepatomegaly from grade 2 non-alcoholic fatty liver and her lipid profile demonstrated raised total cholesterol of 7.65mmol, LDL 5,5 and HDL 1,64, TG 1.12. Liver enzymes were mildly raised and her TSH raised 76.5, T3 0.3 and T4 8.68 (both reduced). Her PCV was 35%. Her blood sugars were normal likewise her HBA1c. She was commenced on levothyroxine 50mcg and gradually up titrated to 100mcg and most of her symptoms subsided. She still has body pain is being evaluated to rule out chronic fatigue syndrome. Conclusion Hypothyroidism is commoner in patients with endometriosis. Chronic fatigue syndrome may also coexist with and be confused with hypothyroidism. Metabolic disorders like NAFLD and dyslipidaemia are often seen in patients with hypothyroidism. This patient was unfortunate to have dire consequences of two related conditions: hypothyroidism and endometriosis and serves to remind us of the complex relationship between autoimmune and endocrine/metabolic disorders
Scholarly article
Hypothyroidism , Endometriosis , Concomitant , Lagos , Reproductive age group , Research Subject Categories::MEDICINE
Ogo EO, Ede O, Otesanya A, Olopade OB, Odeniyi IA, Fasanmade OA. Endometriosis and concomitant hypothyroidism: a harbinger of several metabolic defects. EMSON Book of abstracts 2022.