Non-Cytotoxic Related Primary Ovarian Insufficiency in Adolescents: Multicenter Case Series and Review.

MedStar author(s):
Citation: Journal of Pediatric & Adolescent Gynecology. 31(6):597-604, 2018 Dec.PMID: 29940314Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Pediatric and AdolescentForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Primary Ovarian Insufficiency/et [Etiology] | Adolescent | Amenorrhea/et [Etiology] | Female | Gonadal Dysgenesis/co [Complications] | Humans | Puberty, Delayed/et [Etiology] | Young AdultYear: 2018Local holdings: Available online through MWHC library: 2002 - presentISSN:
  • 1083-3188
Name of journal: Journal of pediatric and adolescent gynecologyAbstract: CONCLUSIONS: Non-cytotoxic POI in adolescents is an uncommon condition with only 64 cases in 6 institutions over 7 years. These patients may not undergo complete etiological workup. Aside from 45X, the most common etiologies are X-chromosome abnormalities or galactosemia.Copyright (c) 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.DESIGN: Case series of patients with POI.INTERVENTIONS: Review and data extraction of records identified with ICD-9 and ICD-10 codes.MAIN OUTCOME MEASURE(S): Data were analyzed for signs and symptoms, workup, and treatments. Complete work-up was based on ACOG guidelines. Characteristics of patients with POI presenting with delayed puberty/primary amenorrhea vs secondary amenorrhea were compared.RESULTS: 135 records were identified. Those who had received cytotoxic therapy (n=52), 46XY gonadal dysgenesis (n=7),or on review did not have POI (n=19) were excluded. Of 57 remaining cases, 16 were 45X, 2 had galactosemia and 4 had X-chromosome abnormalities. Most did not undergo full etiologic evaluation. Girls diagnosed following primary amenorrhea/delayed puberty were less symptomatic and more likely to receive an estrogen patch than those diagnosed following secondary amenorrhea.SETTING: Six tertiary care institutions ParticipantsPatients presenting from 2007-2014 aged 13-21 years diagnosed with non-cytotoxic POI, exclusions gonadotoxic therapy, 46XY gonadal dysgenesis, lack of evidence of hypergonadotropic hypogonadism on chart review.STUDY OBJECTIVE: Primary ovarian insufficiency (POI) in adolescents not due to cytotoxic therapy has not been well studied. Causes of POI have been described in adults, but adolescents may represent a unique subset necessitating a targeted approach to diagnosis, work-up and treatment. We sought to better characterize adolescent POI through a descriptive multicenter study.All authors: Davis Kankanamge C, Gomez-Lobo V, Hakim JC, Kanner L, Patel V, Podany E, Yu VFiscal year: FY2019Fiscal year of original publication: FY2018Digital Object Identifier: Date added to catalog: 2018-07-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 29940314 Available 29940314

Available online through MWHC library: 2002 - present

CONCLUSIONS: Non-cytotoxic POI in adolescents is an uncommon condition with only 64 cases in 6 institutions over 7 years. These patients may not undergo complete etiological workup. Aside from 45X, the most common etiologies are X-chromosome abnormalities or galactosemia.

Copyright (c) 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

DESIGN: Case series of patients with POI.

INTERVENTIONS: Review and data extraction of records identified with ICD-9 and ICD-10 codes.

MAIN OUTCOME MEASURE(S): Data were analyzed for signs and symptoms, workup, and treatments. Complete work-up was based on ACOG guidelines. Characteristics of patients with POI presenting with delayed puberty/primary amenorrhea vs secondary amenorrhea were compared.

RESULTS: 135 records were identified. Those who had received cytotoxic therapy (n=52), 46XY gonadal dysgenesis (n=7),or on review did not have POI (n=19) were excluded. Of 57 remaining cases, 16 were 45X, 2 had galactosemia and 4 had X-chromosome abnormalities. Most did not undergo full etiologic evaluation. Girls diagnosed following primary amenorrhea/delayed puberty were less symptomatic and more likely to receive an estrogen patch than those diagnosed following secondary amenorrhea.

SETTING: Six tertiary care institutions ParticipantsPatients presenting from 2007-2014 aged 13-21 years diagnosed with non-cytotoxic POI, exclusions gonadotoxic therapy, 46XY gonadal dysgenesis, lack of evidence of hypergonadotropic hypogonadism on chart review.

STUDY OBJECTIVE: Primary ovarian insufficiency (POI) in adolescents not due to cytotoxic therapy has not been well studied. Causes of POI have been described in adults, but adolescents may represent a unique subset necessitating a targeted approach to diagnosis, work-up and treatment. We sought to better characterize adolescent POI through a descriptive multicenter study.

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