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[Virilizing tumours of the adrenal cortex with unimpaired menstruation (author's transl)].

Virilizing adenomas of the adrenal cortex entail, typically, hirsutism, amenorrhea and hypertrophy of the clitoris. We report two cases of adrenal adenoma, both revealed by hirsutism and significant biological features, but both without any alteration of the menstrual cycle. One of our 2 patients showed moderate hypertrophy of the clitoris. In the first patient, the tumour has been located thanks to dexamethasone--modifiying adrenal secretion, and in the second patient, thanks to angiography. These two cases reported are a warning never to neglect more hirsutism, even, when unobstrusive, and always to undertake minimal hormonal investigations.

Adenoma↗

Response of various indices of iron status to acute iron depletion produced in menstruating women by low iron intake and phlebotomy.

We investigated response sensitivities of indices of iron status to controlled iron depletion and repletion in 11 premenopausal women. The women were depleted of storage iron (as reflected by serum ferritin) through a combination of a low-iron diet and phlebotomy. They then consumed a diet containing 13.7 mg of iron per 2000 kcal, supplemented with either ascorbic acid or placebo (for 5 1/2 weeks) and a daily 50-mg iron supplement (for the subsequent 17 days). The relative sensitivities of different indices for detecting iron depletion were as follows: ferritin greater than % transferrin saturation greater than plasma iron greater than hemoglobin greater than hematocrit greater than zinc protoporphyrin (ZnPP) and erythrocyte protoporphyrin (EP). Ascorbic acid treatment during repletion, before iron supplementation, significantly (P less than 0.05) affected changes in hemoglobin, ZnPP, ZnPP/heme, and EP/heme. Changes in heme synthesis evidently do not occur until iron stores are depleted and, conversely, during iron repletion hematopoiesis must be satisfied before iron stores, as reflected by ferritin, increase. Thus, the use of only one index of iron status is of limited value for detecting iron depletion.

Adult↗

Iron status in a group of Norwegian menstruating women.

Serum ferritin was determined in 170 healthy Norwegian women (18-48 years; median age 36 years) including 23 blood donors. In women with serum ferritin less than or equal to 20 micrograms/l haemoglobin, serum iron and total iron binding capacity were determined. Women using oral contraceptives were excluded. Information was collected on use of contraceptive techniques, habits of iron prophylaxis, and duration of menses. About 40 per cent of the participants used the intra-uterine device. Geometric mean serum ferritin was 26.9 micrograms/l with a prevalence of 21.8 per cent with exhausted iron stores (serum ferritin less than 17 micrograms/l) among the non-donors. In the group with low to empty iron stores (serum ferritin less than or equal to 20 micrograms/l) 13 per cent had anaemia (Hb less than 120 g/l). This may correspond to 4.1 per cent among all the non-donors. The blood donors had a geometric mean serum ferritin of 20.4 micrograms/l and 30 per cent with empty stores. Our study shows that in the group of non-donors there was a tendency to higher prevalence of low or empty iron stores among IUD-users and premenopausal women. In addition to these groups the blood donors are at risk of iron deficiency.

Adolescent↗

Bioavailability of daily low dose iron supplements in menstruating women with low iron stores.

Women (n = 45; 18-48 years) with serum ferritin less than or equal to 20 micrograms/l and haemoglobin greater than 120 g/l participated in an iron supplement bioavailability study. They were randomized to one of three groups and given one of three different low-dose supplements (18-20 mg iron/d) for 6 months. One of the supplements contained haem iron and non-haem iron, the others contained non-haem iron only. Serum ferritin, haemoglobin, serum iron and total iron binding capacity (TIBC) were determined at start and after 1, 3 and 6 months. Dietary intakes were recorded during 4 and 3 consecutive days after 1 and 3 months, respectively, by the aid of household measures and a set of food models. The increase in mean serum ferritin was significant (P less than 0.01) for two of the supplements, the one containing haem iron giving the best result. All the supplements resulted in a significant (P less than 0.011) mean decrease in TIBC. No significant differences between the groups were found in daily intakes of food factors known to influence iron absorption. The improvement in iron status was therefore attributed to the supplements. None of the supplements caused iron intolerance. Thus low-dose iron supplements given to iron depleted non-anaemic women may be an alternative to high-dose therapy.

Adolescent↗

[Mental disorders associated with disorders of menstruation function].

Based on the data of randomized clinical and psychopathological investigation of 100 somatically healthy females with masked depression the author conventionally distinguished three main variants of "gynecological masks" of endogenic depression. A four-year experience of outpatient management of these persons in psychiatric room of the outpatient setting was discussed.

Adult↗

Recurrent anaphylaxis in menstruating women: treatment with a luteinizing hormone-releasing hormone agonist--a preliminary report.

Recurrent idiopathic anaphylaxis is an illness consisting of recurring anaphylactic or anaphylactoid attacks of unknown cause. A patient has been described whose attacks appeared to be associated with endogenous progesterone secretion and who was treated successfully with an analog of luteinizing hormone-releasing hormone (LHRH). This report summarizes the treatment of four additional women with recurrent anaphylaxis in a randomized, double-blind trial of an LHRH agonist and placebo. Two out of the four women experienced remission of their symptoms with the LHRH analog. The patients who responded to therapy had experienced systemic anaphylactoid reactions after provocation with an LHRH infusion and the intradermal injection of medroxyprogesterone; the nonresponders had no adverse reactions to either challenge. Ovarian suppression with LHRH agonist may benefit a subset of women with recurrent idiopathic anaphylaxis.

Adult↗