leuprolide and Hypothyroidism

Autoimmune estrogen dermatitis is a cyclical cutaneous eruption that occurs premenstrually and goes to the rapid resolution within a few days of menstrual cycles. The disorder has variable clinical manifestations consisting of macules, papules, vesicles, urticarial lesions, bullae, eczematous plaques, and erythema multiforme-like lesions. Herein, we present a case of a 30-year-old woman with attacks of edema and erosions involving the oral and genital mucosal sites on every first day of her menstruation period. She had also multiple endocrinological problems such as hypotroidism and infertility. To determine the sex hormon sensitivity, intradermal skin tests were performed. Based on her personal history and skin test findings, a diagnosis of autoimmune estrogen dermatitis was made. After the oophorectomy, she was free from the skin and mucosal symptoms. We propose that it is important to suspect the diagnosis of autoimmune estrogen dermatitis in patients who present with recurrent cylic eruptions and it must be kept in mind that these patients might have a concomitant infertility.

Topics: Adult; Autoimmune Diseases; Biopsy; Dermatitis; Estrogen Antagonists; Estrogens; Female; Gonadotropin-Releasing Hormone; Humans; Hypothyroidism; Infertility; Leuprolide; Menstrual Cycle; Mouth Mucosa; Ovariectomy; Pain; Pruritus; Skin; Skin Tests; Tamoxifen

Topics: Autoantibodies; Child; Family Health; Female; Fertility Agents, Female; Humans; Hypothyroidism; Leuprolide; Thyroid Diseases; Thyroiditis, Autoimmune

A 45-year-old women with chronic idiopathic thrombocytopenic purpura was given monthly injections of the GnRH agonist leuprolide acetate for the treatment of uterine leiomyoma. Two weeks after the fifth injection, she showed mild symptoms of thyrotoxicosis. At that time, serum thyroxin (T4) and triiodothyronine (T3) levels were elevated whereas TSH level was suppressed. Anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (anti-TPO) antibodies were positive, whereas TSH binding inhibitory immunoglobulin (TBII) was undetectable. Two months later, serum T4 and T3 levels spontaneously decreased below the normal ranges. Five months after the onset of the disease, they returned to normal without any treatment. Anti-TPO and anti-Tg antibodies gradually decreased during the clinical course. Thus, the present case was indicated to be an instance wherein silent thyroiditis developed after leuprolide acetate administration. This is the first report to demonstrate the association of thyroid disorder with leuprolide injection.

Topics: Antineoplastic Agents, Hormonal; Autoantibodies; Female; Humans; Hypothyroidism; Iodide Peroxidase; Leiomyoma; Leuprolide; Middle Aged; Thyroglobulin; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine; Uterine Neoplasms