Intermittent ovarian and thyroid failure and spontaneous twin pregnancy

Ann Clin Biochem 2008;45:331-334
© 2008 Association for Clinical Biochemistry


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Case Reports

Shweta Mehta and
Tim Wang

Department of Clinical Biochemistry, The Royal Surrey County Hospital, Guildford GU2 7XX, UK

Corresponding author: Dr S Mehta, Email: sgauravmehta{at}

Intermittent failure of two endocrine systems is unusual andpresents diagnostic and management challenges. We report a caseof a young woman with intermittent thyroid and ovarian failurewho had spontaneous twin gestation four years after the diagnosisof premature ovarian failure was made. This case demonstratescoincidental biochemical and clinical thyroid and ovarian failureboth of which spontaneously resolved with no treatment, althoughsubsequently irreversible hypothyroidism ensued after the initialrecovery. Elevated gonadotrophins with a menopausal patternon more than one occasion, in an amenorrhoeic patient with menopausalsymptoms, usually indicates permanent ovarian failure. Thiscase demonstrates that this may not be true and while this isprobably a rare occurrence, clinicians need to be aware of thispossibility. It also re-emphasizes the need to consider theclinical picture when interpreting biochemical results.

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