Porto-systemic shunt – a rare cause of hyperandrogenism in children. Two case reports and review of literature
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Mikołaj Danko
, Anna Malinowska
Abstract
Objectives
The main cause of hyperandrogenism in children is congenital adrenal hyperplasia, adrenal and gonadal tumors, polycystic ovary syndrome (PCOs) and Cushing’s disease. In the last 20 years several descriptions of girls with hyperandrogenism and venous porto-systemic shunts appeared in literature.
Case presentation
First case is an eleven and a half-year-old girl, was admitted to Department of Endocrinology because of symptoms of hyperandrogenism. Laboratory tests revealed high serum testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS). The ammonia concentration was also increased. In the abdominal angio-CT scans persistent umbilical vein which connected portal and femoral vein was found. The second case was a seven-year-old boy with symptoms of precocious puberty. Blood tests also revealed high concentration of testosterone, androstenedione, DHEAS and ammonia. Imaging studies showed persistent ductus venosus.
Conclusion
Although pathophysiological relation is not clear, porto-systemic shunts should be considered as a cause of hyperandrogenism of unknown origin in children.
Acknowledgment
The authors thank a lot to Mr Rafał Żegnałek and Ms Anna Małecka for their contribution to edit this manuscript.
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Research funding: None declared.
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Author contributions: Conceptualization, M.D., M.S., E.M. Data curation, M.D Formal analysis, M.D. M.S.,; Investigation, M.D. U.W., A.M.; Methodology, M.D.; Writing-original draft, M.D., M. W-F.; Writing-review & editing, M.S., M.S.-C., M. P.
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Competing interests: The authors have no conflicts of interest to declare.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: We state that the subject and his parents have given their written informed consent to publish their case.
References
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Articles in the same Issue
- Frontmatter
- Review Article
- Pharmacological treatment strategies for patients with monogenic obesity
- Original Articles
- Influence of FTO (Fat mass and obesity) gene and parental obesity on Brazilian children and adolescents adiposity
- Developing waist circumference, waist-to-height ratio percentile curves for Pakistani children and adolescents aged 2–18 years using Lambda-Mu-Sigma (LMS) method
- Screening for celiac disease among children with overweight and obesity: toward exploring celiac iceberg
- Relationship between breastfeeding and obesity in high school girls
- Saudi children with celiac disease: are they at risk of developing type-1 diabetes mellitus?
- The relation of serum endocan and soluble endoglin levels with metabolic control in children and adolescents with type 1 diabetes mellitus
- From infancy to adulthood: challenges in congenital nephrogenic diabetes insipidus
- Thyroid peroxidase antibodies are common in children with HLA-conferred susceptibility to type 1 diabetes, but are weakly associated with thyroid function
- Individualized dosimetry in children and young adults with differentiated thyroid cancer undergoing iodine-131 therapy
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