{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:45:22Z","timestamp":1782398722464,"version":"3.54.5"},"reference-count":21,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Progestogen hypersensitivity (PH) is a rare and underrecognized condition characterized by cyclical allergic reactions to endogenous or exogenous progestogens. We present a 27-year-old woman with an 11-year history of recurrent luteal-phase urticaria, angioedema, and anaphylaxis refractory to antihistamines, corticosteroids, and hormonal suppression. She was diagnosed with PH at age 21. Introduction of elagolix, a GnRH antagonist, led to marked symptomatic improvement by suppressing ovarian hormone production. Due to cost and side effects, definitive surgical management with total laparoscopic hysterectomy and bilateral salpingo-oophorectomy was performed, resulting in complete remission. Fewer than 200 cases are reported in the literature, and standardized diagnostic or treatment protocols are lacking. This case highlights the diagnostic complexity of PH, the therapeutic potential of GnRH antagonists as a bridge to surgery, and the importance of a multidisciplinary approach. It underscores the need for greater awareness, standardized diagnostic criteria, and further research into the immunologic mechanisms underlying PH to guide future management strategies.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf314","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:15:19Z","timestamp":1764854119000},"source":"Crossref","is-referenced-by-count":1,"title":["Elagolix as a Diagnostic and Therapeutic Bridge to Surgery in Refractory Progestogen Hypersensitivity"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4897-2373","authenticated-orcid":false,"given":"Ali Osman","family":"Balkan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Sistla","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin Lyn","family":"Rhinehart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"issue":"9S","key":"2025122921435780600_luaf314-B1","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1016\/j.jaip.2020.08.006","article-title":"Practical guidance for the evaluation and management of drug hypersensitivity: specific drugs","volume":"8","author":"Broyles","year":"2020","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"1","key":"2025122921435780600_luaf314-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11882-018-0758-x","article-title":"Progestogen hypersensitivity","volume":"18","author":"Li","year":"2018","journal-title":"Curr Allergy Asthma Rep"},{"issue":"2","key":"2025122921435780600_luaf314-B3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.autrev.2015.11.003","article-title":"Autoimmune progesterone dermatitis: update and insights","volume":"15","author":"Nguyen","year":"2016","journal-title":"Autoimmun Rev"},{"issue":"4","key":"2025122921435780600_luaf314-B4","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/j.jaip.2016.03.003","article-title":"Progestogen hypersensitivity in 24 cases: diagnosis, management, and proposed renaming and classification","volume":"4","author":"Foer","year":"2016","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"3","key":"2025122921435780600_luaf314-B5","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.jaip.2017.01.019","article-title":"Progestogen hypersensitivity: heterogeneous manifestations with a common trigger","volume":"5","author":"Buchheit","year":"2017","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"1","key":"2025122921435780600_luaf314-B6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s11882-020-0900-4","article-title":"Progestogen sensitization: a unique female presentation of anaphylaxis","volume":"20","author":"Bernstein","year":"2020","journal-title":"Curr Allergy Asthma Rep"},{"issue":"5","key":"2025122921435780600_luaf314-B7","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/ced.14664","article-title":"Intradermal testing for autoimmune progesterone dermatitis: should we be basing the diagnosis on it?","volume":"46","author":"Geros","year":"2021","journal-title":"Clin Exp Dermatol"},{"issue":"1","key":"2025122921435780600_luaf314-B8","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s40618-019-01083-w","article-title":"Non-specific rheumatic manifestations in patients with Hashimoto's thyroiditis: a pilot cross-sectional study","volume":"43","author":"Giuffrida","year":"2020","journal-title":"J Endocrinol Invest"},{"issue":"38","key":"2025122921435780600_luaf314-B9","doi-asserted-by":"crossref","first-page":"e4336","DOI":"10.1097\/MD.0000000000004336","article-title":"Prevalence and clinical significance of nonorgan specific antibodies in patients with autoimmune thyroiditis as predictor markers for rheumatic diseases","volume":"95","author":"Elnady","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"4","key":"2025122921435780600_luaf314-B10","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/ced.12333","article-title":"Catamenial dermatoses: has anyone ever considered prostaglandins?","volume":"39","author":"Verdolini","year":"2014","journal-title":"Clin Exp Dermatol"},{"issue":"4","key":"2025122921435780600_luaf314-B11","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/j.1365-4632.2008.03395.x","article-title":"Autoimmune progesterone dermatitis. 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