{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:10Z","timestamp":1784557030944,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"3","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"\n Summary<\/jats:title>\n Ovarian hyperstimulation syndrome (OHSS) usually occurs in patients undergoing assisted reproduction techniques and ovulation induction. Its variant, spontaneous ovarian hyperstimulation syndrome, a potentially life-threatening disorder, is uncommon and only a few cases have been reported in association with hypothyroidism. This study analysed five patients with untreated chronic hypothyroidism presenting with multicystic ovaries, isosexual precocious puberty, and delayed bone age; subsequently, the follow-up and regression of ovarian pathology was assessed. Two patients had presented to the emergency department with menorrhagia and hypotension, of these, one had ovarian torsion at presentation. Three patients presented to the outpatient department: one for evaluation of short stature, one for premature menarche, and another with polycystic ovaries. They were all diagnosed with long-standing, untreated chronic hypothyroidism. There was regression of the size of the cystic ovaries on subsequent follow-up. In all these patients, long-standing hypothyroidism had resulted in ovarian hyperstimulation syndrome. The potentially life-threatening complications of this syndrome may be prevented by careful screening and a strong index of clinical suspicion at the outset.<\/jats:p>\n <\/jats:sec>\n \n Learning points<\/jats:title>\n \n \n Long-standing, untreated primary hypothyroidism may result in spontaneous ovarian hyperstimulation syndrome.<\/jats:p>\n <\/jats:list-item>\n \n A high index of suspicion is required for an early and accurate diagnosis.<\/jats:p>\n <\/jats:list-item>\n \n The requirement for interdepartmental collaboration between gynaecology and endocrinology departments is essential for the successful management of this life-threatening but easily treatable disorder.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-23-0084","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T14:25:51Z","timestamp":1727447151000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":2,"title":["The clinical diversity of primary hypothyroidism presenting as a spontaneous ovarian hyperstimulation syndrome"],"prefix":"10.1530","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8826-806X","authenticated-orcid":true,"given":"Krishna","family":"Prabha","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5903-6110","authenticated-orcid":true,"given":"K Felix","family":"Jebasingh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Londhe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Unit II, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Radiology Case Reports","first-page":"1050","article-title":"Spontaneous ovarian hyperstimulation syndrome with primary hypothyroidism: imaging a rare entity","volume":"10","author":"Ilanchezhian","year":"2015","unstructured":"Ilanchezhian SMohan SVRamachandran R & Babu SR. Spontaneous ovarian hyperstimulation syndrome with primary hypothyroidism: imaging a rare entity. Radiology Case Reports2015101050. (https:\/\/doi.org\/10.2484\/rcr.v10i1.1050)"},{"key":"bib2","series-title":"World Journal of Radiology","first-page":"20","article-title":"Spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma associated with primary hypothyroidism","volume":"5","author":"Kanza","year":"2013","unstructured":"Kanza REGagnon SVilleneuve HLaverdiere DRousseau IBordeleau E & Berube M. Spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma associated with primary hypothyroidism. World Journal of Radiology2013520\u201324. (https:\/\/doi.org\/10.4329\/wjr.v5.i1.20)"},{"key":"bib3","series-title":"Australasian Medical Journal","article-title":"A case of spontaneous ovarian hyperstimulation syndrome (sOHSS) due to hypothyroidism","volume":"09","author":"Putta","year":"2016","unstructured":"Putta TJohn RThomas NJebasingh FPeedicayil A & Eapen A. A case of spontaneous ovarian hyperstimulation syndrome (sOHSS) due to hypothyroidism. Australasian Medical Journal201609. (https:\/\/doi.org\/10.21767\/AMJ.2015.2542)"},{"key":"bib4","series-title":"Journal of Human Reproductive Sciences","first-page":"158","article-title":"Case report on spontaneous ovarian hyperstimulation syndrome following natural conception associated with primary hypothyroidism","volume":"6","author":"Sridev","year":"2013","unstructured":"Sridev S & Barathan S. Case report on spontaneous ovarian hyperstimulation syndrome following natural conception associated with primary hypothyroidism. Journal of Human Reproductive Sciences20136158\u2013161. (https:\/\/doi.org\/10.4103\/0974-1208.117164)"},{"key":"bib5","series-title":"Obstetrics and Gynecology","first-page":"809","article-title":"Spontaneous ovarian hyperstimulation and primary hypothyroidism with a naturally conceived pregnancy","volume":"93","author":"Cardoso","year":"1999","unstructured":"Cardoso CGGra\u00e7a LMDias TClode N & Soares L. Spontaneous ovarian hyperstimulation and primary hypothyroidism with a naturally conceived pregnancy. Obstetrics and Gynecology199993809\u2013811. (https:\/\/doi.org\/10.1016\/s0029-7844(9800435-9)"},{"key":"bib6","series-title":"Journal of Clinic Case Reports","first-page":"113","volume":"2","author":"Hedayati Emami","year":"2012","unstructured":"Hedayati Emami MHJournal of Clinic Case Reports20122113. (https:\/\/doi.org\/10.4172\/2165-7920.1000113)"},{"key":"bib7","series-title":"Journal of Assisted Reproduction and Genetics","first-page":"120","article-title":"Ovarian hyperstimulation syndrome complicating a spontaneous singleton pregnancy: a case report","volume":"18","author":"Chae","year":"2001","unstructured":"Chae HDPark EJKim SHKim CHKang BM & Chang YS. Ovarian hyperstimulation syndrome complicating a spontaneous singleton pregnancy: a case report. Journal of Assisted Reproduction and Genetics200118120\u2013123. (https:\/\/doi.org\/10.1023\/a:1026543027300)"},{"key":"bib8","first-page":"433","article-title":"Innecco Ar\u00eaas I &","volume":"2","author":"Souza","year":"2021","unstructured":"Souza OELInnecco Ar\u00eaas I & Martins Resende BA. Spontaneous ovarian hyperstimulation syndrome in a pregnant woman with hypothyroidism: a case report. F & S Reports20212433\u2013439. (https:\/\/doi.org\/10.1016\/j.xfre.2021.07.004)"},{"key":"bib9","series-title":"Journal of Clinical Endocrinology & Metabolism","first-page":"555","article-title":"Costagliola Presence","volume":"91","author":"De Leener","year":"2006","unstructured":"De Leener AMontanelli LVan Durme JChae HSmits GVassart G Costagliola Presence and absence of follicle-stimulating hormone receptor mutations provide some insights into spontaneous ovarian hyperstimulation syndrome physiopathology. Journal of Clinical Endocrinology & Metabolism200691555-562. (https:\/\/doi.org\/10.1210\/jc.2005-1580)"},{"key":"bib10","series-title":"American Journal of Obstetrics and Gynecology","first-page":"1220","article-title":"Spontaneous ovarian hyperstimulation syndrome associated with hypothyroidism","volume":"160","author":"Rotmensch","year":"1989","unstructured":"Rotmensch S & Scommegna A. Spontaneous ovarian hyperstimulation syndrome associated with hypothyroidism. American Journal of Obstetrics and Gynecology19891601220\u20131222. (https:\/\/doi.org\/10.1016\/0002-9378(8990196-8)"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2024\/3\/EDM23-0084.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2024\/3\/EDM23-0084.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2024\/3\/EDM23-0084.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:16Z","timestamp":1784555296000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":10,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1530\/edm-23-0084","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}