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Thyroid Pathogenesis Lab Report

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Thyroid Disorder27
Pathogenesis: both hyperthyroidism and hypothyroidism can lead to amenorrhea, though most commonly it present as primary amenorrhea in patients with hypothyroidism. Low levels of thyroid hormones, T3 and T4, stimulate the hypothalamus to produce thyrotropin-releasing hormone (TRH), which stimulates both thyroid stimulating hormone (TSH) and prolactin production in the anterior pituitary. High prolactin levels inhibit GnRH production in the hypothalamus, which is needed for LH and FSH activation in the anterior pituitary. Without LH and FSH, ovarian follicles cannot mature and menstruation does not occur.

Diagnosis: patients who present with signs and symptoms of hypothyroidism, such as low energy, weight gain, cold intolerance, and amenorrhea, should be tested for the disorder with serum measurements of TSH and free T4. High TSH and low free T4 levels suggest hypothyroidism. Conversely, measurement of anti-thyroid antibodies may also be tested, such as anti-thyroglobulin, anti-thyroid peroxidase, and anti-TSH receptor. Clinical suspicion should still be present when patients do not have these characteristic hypothyroid symptoms, but present with primary amenorrhea in the
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Imaging may show the presence of testes, karyotype analysis demonstrates a 46XY karyotype, and serum testosterone concentrations in the normal adult male range. CAIS should also be suspected in females with inguinal hernias or inguinal or labial masses as about 1-2% of these individuals may have CAIS. Newborns with a female phenotype can also be diagnosed if prenatal karyotyping identifies a 46,XY karyotype. In CAIS, testes may be located in the abdomen or inguinal region. If the site and size of the testes cannot be elucidated by ultrasonography then MRI may be more
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