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Suggestive hypothesis on a case report: Patient presenting with cyclical ovarian cysts coupled to increased cholestatic enzymes
Author(s) -
Conca Paolo,
Cafaro Giovanni,
Savastano Silvia,
Coppola Antonio,
Cimino Ernesto,
Tarantino Giovanni
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13859
Subject(s) - medicine , cholestasis , asymptomatic , liver biopsy , hormone , inflammation , estrogen , gastroenterology , pathology , endocrinology , biopsy
We describe the case of a childbearing‐age woman presenting with spontaneous recurrent functional ovarian cysts and, more interestingly, chronic and asymptomatic elevation of cholestatic parameters. The patient showed no history of chronic viral infections, immunological and metabolic disorders, alcohol abuse and environmental toxins exposition. Hepatic ultrasonography and cholangio‐pancreatography‐magnetic‐resonance excluded any morphological and structural abnormalities, while liver biopsy evidenced only minimal and not specific features of inflammation. Cholestasis indices obtained prompt recovery after each cycle of synthetic hormone therapy, implanted to treat functional ovarian cysts. She has continuously experienced the off‐therapy asynchronous recurrence of liver laboratory abnormalities and functional ovarian cysts. The favorable effect of the synthetic hormone therapy to obtaining a stable recovery of this unexplained long‐lasting cholestatic syndrome could be likely explained by downregulation of an endogenous ovarian overproduction, although estrogen‐regulated local intracellular transduction pathways cannot be excluded.