Profound hypothyroidism-induced acute menorrhagia resulting in life-threatening anemia.
BACKGROUND
Menorrhagia is a very common gynecologic entity with a broad differential diagnosis which includes both hypothyroidism and hyperthyroidism.


METHODS
We present the case of a 31-year-old patient with acute menorrhagia causing life-threatening anemia that resulted from profound hypothyroidism. Despite timely institution of thyroid replacement, the patient required emergent embolization of a uterine arteriovenous malformation after dilatation and curettage failed to control her bleeding. She was stabilized and discharged to home on the sixth hospital day. Three years later, she successfully conceived and delivered a healthy infant.


CONCLUSIONS
Our case demonstrates the importance of thyroid evaluation in the patient who presents with menorrhagia. Timely management with medical treatment as well as conservative surgical or radiological interventions can facilitate resolution of symptoms and preserve the patient's fertility potential.
Department of Obstetrics and Gynecology, Abington Memorial Hospital, Abington, Pennsylvania 19001, USA.
Vasiliki A
VA
Moragianni
Stephen G
SG
Somkuti
D000328:Adult; D000740:Anemia / Q000209:etiology*; D001165:Arteriovenous Malformations / Q000628:therapy; D003937:Diagnosis, Differential; D004107:Dilatation and Curettage; D004621:Embolization, Therapeutic; D005260:Female; D005298:Fertility; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008595:Menorrhagia / Q000150:complications* / Q000209:etiology* / Q000601:surgery; D013963:Thyroid Hormones / Q000627:therapeutic use; D013972:Thyrotropin / Q000097:blood
D013963:Thyroid Hormones; D013972:Thyrotropin