Abstract
Objective : to evaluate the prescription of drug treatment of hyperandrogenism according to the diagnostic algorithm by endocrinologists in clinical practice. Materials and methods : retrospective analysis of 15 case reports of women with established diagnosis of hyperandrogenism. The following parameters were analyzed: clinical manifestations of hyperandrogenism, laboratory studies, prescribed drugs and complications of the treatment. Results : despite of absence of any clinical indications laboratory examination was performed, the diagnosis of hyperandrogenism was established in all cases and glucocorticoid treatment was prescribed to all patients. Because of long-term drug intake signs of drug overdose were assessed: iatrogenic hypercortisolism was observed in 4 women. The abolition of glucocorticoid treatment was performed in all patients because of absence of any indications. Nevertheless, chronic adrenal insufficiency developed in 2 women, which required lifelong replacement glucocorticoid treatment. Conclusions : noncompliance of the diagnostic algorithm of hyperandrogenism has led to iatrogenic hypercortisolism.
Highlights
Objective: to evaluate the prescription of drug treatment of hyperandrogenism according to the diagnostic algorithm by endocrinologists in clinical practice
Results: despite of absence of any clinical indications laboratory examination was performed, the diagnosis of hyperandrogenism was established in all cases and glucocorticoid treatment was prescribed to all patients
Because of long-term drug intake signs of drug overdose were assessed: iatrogenic hypercortisolism was observed in 4 women
Summary
Цель: оценить назначение пациенткам медикаментозной терапии СГА врачами-эндокринологами в клинической практике согласно алгоритму диагностики. Оценивалось наличие клинических признаков гиперандрогении, лабораторное дообследование, схема назначения медикаментозной терапии СГА, а также развитие осложнений проводимого лечения. Results: despite of absence of any clinical indications laboratory examination was performed, the diagnosis of hyperandrogenism was established in all cases and glucocorticoid treatment was prescribed to all patients. Именно оценка вышеуказанных проявлений служит первым этапом в диагностике СГА. Что на сегодняшний день в клинической практике отсутствует стандартизированный подход к оценке клинических проявлений гиперандрогении [4,5]. На сегодняшний день первым этапом диагностического алгоритма СГА является тщательная оценка клинических проявлений гиперандрогении: подсчет гирсутного числа по шкале Ferriman-Gallwey Сбор анамнеза и тщательный объективный осмотр являются первым и важным этапом, так как только наличие клинических проявлений позволяет перейти на второй этап.
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