Hypothalamic Syndrome Research Articles

Periostin concentrations in childhood-onset craniopharyngioma patients.

Periostin is highly expressed in craniopharyngioma (CP)-associated fibroblasts and has been identified as a marker for non-alcoholic fatty liver disease (NAFLD). Half of CP patients with hypothalamic syndrome develop NAFLD. We hypothesized that periostin concentration is elevated in biological fluids of CP and associated with pathological hepatic parameters, indicating increased risk for NAFLD. A cross-sectional study on 35 patients with sellar masses (SMP) recruited in the German Childhood Craniopharyngioma Registry (32 CP, 2 xanthogranuloma, 1 pilocytic astrocytoma), three short-statured patients with isolated growth hormone deficiency, five short-statured patients with normal findings in GH-stimulating tests and decreased insulin-like growth factor (IGF)-1 and seven healthy controls. Periostin was measured by Elisa in serum, urine and saliva. Periostin serum, urine and saliva concentrations in CP were similar to concentrations of the other groups. Hypothalamic involvement/hypothalamic lesions, degree of obesity as well as hepatic enzymes were not associated with elevated periostin concentrations. Due to low patient numbers with pathological hepatic parameters, missing imaging data on the degree of steatosis hepatis and the lack of histological proof of NAFLD, no definitive conclusions can be drawn from measured periostin concentrations in serum. Interestingly, the subgroup of patients with decreased IGF-1 levels showed elevated concentrations of serum periostin when compared with other groups. In CP, periostin concentrations are not associated with known risk factors for NAFLD such as hepatic and metabolic parameters, obesity and hypothalamic lesions. Accordingly, periostin does not seem to be a suitable marker for NAFLD in CP.

FREQUENCY OF METABOLIC SYNDROME AND OTHER COMPLICATIONS OF OBESITY IN PRACTICE OF A CHILD ENDOCRINOLOGIST

The analysis of 121 medical history of children with obesity at the age from 5 to 17 years is carried out. The leading complications and concomitant diseases are: gastropathology (96 %), cardiac disorders (50 %), metabolic disorders (47 %), hypothalamic syndrome (46 %), accelerated or accelerated physical development (85 %), delayed sexual development in boys 25 %), accelerated puberty (60 %) and hyperandrogenism in girls (5 %). It was found that the metabolic syndrome was 1,5 times more common in children with a 1-2 degree of obesity than in children with a 3 degree of obesity. The high morbidity of children with obesity is revealed, which reflects the reduced immunological reactivity of the organism.

From appetite setpoint to appetition: 50years of ingestive behavior research.

I review the main themes of my 50-year research career in ingestive behavior as a graduate student at the University of Chicago and a professor at the City University of New York. A seminar course with my Ph.D. mentor, S. P. Grossman, sparked my interest in the hypothalamic obesity syndrome. I developed a wire knife to dissect the neuropathways and the functional disorder responsible for the syndrome. An elevated appetite setpoint that permitted the overconsumption of palatable foods appeared central to the hypothalamic syndrome. In brain-intact rats, providing an assortment of highly palatable foods (the cafeteria diet) stimulated diet-induced obesity that mimicked elements of hypothalamic obesity. Studies of the determinants of food palatability led to the discovery of a "new" carbohydrate taste (maltodextrin taste) and the confirmation of a fatty taste. In addition to oral taste receptors, gut nutrient sensors stimulated the intake/preference for carbohydrate- and fat-rich foods via an appetition process that stimulates brain reward systems. My research career greatly benefited from many diligent and creative students, collaborators and technicians and research support from my university and the National Institutes of Health.

Studies of narcolepsy in Russia. Historical view

Narcolepsy is a hardly known and obscure disease for Russian doctors while the first description and studying of the disease in Russia occurred almost simultaneously with the rest of the world. The contribution of Russian neurology in the studying of narcolepsy remains underestimated, especially in identifying the clinical features (A. Vein's 'narcoleptic pentad'), the concept of the pathogenesis (hypothalamic syndrome), the determination of provoking factors (postinfectious, postvaccinal reacions) and the use of effective medications (sodium oxybate).

Endocrine and metabolic assessment in adults with Langerhans cell histiocytosis

ContextDiabetes insipidus (DI) is one of most common complications of Langerhans cell histiocytosis (LCH) but prevalence of anterior pituitary deficiencies and metabolic alterations have not been clearly defined yet. ObjectivesEvaluate prevalence of endocrine and metabolic manifestations in a cohort of patients affected by Pulmonary LCH. MethodsObservational cross-sectional study on 18 adults (7 M/11 F, 42±12years) studied for complete basal and dynamic endocrine lab tests and glucose metabolism. ResultsHypothalamic-pituitary endocrine alterations were found in 9 patients: 9 had DI, 5 Growth Hormone Deficiency (GHD), 5 central hypogonadism, 3 central hypothyroidism and 1 central hypoadrenalism. Hyperprolactinemia and hypothalamic syndrome were found in 2 patients each. All these central endocrine alterations were always associated to DI. Five of the 10 MRI performed showed abnormalities. Prevalence of obesity and glucose alterations (either DM or IFG/IGT) were respectively 39% and 33%, higher than expected basing on epidemiological data on general Italian population. Multi-system-LCH without risk-organ involvement (LCH MS-RO−) seems to have slightly higher prevalence of insulin resistance, glucose alterations and metabolic syndrome than LCH with isolated lung involvement (LCH SS lung+). A papillary BRAFV600E positive thyroid carcinoma was diagnosed in one patient. ConclusionsThe presence of anterior pituitary deficiencies should be systematically sought in all LCH patients with DI both at diagnosis and during the follow-up by basal and dynamic hormonal assessment. Patients with pulmonary LCH, particularly those with MS disease, have a worse metabolic profile than general population. Occurrence of papillary thyroid carcinoma has been reported.

Особливостi перебiгу гiпоталамiчного синдрому в пiдлiткiв Пiвнiчної Буковини

Особливостi перебiгу гiпоталамiчного синдрому в пiдлiткiв Пiвнiчної Буковини

THE ROLE OF CLINICO-ANAMNESTIC FACTORS IN FORMATION OF REPRODUCTIVE DISORDERS IN HYPOTHALAMIC SYNDROME IN WOMEN

The role of clinical and anamnestic factors in the formation of reproductive disorders in the hypothalamic syndrome in 107 women in the Astrakhan region aged 21 to 32 years was assessed. Analysis of the results of the survey showed that 87,7 % of the subjects had aggravated heredity and complications of the perinatal period, which are an unfavorable premorbid background for the formation of reproductive disorders in the hypothalamic syndrome.

Diagnosis, treatment, clinical course, and prognosis of childhood-onset craniopharyngioma patients.

For decades gross-total resection was the preferred treatment option in childhood-onset craniopharyngioma, assuming that radical strategies at the time of initial diagnosis and treatment would result in cure. Recent reports on long-term prognosis, novel treatment approaches, and molecular genetics provide new insights into more risk-adapted treatment strategies in order to prevent sequelae such as hypothalamic syndrome. A search for original articles published between 2000 and 2016 was performed in PubMed, Science Citation Index Expanded, EMBASE and Scopus. The search terms used were "craniopharyngioma", "hypothalamus", "pituitary", "obesity", "irradiation", and "neurosurgery". The clinical, neuroradiological and surgical definition of hypothalamic involvement is a fundamental factor related to postoperative poor outcome, progressive obesity and neuropsychological impairment after surgical removal. There is a need to change the previous "gold-standard" objective of a primary radical tumor removal in all cases by the new paradigm of a limited resection plus focused radiotherapy in patients with hypothalamic lesions. Hypothalamic involvement and treatment-related hypothalamic lesions are associated with the highest risk of postoperative sequelae. Three dimensional intensity modulated proton beam radiotherapy has potential advantage of over photon beam methods to focus and limit the radiation effects to optic and hypothalamic structures. Preclinical, in vivo mouse models of craniopharyngioma have potential advantage to investigate molecular pathways deregulated in the tumor and to test the use of specific drugs. As expertise has been shown to have impact on post-treatment morbidity, medical societies should establish criteria of adequate professional expertise for the treatment of craniopharyngioma.

Morbidité et impact sur la participation sociale du craniopharyngiome de l’enfant

This was a descriptive study, including all patients having presented childhood craniopharyngioma (before 18 years of age), followed in the Lyon region between 2007 and 2013. The main criterion was the LIFE-H results, completed by the patient or the carer. Of 21 patients included in the study, 14 completed the questionnaire, a mean 6.7 years after the diagnosis (SD: 3.9 years). The mean total LIFE-H score was 8.4 (SD: 1.03) for a normal score estimated at 10 in the general population. The lowest scores affected the nutrition, community life, and recreation dimensions. No patient had a normal score on all dimensions; 57% of the patients had more than three dimensions affected. The variability of the results between patients was lower for some dimensions with high means (fitness, personal care, communication, housing, mobility, responsibilities, and education) than in others (nutrition, interpersonal relationships, community life, employment, and recreation) with rather low means. All patients had an endocrinological deficit, 19% hypothalamic syndrome, 52% an impaired fulfillment feeling, 76% visual impairment, 14% neurologic impairment, and 91% neurocognitive impairment. In the entire group of patients, 57% were able to attend a normal school (of which 38% needed a personal helper), 43% had to enter a specialized school. In patients in a specialized school, the LIFE-H results were significantly lower in the nutrition, communication, housing, and recreation dimensions. Girls also had significantly better results in many dimensions than boys. Heavy comorbidity goes with childhood craniopharyngioma and affects patients' participation in life activities, which is not very low but multidimensional (more than three affected dimensions). This participation is mainly affected in social dimensions, whereas in cerebral palsy, where the LIFE-H has been tested several times, the daily activities dimensions are more affected. Patients with childhood craniopharyngioma are affected in their participation in daily activities, mainly in the social dimensions. This could be improved with systematic diagnosis of these participation impairments, with the goal of adapted multidisciplinary management.

Risk-adapted, long-term management in childhood-onset craniopharyngioma.

This report is a review of findings on the diagnosis, treatment, clinical course, follow-up, and prognosis of craniopharyngioma patients with special regard to clinical trials and long-term management. Literature search on Pubmed for paper published after 1994. Craniopharyngiomas are rare, embryonic malformations of the sellar/parasellar region with low histological grade. Clinical manifestations are related to increased intracranial pressure, visual impairment, and hypothalamic/pituitary deficiencies. If the tumor is favorably localized, therapy of choice is complete resection, with care taken to preserve hypothalamic and optic functions. In patients with unfavorable tumor location (i.e. involvement of hypothalamic areas), recommended therapy is limited hypothalamus-sparing surgical strategy followed by irradiation. Irradiation has proven effective in treatment of recurrences and progression. Surgical lesions and/or anatomical involvement of posterior hypothalamic areas can result in serious sequelae, mainly hypothalamic syndrome. It is crucial that craniopharyngioma be managed as a frequently chronic disease, providing ongoing care of pediatric and adult patients' by experienced multidisciplinary teams in the context of multicenter trials.

Maternal overnutrition programs hypothalamic neuropeptides and metabolic syndrome in offspring

Maternal overnutrition programs hypothalamic neuropeptides and metabolic syndrome in offspring

Childhood craniopharyngioma: What about participation?

Craniopharyngioma is a rare, benign central nervous system tumor, which may be source of multiple complications, from endocrinology to vision, neurology and neurocognitive fonctions. This morbidity can lead to participation restrictions, as described in the International Clasification of Functioning. Primary objective of this study was to measure participation in a population of children and young adults having been affected by a childhood carniopharyngioma, using the LIFE-H questionnaire (Assessment of Life Habits), valid as a participation measure in various pediatric disabilities. We also examined potential links between the tumor characteristics, the complications and the participation. Descriptive, multicenter study, including all patients having presented a childhood craniopharyngioma (before 18), followed in Lyon region between 2007 and 2013. Main criteria was the LIFE-H results, completed by the patient or the carer. On 21 patients included in the study, 14 have completed the questionnaire, with a mean answer delay of 6.7 years after the diagnosis (SD: 3.9 years). Mean total LIFE-H score was 8.4 (SD: 1.03) for a normal score estimated at 10 in general population. The lowest scores affected nutrition, community life and recreation dimensions. All patients had a endocrinological deficit, 19% an hypothalamic syndrome, 52% an impaired fullfilness feeling, 76% visual impairment, 14% a neurologic impairment, 91% a neurocognitive impairment. 57% of all patients could keep on attending a normal school, 43% had to enter a specific school. In patients in specific school, LIFE-H results were significantly lower in nutrition, communication, housing and recreation dimensions. Patients with childhood craniopharyngioma have their participation affected, mainly in the social dimensions. We could enhance it with systematic diagnosis of those participation impairements, with the goal of a suitable multidisciplinary management.

Magnetic resonance imaging as predictor of functional outcome in craniopharyngiomas.

Quality of life of craniopharyngioma patients can be severely impaired by derangement of hypothalamic function. A classification, taking into account preoperative hypothalamic damage, evaluated by magnetic resonance imaging (MRI), and correlating it with postoperative weight change is still missing in the literature. The aim of our study is to identify objective radiological criteria as preoperative prognostic factors for hypothalamic damage. Pre- and post-operative MRI and clinical data of 47 patients, treated at our Institution for craniopharyngioma, were retrospectively analyzed, based on radiological variables, identified as prognostic factor for hypothalamic involvement. Main factors associated with postoperative obesity were hypothalamic hyperintensity in T2-weighted/FLAIR imaging (p < 0.033), mammillary body involvement according to Müller classification (p < 0.020), unidentifiable pituitary stalk (p < 0.001), dislocated chiasm (p < 0.038), either not visible infundibular recess (p < 0.019) or unrecognizable supra-optic recess (p < 0.004), and retrochiasmatic tumor extension (p < 0.019). Accordingly, postoperative hypothalamic syndrome was associated with peritumoral edema in T2-weighted/FLAIR images (p < 0.003), unidentifiable hypothalamus (p < 0.024), hypothalamic compression (p < 0.006), fornix displacement (p < 0.032), and unrecognizable supra-optic recess (p < 0.031). Ultimately, variables identified as predictive factors of postoperative hypothalamic syndrome were the degree of hypothalamic involvement according to the classification described by Sainte-Rose and Puget (p < 0.002; grade 0 vs 2 p < 0.001), Van Gompel (p < 0.002; grade 0 vs 1, p < 0.027; and grade 0 vs 2, p < 0.002), and Muller (p < 0.006; grade 0 vs 1, p < 0.05; and grade 0 vs 2, p < 0.004). The identification of these predictive factors will help to define and score the preoperative hypothalamic involvement in craniopharyngioma patients.

An infantile exogenous Cushing syndrome caused by topical steroid

Corticosteroids are widely use for the treatment of various diseases. Long-term use of corticosteroids may lead to development of Cushing syndrome and hypothalamic pituitary adrenal axis suppression. However, iatrogenic Cushing syndrome from absorption of topical steroids to systemic circulation is less common comparing to parenteral or oral use. Infantile age group have greater risks for systemic side effects of the drugs because their skin has poorly developed barrier function and large surface area. We reported a 5-month-old female child was admitted to our hospital with puffiness of face and excessive weight gain after 4 months old. She was born at term with an uneventful pregnancy with a birth weight of 3.4 kg. Her body weight was 8.2 kg (+2SDS), height was 63.5 cm (+0.2SDS). Physical examination showed her was moon face appearance, generalized obesity, hirsutism and buffalo hump. There were few erythema and weeping present at skin fold areas. Blood pressure was 105/68 mmHg (>95th percentile). Past history revealed that the child had diaper dermatitis at 3.5 month of age. She was prescribed a topical combination drug containing nystatin, neomycin, gramicidin and triamcinolone acetonide from private pediatric clinic. Since then she was applying the drug 3-4 times daily on neck, axilla, diaper area and all skin fold areas. Totally drug usage was 30 g in 6 weeks. Investigations showed hemoglobin of 15 g/dL, white blood cell count 18,240/mm3, platelet count 471,000/mm3, blood glucose 74 mg/dL and normal electrolyte, renal and liver function. Ultrasonography of whole abdomen revealed no abnormality. Random PM cortisol was low (0.2 mcg/dL). Secondary adrenal insufficiency was suspected. 1-mcg ACTH stimulation test was done and the peak cortisol was 1.9 mcg/dL. Therefore, exogenous Cushing syndrome and secondary adrenal insufficiency due to overuse of topical combination drug which containing moderate potency steroid was diagnosed. She was promptly treatment by discontinued applying the drug and administered steroid during stress. This report highlights the importance of prolonged use of moderate potency topical steroids can causes hypothalamic pituitary adrenal axis suppression and Cushing syndrome, especially during infantile period. Therefore, limiting the use of moderate- to high-potency topical steroids in children and provide information about potential adverse effects to the caregivers are crucial. Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Hyperandrogenism. Cases of Combination of Different Variants of Hyperandrogenism in Adolescent Girls with the Peripheral Form of Hyperandrogenism

Hyperandrogenism is a pathological process associated with an excessive effect of androgens in a female organism. In addition to the appearance changes hyperandrogenism (HA) can declare itself by some disorders of reproductive system functioning (anovulation, sterility, miscarriage). The causes of hyperandrogenism can be absolutely different by their pathogenesis conditions. Such external (peripheral) manifestations of hyperandrogenism as hirsutism can be determined by the only reason - excess of 5a-reductase enzyme. There are more cases of combined (associated) forms in the clinical practice. The article considers the cases of combinations of various forms of hyperandrogenism with peripheral forms and their influence on the change of clinical and laboratory parameters. The highest frequency of the excess of 5a-reductase enzyme was found in the group of girls with congenital adrenal dysfunction - 75 %, among the girls with a polycystic ovary syndrome the frequency of this pathology was 9,5 %, and among the girls with hypothalamic syndrome of pubertal period - 14,3 %. The combination of any hyperandrogeny form with the excess of 5a-reductase enzyme was accompanied by hirsutism increase, reduction of mammary glands in adolescents, suprarenal hormones level increase - DEA-s and 17-OHPg. In the case of combination of congenital adrenal dysfunction or hypothalamic syndrome of pubertal period with the excess of 5a-reductase enzyme the laboratory parameters of hyperandrogenism (testosterone, index of free testosterone) were expressed more intensively. In the case of the combination of the excessive production of 5a-reductase enzyme with a polycystic ovary syndrome the diagnosis was more complicated because the index of free testosterone was normal. In the case of combined forms polycystic ovary syndrome is not frequently proved by the laboratory hyperandrogenism, more often these are the cases of incomplete polycystic ovary syndrome.

Kumbhakarna: Did he suffer from the disorder of the hypothalamus?

Kumbhakarna was brother of the evil Raavana in the mythological tale of Ramayana. According the legend, Kumbhakarna had an insatiable appetite and thirst and used to sleep for great lengths of time. He also had an uncontrollable temper, which was feared by many. It is our assessment that Kumbhakarna possibly suffered from hypothalamic obesity. Hypothalamic obesity can be defined as significant polyphagia and weight gain that occurs because of structural or function involvement of the ventromedial nucleus of the hypothalamus bilaterally. The characteristic features are obesity associated with polyphagia. Somnolence is present in 40% of cases. Sham rage is a characteristic behavioral abnormality seen in these patients. All these symptoms are described in the mythological text while describing Kumbhakarna. The episodic nature of Kumbhakarna's symptoms can also be explained by another hypothalamic syndrome called Klein–Levine syndrome. This syndrome is characterized by with periodic episodes of somnolence, hyperphagia and hypersexuality along with other behavioral and cognitive difficulties.

The infundibulo-tuberal syndrome caused by craniopharyngiomas: clinicopathological evidence from an historical French cohort (1705-1973).

Infundibulo-tuberal syndrome groups endocrine, metabolic and behavioral disturbances caused by lesions involving the upper neurohypophysis (median eminence) and adjacent basal hypothalamus (tuber cinereum). It was originally described by Henri Claude and Jean Lhermitte in 1917, in a patient with a craniopharyngioma. This study investigates the clinical, pathological and surgical evidence verifying the infundibulo-tuberal syndrome caused by craniopharyngiomas (CPs). A systematic retrospective review of craniopharyngiomas reported in French literature between 1705 and 1973 was conducted. A total of 128 well described reports providing a comprehensive clinical and pathological description of the tumors were selected. This series represents the historical French cohort of CPs reported in the pre-CT/MRI era. Three major syndromes caused by CPs were categorized: pituitary syndrome (35%), infundibulo-tuberal syndrome (52%) and hypothalamic syndrome (49%). CP topography was significantly related to the type of syndrome described (p < 0.001). Infundibulo-tuberal syndrome occurred in CPs which replaced or invaded the third ventricle floor. In contrast, the majority of sellar/suprasellar CPs growing below the third ventricle showed a pituitary syndrome (82%). Cases with hypothalamic syndrome were characterized by anatomical integrity of the pituitary gland and stalk (p = 0.033) and occurred predominantly in adults older than 41 years old (p < 0.005). Among infundibulo-tuberal symptoms, abnormal somnolence was not related with the presence of hydrocephalus. All squamous-papillary CPs presented psychiatric disturbances (p < 0.001). This historical CP cohort evidences a clinical-topographical correlation between the patient's type of syndrome and the anatomical structures involved by the tumor along the hypophysial-hypothalamic axis.

Neurological form of Erdheim-Chester disease : Case report and review of the literature

ObjectiveReport an unusual presentation of Erdheim-Chester disease revealed by a severe hypothalamic syndrome due to a hypothalamic infiltration and a review of the literature. MethodsA 28-year-old man was admitted for a previous three-month history of asthenia, weight loss, and polyuria-polydipsia. Magnetic resonance imaging on gadolinium T1-weighted sequence revealed a contrast-enhancing hypothalamic mass extending to the floor of the fourth ventricle. Cerebrospinal fluid examination was not suggestive of a germinal lesion. Lung nodules were found on thoracic CT-scan but due to their small size, brain stereotactic biopsies were required. ResultsHistological examination revealed a diffuse polymorphic inflammatory infiltrate including numerous foamy histiocytes which displayed large eosinophilic CD68-positive, CD1a-negative cytoplasms, and collagen deposition, characteristic of Erdheim-Chester disease. Despite symptomatic and etiologic treatment, death occurred within twelve months. ConclusionErdheim-Chester disease is a rare multisystem non-Langerhans cell histiocytosis which typically affects long bones, lung, retroperitoneal and orbital spaces and less frequently primary central nervous system. The pathogenesis of the disease remains unknown and no significant prognostic factor has been correlated with survival time. The recently reported BRAF V600E mutation suggests that specific therapeutics (BRAF inhibitors) should be considered.

Clinical and psychological characteristics and quality of life in teenagers with а long-lasting low-grade fever both associated and not associated with hypothalamic syndrome

Aim. To describe clinical and psychological characteristics and quality of life in teenagers with a long-lasting low-grade fever associated with hypothalamic syndrome. Methods. Life history, objective status were assessed, clinical, laboratory and instrumental examinations were performed, quality of life and psychological status were estimated throughout the study. Clinical and laboratory investigations included complete blood count, urinalysis, stool examination; blood immunochemistry for mycoplasma, chlamydia, herpes virus, cytomegalovirus; blood biochemistry; bacteriology of nose and the pharynx swabs. Instrumental investigations included skull and cervical spine X-Ray, neurophysiological examinations (electroencephalography, echoencephalography, rheoencephalography), cranial and cervical blood vessels ultrasonography. The quality of life was estimated using special pediatric questionnaires (proposed by Molchanova L.F., Izhevsk State Medical Academy). Psychological status was assessed by questionnaires of H. Eysenck (temperament assessment) and C.D. Spielberg (research of personal and situation anxiety). Results. All teenagers underwent a complex treatment according to diagnosis, including antimicrobial treatment in case of chronic infections, antimicrobial treatment and immunostimulators in case of upper and lower airway infections caused by chlamydia and mycoplasma, correction of functional conditions of central nervous system (nootropics, vasoactive drugs, diuretics, anxiolytics, metabolic medications, hypotensives), massages, exercise therapy, physiotherapy, herbal treatment. After the course of treatment relapse of low-grade fever was 4-fold more often in teenagers with hypothalamic syndrome compared to those without. Teenagers with low-grade fever associated with hypothalamic syndrome had higher rates of melancholy, higher anxiety levels, leading to significant alterations of physical and mental health. Those changes may lead to mental and social adaptation problems, borderline social and family behavior, and increased rate of psychosomatic diseases. Conclusion. As it was revealed that relapsing low-grade fever might lead to reduced quality of life, further exacerbations of borderline mental problems, aggravate mental adaptation and social and family behavior problems, these teenagers require family and individual mental therapy, repeated treatment with nootropics, vasoactive drugs, diuretics, anxiolytics.

Metabolic role of lipid peroxidation processes and antioxidant defense system in the pathogenesis of hypothalamic syndrome.

LPO processes and blood antioxidant status were studied in reproductive-age women with the hypothalamic syndrome. The control group consisted of somatically healthy women without reproductive disorders. Female patients with the hypothalamic syndrome were characterized by an imbalance in the LPO-antioxidant defense system, which aggravated the course of the underlying disease.