Endocrine Dysfunction in Recurrent Pregnancy Loss

Introduction: Miscarriage is the spontaneous loss of theconceptus before 20 weeks of gestation. Several disordersare known to contribute to recurrent miscarriage including:chromosomal anomalies; anti-cardiolipin antibodies;endocrine disorders such as poorly controlled diabetesmellitus; hyperprolactinaemia and thyroid diseases; andpelvic anatomic abnormalities. Study aimed to investigate theendocrine dysfunction in recurrent pregnancy lossMaterial and Methods: A prospective study comprising 70subjects was carried out. Fifty cases of recurrent abortionsconstituted the study group. Twenty healthy multipara femalesof same reproductive age group constituted the controlgroup. Venous blood samples were collected, and serum wasanalyzed for hormone analysis (T3, T4, TSH, LH, FSH, PRL,Testosterone) by ELISA method.Results: The mean prolactin level in cases of recurrentabortions was 19.96 ng/ml, while in controls was 11.77 ng/ml. The p value was 0.006 which was found to be statisticallyhighly significant. The mean TSH level in recurrent abortionscases was 5.81 mIU/L, while in controls was 1.95 mIU/L. Thep value was 0.004 which was found to be statistically highlysignificant.Conclusion: The patients with recurrent abortions hadsignificantly raised levels of TSH and Prolactin. Theprevalence of thyroid disorder and hyperprolactinemiawere higher in pregnant women with a history of recurrentabortion compared with healthy pregnant control population.Universal screening of pregnant females for endocrine profilecan improve the foetal outcome as well as social well-beingof females.

Toxic Epidermal Necrolysis- A Caution before Prescribing Anti-Epileptics.

We report a case of Toxic Epidermal Necrolysis (TEN) in a 10 year old male child resulted from inadvertent anti-epileptic usage. Steven-Johnson Syndrome (SJS) /TEN has been seen as a side-effect of many drugs like Cotrimoxazole, Phenytoin, Carbamazepine, Valproic acid, NSAID’S, Allopurinol. Etc., but TEN in a patient who is on valproic acid with addition of lamotrigine is rare which is a point of interest in our case which was successfully treated with Intravenous immunoglobulins.