A Case Report of Hyperestrogenism in Prader-Willi Syndrome
Bibliographic record
Abstract
OBJECTIVE: Prader-Willi syndrome (PWS) is associated with multiple endocrinopathies, including hypogonadism. The mechanism underlying hypogonadism in PWS is thought to be secondary to hypothalamic dysfunction, primary gonadal defect, or a combination of both. Here, we present a case of hyperestrogenism in PWS due to concomitant polycystic ovary syndrome (PCOS) and therapeutic considerations regarding hormone replacement therapy (HRT). CASE REPORT: An 18-year-old woman with PWS transferred to adult care from pediatrics was found to have hyperestrogenism (specifically, elevated estrone with normal estradiol levels). Additionally, she demonstrated oligomenorrhea and hyperandrogenism, meeting diagnostic criteria for PCOS. After 3 months of therapy with cyclic medroxyprogesterone alone, she developed normal withdrawal bleeding. DISCUSSION: Given the elevated estrone and normal estradiol levels, our patient's hyperestrogenism is thought to be a direct result of her hyperandrogenism due to peripheral conversion. Prolonged exposure to unopposed estrogen is an established risk factor for endometrial cancer development in PCOS; thus, this was taken into account regarding her HRT, and she was treated with cyclic progesterone alone. CONCLUSION: Women with PWS are typically treated with combined estrogen and progesterone HRT; however, our case, a unique presentation of PCOS in PWS, demonstrated the importance of tailoring HRT to a patient's specific needs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".