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The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us .
Background
A 35-year-old woman presents with amenorrhea and galactorrhea over the past 3 months. Previously, she was in her usual state of good health. A review of systems is positive for dry skin, constipation, and a weight gain of 10 lb (4.5 kg) since her last clinic visit. She denies any visual symptoms or headache. She states that she engages in moderate jogging and caloric restriction to prevent further weight gain. The results of a recent home pregnancy test were negative.
Her medical history is significant for hypothyroidism, which is common in her family, including her oldest child. Her older sister is still menstruating, and her mother underwent menopause at age 49 years. The patient is a retired veteran and recently returned from a 6-month deployment. Her menarche was at age 11 years, and she has had regular menstrual cycles until 3 months ago. She had no difficulty in getting pregnant and had two full-term pregnancies. She has two children, aged 7 and 3 years.
Her only medications are levothyroxine, 88 µg/d, and over-the-counter multivitamin and iron supplements. She does not take an oral contraceptive. She reports taking levothyroxine regularly until about 6 months ago, when she was deployed by the US Army and had to make her supply of levothyroxine last until her next clinic visit.
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Cite this: Ranjodh Singh Gill. A 35-Year-Old Soldier With Galactorrhea and Amenorrhea - Medscape - May 24, 2021.
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