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Endocrinología, Diabetes y Nutrición (English ed.)
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Inicio Endocrinología, Diabetes y Nutrición (English ed.) Herlyn–Werner–Wunderlinch: An unusual presentation in a patient with Prader...
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Vol. 71. Issue 4.
Pages 171-176 (April 2024)
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Vol. 71. Issue 4.
Pages 171-176 (April 2024)
Review article
Herlyn–Werner–Wunderlinch: An unusual presentation in a patient with Prader–Willi syndrome
Síndrome de Herlyn-Werner-Wunderlich: Una forma de presentación inusual en pacientes con síndrome de Prader-Willi
Laura Costaa,
Corresponding author
lcosta@tauli.cat

Corresponding author.
, Emma Garcia-Graua, Laura Toledoa, Nuria Burgayaa, Ramon Cosa, Mireia Rojasa, Olga Giménez-Palopb, Assumpta Caixasb
a Obstetrics and Gynaecology Department, Gynaecological Unit, Spain
b Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT-CERCA-ISCIII, Department of Medicine, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
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Abstract

Herlyn–Werner–Wunderlich syndrome is an uncommon urogenital anomaly defined by uterus didelphys, obstructed hemi-vagina and unilateral renal anomalies. The most common clinical presentation is dysmenorrhoea following menarche, but it can also present as pain and an abdominal mass.

Prader–Willi syndrome is a rare neuroendocrine genetic syndrome. Hypothalamic dysfunction is common and pituitary hormone deficiencies including hypogonadism are prevalent.

We report the case of a 33-year-old female with Prader–Willi syndrome who was referred to the Gynaecology clinic due to vaginal bleeding and abdominal pain. Abdominal ultrasound revealed a haematometra and haematocolpos and computed tomography showed a uterus malformation and a right uterine cavity occupation (hematometra) as well as right kidney agenesis.

Vaginoscopy and hysteroscopy were performed under general anaesthesia, finding a right bulging vaginal septum and a normal left cervix and hemiuterus. Septotomy was performed with complete haematometrocolpos drainage. The association of the two syndromes remains unclear.

Keywords:
Prader–Willi syndrome
Herlyn–Werner–Wunderlichs syndrome
Obstructed hemivagina
Hypogonadism
Resumen

El síndrome de Herlyn-Werner-Wunderlich es una anomalía urogenital infrecuente definida por útero didelfo, hemivagina obstruida y anomalías renales unilaterales. La presentación clínica más común es la dismenorrea después de la menarquia, pero también puede presentarse como dolor y masa abdominal.

El síndrome de Prader-Willi es un síndrome genético neuroendocrino poco común. A menudo se acompaña de disfunción hipotalámica y son frecuentes las deficiencias de hormonas hipofisarias, incluido el hipogonadismo.

Se presenta el caso de una mujer de 33 años con síndrome de Prader-Willi que acude a consulta de Ginecología por sangrado vaginal y dolor abdominal. La ecografía abdominal reveló hematometra y hematocolpos. Mediante tomografía computarizada se evidenció una malformación del útero y una ocupación de la cavidad uterina derecha (hematometra), así como agenesia del riñón derecho.

Se realizó vaginoscopia e histeroscopia bajo anestesia general, encontrándose un tabique vaginal derecho abultado, y un cuello uterino y hemiútero izquierdos normales. Se realizó septotomía con drenaje completo del hematometrocolpos. La asociación de ambos síndromes no está clara.

Palabras clave:
Síndrome de Prader-Willi
Síndrome de Herlyn-Werner-Wunderlich
Hemivagina obstruida
Hipogonadismo

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