Drospirenone in the treatment of severe premenstrual cerebral edema in a woman with antiphospholipid syndrome, lateral sinus thrombosis, situs inversus and epileptic seizures

Cerebral Vein Thrombosis in the Antiphospholipid Syndrome: Analysis of a Series of 27 Patients and Review of the Literature

(1) Background: The Antiphospholipid Syndrome (APS) is a systemic autoimmune disorder characterized by arterial and/or venous thrombosis, pregnancy morbidity and raised titers of antiphospholipid antibodies. Cerebral vein thrombosis (CVT) is a rare form of cerebrovascular accident and an uncommon APS manifestation; the information in the literature about this feature consists of case reports and small case series. Our purpose is to describe the particular characteristics of CVT when occurs as part of the APS and compare our series with the patients published in the literature. (2) Methods: We conducted a retrospective observational study collecting data from medical records in three referral centers for APS and CVT, and a systematic review of the literature for CVT cases in APS patients. (3) Results: Twenty-seven APS patients with CVT were identified in our medical records, the majority of them diagnosed as primary APS and with the CVT being the first manifestation of the disease; additional risk factors for thrombosis were identified. The review of the literature yielded 86 cases, with similar characteristics as those of our retrospective series. (4) Conclusions: To our knowledge, our study is the largest CVT series in APS patients published to date, providing a unique point of view in this rare thrombotic manifestation.

The cytokine-hormone axis - the link between premenstrual syndrome and postpartum depression

Premenstrual syndrome (PMS) and related disorders, and postpartum depression (PPD) can affect women to the extent that their quality of life and that of their near ones can be severely impaired. This review focuses on the different theories regarding the etiologies of PMS and PPD, and attempts to draw a link between the two. Theories focus mainly on hormonal and cytokine factors throughout different phases in the female reproductive cycle. Changes in this symptomatology during pregnancy are also reviewed, as are changes in hormones and cytokine levels. Hypotheses are thus developed as to why the symptoms experienced in PMS often subside during pregnancy yet may recur and be exacerbated after birth, giving rise to the symptoms experienced in PPD.

Isolating with physical restraint low status female monkeys during luteal phase might make an appropriate premenstrual depression syndrome model

BACKGROUND

Rhesus monkeys (Macaca mulatta) have a close phylogenetic relationship to humans, and have a similar 28-day menstrual cycle with similar hormonal fluctuations. In this study, we attempt to establish the premenstrual depression syndrome of rhesus monkey (M. mulatta) models by isolation with physical restraint of low social status young female monkeys during their luteal phase.

METHODS

Low social status young female rhesus monkeys (M. mulatta) were isolated with physical restraint during their luteal phase by using a specifically designed isolating-cage. During the entire menses cycle, serum levels of 5-hydroxytrypamine, noradrenalin and adrenalin were detected by capillary zone electrophoresis, and the changes in the serum levels of progesterone, estradiol and prolactin were investigated by radioimmunoassay. At the same time, the pharmaceutical interference effect of Jingqianshu granule, a traditional Chinese medicine specifically used to cure premenstrual depression patients, was tested using this premenstrual depression syndrome monkey model.

RESULTS

After being immured in two consecutive menstrual cycles, monkeys presented depressive symptoms during the premenstrual phase of three consecutive menstrual cycles. The serum contents of the three kinds of monoamine neurotransmitters in depressive monkeys were significantly higher than the normal ones. The serum levels of progesterone and prolactin increased obviously, and a marked change in the pattern of progesterone secretion could be observed. Moreover, the premenstrual depressive symptoms of model group monkeys could not only be cured by Jingqianshu granule, but the higher serum levels of prolactin and monoamine neurotransmitters in these monkeys could be reduced by this herbal medicine. These data were well in line with clinical observations of women with premenstrual depression syndrome.

CONCLUSION

Our results in this study for the first time indicate that isolation with physical restraint of low status young female monkeys during their luteal phase makes an appropriate premenstrual depression syndrome model. This model might potentially facilitate studies on the etiology of premenstrual depression syndrome and the development of better methods for the therapy of this disease.