TREATMENT OF PULMONARY ENDOMETRIOSIS WITH A LONGACTING GnRH AGONIST

Vicki Seltzer, Fred Benjamin
In: Obstetrics & Gynecology · 1990 · vol. 76(Supplement) , pp. 929–930 · doi:10.1097/00006250-199011001-00014 · W4249054306
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A long-acting GnRH agonist achieved complete remission of chest symptoms in a patient with pulmonary endometriosis after surgical and other medical treatments failed.

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This case report describes a 28-year-old woman with biopsy-proven pleural and pelvic endometriosis who experienced persistent chest symptoms despite two surgical interventions and pseudopregnancy treatment. While danazol provided symptomatic relief, it was discontinued due to severe side effects, whereas therapy with the long-acting GnRH agonist leuprolide acetate resulted in complete remission of her pulmonary symptoms. The patient subsequently achieved pregnancy immediately after stopping the medication, highlighting the potential for fertility preservation following this specific hormonal intervention. This paper is centrally about endometriosis — specifically the medical management of thoracic manifestations known as pulmonary or pleural endometriosis.

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Abstract

We report the case of a patient who was successfully treated with a long-acting GnRH agonist for pulmonary endometriosis. This 28-year-old woman had symptomatic pleural endometriosis, documented by biopsies, as well as symptomatic pelvic endometriosis. Two surgical procedures, consisting of excision of pleural endometriotic tissue and partial pleurectomies, failed to relieve her chest symptoms. Little relief was achieved with pseudopregnancy treatment. Satisfactory symptomatic improvement was obtained with danazol, but this medication had to be discontinued because of severe side effects. Trial of a GnRH agonist, leuprolide acetate, achieved complete remission of her chest symptoms; in addition, the patient became pregnant immediately after cessation of therapy. Gonadotropin-releasing hormone agonist therapy may be an important therapeutic alternative for women with pulmonary endometriosis who cannot tolerate danazol treatment and in whom surgical therapy fails to relieve the chest symptoms.
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TREATMENT OF PULMONARY ENDOMETRIOSIS WITH A LONGACTING GnRH AGONIST - Vicki L. Seltzer - Fred Benjamin We report the case of a patient who was successfully treated with a long-acting GnRH agonist for pulmonary endometriosis. This 28-year-old woman had symptomatic pleural endometriosis, documented by biopsies, as well as symptomatic pelvic endometriosis. Two surgical procedures, consisting of excision of pleural endometriotic tissue and partial pleurectomies, failed to relieve her chest symptoms. Little relief was achieved with pseudopregnancy treatment. Satisfactory symptomatic improvement was obtained with danazol, but this medication had to be discontinued because of severe side effects. Trial of a GnRH agonist, leuprolide acetate, achieved complete remission of her chest symptoms; in addition, the patient became pregnant immediately after cessation of therapy. Gonadotropin-releasing hormone agonist therapy may be an important therapeutic alternative for women with pulmonary endometriosis who cannot tolerate danazol treatment and in whom surgical therapy fails to relieve the chest symptoms.

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endometriosis

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