Natural history of autoimmune primary ovarian insufficiency in patients with Addison's disease: from normal ovarian function to overt ovarian dysfunction
| Autor: | Annamaria De Bellis, Giuseppe Bellastella, Alberto Falorni, Ernesto Aitella, Mariluce Barrasso, Maria Ida Maiorino, Elio Bizzarro, Antonio Bellastella, Dario Giugliano, Katherine Esposito |
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| Přispěvatelé: | DE BELLIS, Annamaria, Bellastella, G, Falorni, Alberto, Aitella, Ernesto, Barrasso, Mariluce, Maiorino, Maria Ida, Bizzarro, Elio, Bellastella, Antonio, Giugliano, Dario, Esposito, Katherine |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent PREDICTION Endocrinology Diabetes and Metabolism ANTI-MULLERIAN HORMONE POLYENDOCRINE SYNDROMES ADRENAL INSUFFICIENCY CELL ANTIBODIES FAILURE AUTOANTIBODIES WOMEN OOPHORITIS CRITERIA 030209 endocrinology & metabolism Context (language use) Primary Ovarian Insufficiency Premature ovarian insufficiency 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Addison Disease Internal medicine Follicular phase medicine Humans Longitudinal Studies Prospective Studies Young adult Prospective cohort study Subclinical infection 030219 obstetrics & reproductive medicine Predictive marker business.industry Ovary General Medicine medicine.disease Addison's disease Female business Follow-Up Studies |
| Popis: | ContextWomen with autoimmune Addison’s disease with normal ovulatory cycles but positive for steroid cell antibodies (StCA) have been considered at risk of premature ovarian insufficiency (POI).DesignThirty-three women younger than 40 years, with subclinical-clinical autoimmune Addison’s disease but with normally ovulatory menses, were followed up for 10 years to evaluate the long-term time-related variations of StCA, ovarian function and follicular reserve. All patients and 27 control women were investigated at the start and every year for the presence and titre of StCA (by indirect immunofluorescence), serum concentrations of anti-Mullerian hormone (AMH) and ovarian function at four consecutive menses every year.ResultsAt the start of the study StCA were present in 16 women (group 1), at low/middle titres (≤1:32) in seven of them (43.8%, group 1A), at high titres (>1:32) in the remaining nine patients (group 1B, 56.2%), while they were absent from 17 patients (group 2). During the follow-up period, all women in group 1A remained StCA-positive at low/middle titres with normal ovulatory menses and normal gonadotrophin and AMH levels, while all patients in group 1B showed a further increase of StCA titres (1:128–1:256) and progressed through three stages of ovarian function. None of the patients in group 2 and controls showed the appearance of StCA or ovarian dysfunction during the follow-up.ConclusionsThe presence of StCA at high titres can be considered a good predictive marker of subsequent development of autoimmune POI. To single out the stages of autoimmune POI may allow a timely therapeutic choice in the subclinical and early clinical stages. |
| Databáze: | OpenAIRE |
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