1
|
Ferreira GRV, Tomioka RB, Aikawa NE, Leon EP, Maciel GAR, Serafini PC, Baracat EC, Goldenstein-Schainberg C, Pereira RMR, Bonfá E, Silva CA. Ovarian reserve in young juvenile idiopathic arthritis patients. Mod Rheumatol 2018; 29:447-451. [PMID: 29652213 DOI: 10.1080/14397595.2018.1465646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Juvenile idiopathic arthritis (JIA) occurs during reproductive age, however, there are no systematic data regarding ovarian function in this disease. METHODS Twenty-eight post-pubertal JIA patients and age-matched 28 healthy controls were studied. Complete ovarian function was assessed during the early follicular phase of the menstrual cycle including anti-Müllerian hormone (AMH), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and antral follicle count (AFC) by ovarian ultrasound, and anti-corpus lutheum antibodies (anti-CoL). Demographic data, menstrual abnormalities, disease parameters and treatment were also evaluated. RESULTS The mean current age (22.6 ± 6.59 vs. 22.5 ± 6.59 years, p = .952) was similar in JIA patients and healthy controls with a higher median menarche age [13(8-16) vs. 12(8-14) years, p = .029]. A lower median AMH levels [2.65(0.47-9.08) vs. 4.83(0.74-17.24) ng/mL, p = .029] with a higher LH [8.44 ± 4.14 vs. 6.03 ± 2.80 IU/L, p = .014] and estradiol levels [52.3(25.8-227.4) vs. 38.9(26.2-133.6) pg/mL, p = .008] were observed in JIA compared to control group. Anti-CoL and AFC were similar in both groups (p > .05). Further analysis of JIA patients revealed that current age, disease duration, number of active/limited joints, ESR, CRP, patient/physician VAS, JADAS 71, DAS 28, CHAQ, HAQ, patient/parents PedsQL, PF-SF 36, cumulative glucocorticoid and cumulative methotrexate doses were not correlated with AMH, FSH, estradiol levels or AFC (p > .05). CONCLUSION The present study was the first to suggest diminished ovarian reserve, not associated to hypothalamic pituitary gonadal axis, in JIA patients during reproductive age. The impact of this dysfunction in future fertility of these patients needs to be evaluated in prospective studies.
Collapse
Affiliation(s)
- Gabriela R V Ferreira
- a Pediatric Rheumatology Unit , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Renato B Tomioka
- b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil.,c Discipline of Gynecology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Nadia E Aikawa
- a Pediatric Rheumatology Unit , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil.,b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Elaine P Leon
- b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Gustavo A R Maciel
- c Discipline of Gynecology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Paulo C Serafini
- c Discipline of Gynecology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Edmund C Baracat
- c Discipline of Gynecology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Claudia Goldenstein-Schainberg
- b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Rosa M R Pereira
- b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Eloisa Bonfá
- b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| | - Clovis A Silva
- a Pediatric Rheumatology Unit , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil.,b Division of Rheumatology , Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo , Sao Paulo , Brazil
| |
Collapse
|
2
|
Yamakami LYS, Serafini PC, de Araujo DB, Bonfá E, Leon EP, Baracat EC, Silva CA. Clark CA, Laskin CA. Ovarian reserve in antiphospholipid syndrome: the jury is still out. Lupus 2015; 24: 773. Lupus 2015; 24:1007. [PMID: 26082466 DOI: 10.1177/0961203315591029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/07/2015] [Indexed: 11/17/2022]
Affiliation(s)
- L Y S Yamakami
- Department of Gynecology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - P C Serafini
- Department of Gynecology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - D B de Araujo
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - E Bonfá
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - E P Leon
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - E C Baracat
- Department of Gynecology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - C A Silva
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|