Autoimmune oophoritis as a mechanism of follicular dysfunction in women with 46,XX spontaneous premature ovarian failure
Autoimmune oophoritis as a mechanism of follicular dysfunction in women with 46,XX spontaneous premature ovarian failure
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DOI：
10.1016/j.fertnstert.2005.04.060
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发表时间：
2005-10-01
影响因子：
6.7
通讯作者：
Nelson, LM
中科院分区：
文献类型：
--
作者：
Bakalov, VK;Anasti, JN;Nelson, LM
目的：评估血清肾上腺皮质自身抗体与组织学证实的自身免疫性淋巴细胞性卵巢炎之间的关系。设计：对照，前瞻性。设置：三级研究中心。患者：266名46，XX自发性卵巢早衰的妇女。干预：10名妇女的卵巢活检。主要结果测量：通过间接免疫荧光法评估血清肾上腺皮质自身抗体，通过免疫组织化学淋巴细胞标记物评估自身免疫性卵巢炎。我们在4名肾上腺皮质自身抗体检测阳性的妇女中获得了自身免疫性卵巢炎的组织学诊断，并在6名肾上腺皮质自身抗体检测阴性的妇女的卵巢活检中排除了这一诊断（4/4 vs. 0/6）。经阴道超声检查评估，患有组织学确诊的自身免疫性卵巢炎的女性卵巢总体积更大（11.4 +/- 5.6 mL与1.5 +/- 0.4 mL）（平均值+/- SEM）。他们也更可能有亚临床肾上腺功能不全和雄激素缺乏的临床体征（3/4 vs. 0/6）。总体而言，266名女性中有10名肾上腺皮质自身抗体检测呈阳性（3.8%，95%置信区间：1.8%-6.5%）。结论：在患有46，XX自发性卵巢早熟、衰竭的女性中，她们的首要问题是血清肾上腺皮质自身抗体与组织学证实的自身免疫性卵巢炎之间存在明显的相关性。（Fertil Sterilg（R）2005;84：958-65. (c)2005年，美国生殖医学会（American Society for Reproductive Medicine）
Objective: To assess the association between serum adrenal cortex autoantibodies and histologically confirmed autoimmune lymphocytic oophoritis.Design: Controlled, prospective.Setting: Tertiary research center.Patient(s): Two hundred sixty-six women with 46,XX spontaneous premature ovarian failure.Intervention(s): Ovarian biopsy in 10 women.Main Outcome Measure(s): Serum adrenal cortex autoantibodies assessed by indirect immunofluorescence and autoimmune oophoritis assessed by immunohistochemical lymphocyte markers.Result(s): We obtained a histologic diagnosis of autoimmune oophoritis in four women who tested positive for adrenal cortex autoantibodies and excluded this diagnosis in ovarian biopsies from six women who tested negative for adrenal cortex autoantibodies (4/4 vs. 0/6). Women with histologically confirmed autoimmune oophoritis had a greater total ovarian volume as assessed by transvaginal sonography (11.4 +/- 5.6 mL vs. 1.5 +/- 0.4 mL) (mean +/- SEM). They were also more likely to have subclinical adrenal insufficiency and clinical signs of androgen deficiency (3/4 vs. 0/6). Overall, 10/266 women tested positive for adrenal cortex autoantibodies (3.8%, 95% confidence interval: 1.8%-6.5%).Conclusion(s): In, women who present with 46,XX spontaneous premature ovarian,failure as their primary concern there is a clear association between serum adrenal cortex autoantibodies and the presence of histologiically confirmed autoimmune oophoritis. (Fertil Sterilg (R) 2005;84:958-65. (c) 2005 by American Society for Reproductive Medicine.)