Noncytotoxic-Related Primary Ovarian Insufficiency in Adolescents: Multicenter Case Series and Review.
Noncytotoxic-Related Primary Ovarian Insufficiency in Adolescents: Multicenter Case Series and Review.
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DOI：
10.1016/j.jpag.2018.06.006
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发表时间：
2018-12
影响因子：
1.8
通讯作者：
Gomez-Lobo V
中科院分区：
文献类型：
--
作者：
Kanner L;Hakim JCE;Davis Kankanamge C;Patel V;Yu V;Podany E;Gomez-Lobo V
未经细胞毒治疗的青少年原发性卵巢功能不全(POI)尚未得到很好的研究。POI的病因在成人中已有描述，但青少年可能是一个独特的亚群，需要有针对性的诊断、体检和治疗。我们试图通过一项描述性多中心研究来更好地描述青少年POI。POI患者系列病例。六家三级护理机构。2007年至2014年的患者，年龄13-21岁，诊断为非细胞毒性POI，排除了接受性腺毒性治疗的患者，患有46XY性腺发育不全，或在图表回顾中缺乏高促性腺激素低促性腺功能低下的证据。根据《国际疾病分类》第九版或第十版代码确定的记录的审查和数据提取。对数据进行了体征和症状、检查和治疗的分析。完整的体检是基于美国妇产科医师学会的指导方针。比较青春期延迟/原发闭经与继发性闭经的POI患者的特点。确定了135条记录。接受细胞毒治疗(n=52)、46XY性腺发育不全(n=7)或复习中没有POI(n=19)的患者被排除。其余57例中，16例为45X，2例为半乳糖血症，4例为X染色体异常。大多数人没有接受全面的病因学评估。与继发性闭经后确诊的女孩相比，在原发闭经/青春期延迟后确诊的女孩症状较少，更有可能接受雌激素贴片。青少年非细胞毒性POI是一种罕见的情况，据我们所知，7年多来只有6个机构的病例。这些患者可能不会接受全面的病原学检查。除45x外，最常见的病因是X染色体异常或半乳糖血症。
Primary ovarian insufficiency (POI) in adolescents not due to cytotoxic therapy has not been well studied. Causes of POI have been described in adults, but adolescents might represent a unique subset necessitating a targeted approach to diagnosis, workup, and treatment. We sought to better characterize adolescent POI through a descriptive multicenter study. Case series of patients with POI. Six tertiary care institutions. Patients presenting from 2007 to 2014 aged 13-21 years diagnosed with noncytotoxic POI, with exclusions for those who received gonadotoxic therapy, with 46XY gonadal dysgenesis, or lack of evidence of hypergonadotropic hypogonadism on chart review. Review and data extraction of records identified according to International Classification of Diseases Ninth or Tenth Revision codes. Data were analyzed for signs and symptoms, workup, and treatments. Complete workup was on the basis of American College of Obstetricians and Gynecologists guidelines. Characteristics of patients with POI who presented with delayed puberty/primary amenorrhea vs secondary amenorrhea were compared. One hundred thirty-five records were identified. Those who had received cytotoxic therapy (n = 52), 46XY gonadal dysgenesis (n = 7), or on review did not have POI (n = 19) were excluded. Of 57 remaining cases, 16 were 45X, 2 had galactosemia, and 4 had X-chromosome abnormalities. Most did not undergo full etiologic evaluation. Girls diagnosed after primary amenorrhea/delayed puberty were less symptomatic and more likely to receive an estrogen patch than those diagnosed after secondary amenorrhea. Noncytotoxic POI in adolescents is an uncommon condition with, to our knowledge, only 64 cases in 6 institutions over 7 years. These patients might not undergo complete etiological workup. Aside from 45X, the most common etiologies were X-chromosome abnormalities or galactosemia.
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影响因子：
1.8
作者：
Chaloutsou, Kallirroi;Aggelidis, Pantelis;Michala, Lina
通讯作者：
Michala, Lina
影响因子：
3.1
作者：
Naessen, Sabine;Bergstrom, Ingrid;Landgren, Britt-Marie
通讯作者：
Landgren, Britt-Marie
影响因子：
3.2
作者：
Morse, Helena;Elfving, Maria;Ora, Ingrid
通讯作者：
Ora, Ingrid
DOI：
10.1056/nejmcp0808697
发表时间：
2009-02-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Nelson LM
通讯作者：
Nelson LM
影响因子：
5.8
作者：
Cartwright, Beth;Robinson, Jillian;Rymer, Janice
通讯作者：
Rymer, Janice