Avaliação da reserva ovariana, anticorpo anti-corpo lúteo, citologia cérvico-vaginal, infecções do trato genital inferior, metabolômica e disfunção ovulatória em mulheres com artrite idiopática juvenil

Resumo

Juvenile idiopathic arthritis (JIA) is a group of diseases characterized by arthritis of unknown origin with onset before 16 years of age, the most common chronic rheumatic disease in childhood . Treatment with drugs modifying the course of disease, particularly methotrexate (MTX) and biological agents is allowing better prognosis and raises issues related to gonadal function in young patients. Recently, it was observed that high cumulative doses of MTX reduced ovarian reserve in patients with systemic lupus erythematosus, juvenile onset , and the presence of anti-corpus luteum antibody were associated. The recent advance of metabolomics technology has also allowed the identification of several biomarkers related to chronic diseases, including seven classes of components : prostaglandins, steroid hormones, acylcarnitines, aminoacids, biogenic amines and hexoses phospho and sphingolipids. However, there is no study evaluating the interference of these metabolites on ovarian reserve in patients with JIA. Despite the higher prevalence of cervicovaginal abnormalities in patients with systemic lupus erythematosus, no study has evaluated these changes and the presence of lower genital tract infections in patients with JIA. Moreover, a considerable part of the population with JIA using anti -inflammatory non-steroidal drugs (NSAIDs) to control the disease. These drugs can induce ovulatory dysfunction in women, but no studies have evaluated this change in JIA patients on chronic NSAID use. (AU)