Ovarian reserve in young juvenile idiopathic arthritis patients

Author(s):Show less -

Ferreira, Gabriela R. V. ^[1] ; Tomioka, Renato B. ^{[2, 3]} ; Aikawa, Nadia E. ^{[2, 1]} ; Leon, Elaine P. ^[2] ; Maciel, Gustavo A. R. ^[3] ; Serafini, Paulo C. ^[3] ; Baracat, Edmund C. ^[3] ; Goldenstein-Schainberg, Claudia ^[2] ; Pereira, Rosa M. R. ^[2] ; Bonfa, Eloisa ^[2] ; Silva, Clovis A. ^{[2, 1]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Pediat Rheumatol Unit, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Div Rheumatol, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Discipline Gynecol, Sao Paulo - Brazil

• Document type: Journal article
• Source: MODERN RHEUMATOLOGY; v. 29, n. 3, p. 447-451, MAY 4 2019.
• Web of Science Citations: 2

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-Mullerian 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. (AU)

• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 14/14806-0 - Evaluation of ovarian reserve, antibody anti-corpus luteum, cervicovaginal cytology, lower genital tract infections, metabolomics and ovulatory dysfunction in women with juvenile idiopathic arthritis
• Grantee: Clovis Artur Almeida da Silva
• Support Opportunities: Regular Research Grants