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Autoimmune primary ovarian insufficiency

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Autor(es):
Silva, C. A. ; Yamakami, L. Y. S. ; Aikawa, N. E. ; Araujo, D. B. ; Carvalho, J. F. ; Bonfa, E.
Número total de Autores: 6
Tipo de documento: Artigo Científico
Fonte: AUTOIMMUNITY REVIEWS; v. 13, n. 4-5, p. 4-pg., 2014-04-01.
Resumo

Primary ovarian insufficiency (POI) is defined as sustained amenorrhea, increased follicle-stimulating hormone and low estrogen levels, whereas diminished ovarian reserve (DOR) is characterized as regular menses and alterations of ovarian reserve tests. POI of autoimmune origin may be associated with adrenal autoimmunity, non-adrenal autoimmunity or isolated. This autoimmune disease is characterized by serum ovarian, adrenocortical or steroidogenic cell autoantibodies. POI of adrenal autoimmune origin is the most frequent type observed in 60-80% of patients. Clinically, amenorrhea is the hallmark of POI, however before menstruation stops completely, irregular cycles occur. Infertility, hot flushes, vaginal atrophy, and dyspareunia are also common. Autoimmune oophoritis is characterized by mononuclear inflammatory cell infiltrate in the theca cells of growing follicles, with early stage follicles without lymphocytic infiltration. This infiltrate includes plasma, B and T-cells. A novel classification criterion for autoimmune POI/DOR is proposed subdividing in three distinct categories (possible, probable and confirmed) according to autoantibodies, autoimmune disease and ovarian histology. Unfortunately, up to date guidelines for the treatment of autoimmune oophoritis are not available. Strategies to POI treatment include hormone replacement and infertility therapy. Assisted conception with donated oocytes has been proven to achieve pregnancy by intra cytoplasmic sperm injection in POI women. (C) 2014 Elsevier B.V. All rights reserved. (AU)

Processo FAPESP: 11/12471-2 - Avaliação da reserva ovariana, do anticorpo anti-corpo lúteo e da infecção do trato genital inferior de mulheres adultas com lúpus eritematoso sistêmico, síndrome de Behçet e arterite de Takayasu
Beneficiário:Clovis Artur Almeida da Silva
Modalidade de apoio: Auxílio à Pesquisa - Regular
Processo FAPESP: 09/51897-5 - Terapia anti-TNF em doenças auto-imunes reumatológicas: abordagem de aspectos peculiares
Beneficiário:Eloisa Silva Dutra de Oliveira Bonfá
Modalidade de apoio: Auxílio à Pesquisa - Temático
Processo FAPESP: 08/58238-4 - Autoimunidade na criança: investigação das bases moleculares e celulares da autoimunidade de início precoce
Beneficiário:Magda Maria Sales Carneiro-Sampaio
Modalidade de apoio: Auxílio à Pesquisa - Temático