Alviggi C, Carrieri P B, Pivonello R, Scarano V, Pezzella M, De Placido G, Colao A, Matarese G
Department of Gynecological, Obstetric, and Urological Sciences and Medicine of Reproduction, Institute of Experimental Endocrinology and Oncology, National Research Council (IEOS-CNR), Napoli, Italy.
J Endocrinol Invest. 2006 Feb;29(2):182-9. doi: 10.1007/BF03344095.
An adult Caucasian female developed a previously unreported association of pelvic endometriosis (PE) with the triad of alopecia universalis (AU), autoimmune thyroiditis (AT) and multiple sclerosis (MS). Molecular human leukocyte antigen (HLA)-tissue typing of this subject showed the presence of the DR(2) 15 and DR(3) 17 alleles, which are associated to an increased risk of MS and AT, respectively. Clinical onset of AT followed withdrawal of corticosteroid treatment for AU, whereas MS become clinically evident after withdrawal from long-term estroprogestin therapy for PE. This clinical case is presented to discuss the autoimmune origin of PE, its possible association with multiple autoimmune disorders as well as the effect of other factors, such as administration and/ or discontinuation of specific hormonal regimens, on genetic autoimmunity-prone background.
一名成年白种女性出现了盆腔子宫内膜异位症(PE)与全秃(AU)、自身免疫性甲状腺炎(AT)和多发性硬化症(MS)三联征之间此前未报道的关联。对该患者进行的人类白细胞抗原(HLA)分子组织分型显示存在DR(2) 15和DR(3) 17等位基因,它们分别与MS和AT的风险增加相关。AT的临床发作发生在停止针对AU的皮质类固醇治疗之后,而MS在停止针对PE的长期雌孕激素治疗后临床上变得明显。本文呈现这一临床病例,以讨论PE的自身免疫起源、其与多种自身免疫性疾病的可能关联,以及其他因素(如特定激素方案的使用和/或停用)对易发生自身免疫的遗传背景的影响。