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卵巢早衰女性自身免疫性疾病的患病率。

Prevalence of autoimmune disease in women with premature ovarian failure.

作者信息

Grossmann Benita, Saur Sebastian, Rall Katharina, Pecher Ann-Christin, Hübner Stephanie, Henes Joerg, Henes Melanie

机构信息

Eberhard Karls University of Tübingen, Tübingen, Germany.

Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases (INDIRA), Tübingen University Hospital, Tübingen, Germany.

出版信息

Eur J Contracept Reprod Health Care. 2020 Feb;25(1):72-75. doi: 10.1080/13625187.2019.1702638. Epub 2019 Dec 18.

Abstract

The aim of the study was to investigate the relationship between premature ovarian failure and autoimmune disease. This interdisciplinary prospective study included 52 consecutively recruited women with premature ovarian failure, aged 18-40 years. Diagnosis of premature ovarian failure was defined as amenorrhoea lasting more than 4 months and anti-Müllerian hormone levels below the age-appropriate range. Women with an abnormal karyotype or Fragile X syndrome were excluded from the study. All participants were screened by a rheumatologist for the presence of underlying autoimmune disease. The average age at first diagnosis of premature ovarian failure was 29.5 years; 92.3% of participants ( = 48) presented with a secondary amenorrhoea, while only 7.7% ( = 4) had primary amenorrhoea. Of all 52 participants, 40.4% ( = 21) had at least one confirmed autoimmune disease, including Hashimoto's disease, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, Crohn's disease, polyglandular autoimmune syndrome and coeliac disease. Response rates for hormonal stimulation therapy were low and the presence of autoimmune disease was associated with poor infertility treatment outcome. We found a high prevalence of autoimmune disease in women with premature ovarian failure. Screening for autoimmune diseases should be offered to all women with premature ovarian failure.

摘要

本研究的目的是调查卵巢早衰与自身免疫性疾病之间的关系。这项跨学科前瞻性研究纳入了52名连续招募的年龄在18至40岁之间的卵巢早衰女性。卵巢早衰的诊断定义为闭经持续超过4个月且抗苗勒管激素水平低于相应年龄范围。染色体核型异常或患有脆性X综合征的女性被排除在研究之外。所有参与者均由风湿病学家进行筛查,以确定是否存在潜在的自身免疫性疾病。首次诊断卵巢早衰的平均年龄为29.5岁;92.3%的参与者(n = 48)表现为继发性闭经,而只有7.7%(n = 4)有原发性闭经。在所有52名参与者中,40.4%(n = 21)至少有一种确诊的自身免疫性疾病,包括桥本氏病、系统性红斑狼疮、类风湿性关节炎、银屑病、克罗恩病、多腺体自身免疫综合征和乳糜泻。激素刺激疗法的反应率较低,且自身免疫性疾病的存在与不孕症治疗效果不佳有关。我们发现卵巢早衰女性中自身免疫性疾病的患病率很高。应为所有卵巢早衰女性进行自身免疫性疾病筛查。

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