Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지

Association with Autoimmune Disease in Patients with Premature Ovarian Failure

조기 난소기능 부전증 환자에서 자가면역 질환과의 상관관계

  • Park, Joon-Cheol (Department of Obstetrics and Gynecology, School of Medicine, Keimyung University) ;
  • Kim, Jong-In (Department of Obstetrics and Gynecology, School of Medicine, Keimyung University) ;
  • Rhee, Jeong-Ho (Department of Obstetrics and Gynecology, School of Medicine, Keimyung University)
  • 박준철 (계명대학교 의과대학 산부인과학교실) ;
  • 김종인 (계명대학교 의과대학 산부인과학교실) ;
  • 이정호 (계명대학교 의과대학 산부인과학교실)
  • Published : 2004.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. Methods: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. Results: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. Conclusions: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.

Keywords

References

  1. Coulam CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol 1986; 67: 604-6
  2. Nelson LM, Anasti JN, Flack MR. Premature ova- rian failure. In: Adashi EY, Rock JA, Zev Rosen- waks, editor. Reproductive endocrinology, surgery, and technology. New York: Lippincott-Raven; 1996. p1394-1410
  3. Coulam CB, Ryan RJ. Premature menopause 1.Etio- logy. Am J Obstet Gynecol 1979; 133: 639-43 https://doi.org/10.1016/0002-9378(79)90011-5
  4. Damewood MD, Zacur HA, Hoffman GT, Rock JA. Circulating antiovarian antibodies in premature ova- rian failure. Obstet Gynecol 1986; 68: 850-4
  5. Wheatcroft NJ, Toogood AA, Li TC, Cooke ID, Weetman AP. Detection of antibodies to ovarian antigens in woman with premature ovarian failure. Clin Exp Immunol 1994; 96: 122-8 https://doi.org/10.1111/j.1365-2249.1994.tb06241.x
  6. 김미정, 김현진, 유수정, 김종인, 이정호. 조기 난소기능 부전증 여성에서 난소기능의 복원 및 자발적 임신 2예. 대한산부회지 2000; 43: 145-9
  7. Luborsky J, Llanes B, Davies S, Binor Z, Rad- wanska E, Pong R. Ovarian autoimmunity: greater frequency of autoantibodies in premature meno- pause and unexplained infertility than in the general population. Clin Immunol 1999; 90: 368-74 https://doi.org/10.1006/clim.1998.4661
  8. Kim TJ, Anasti JN, Flack MR, Kimzey LM, De- fensor RA, Nelson LM. Routine endocrine screen- ing for patients with karyotypically normal spon- taneous ovarian failure. Obstet Gynecol 1997; 89:777-9 https://doi.org/10.1016/S0029-7844(97)00077-X
  9. Alper MM, Garner PR. Premature ovarian failure: its relationship to autoimmune disease. Obstet Gy- necol 1985; 66: 27-30
  10. Conway GS, Davis MC, Kaltsas G, Patel A. Char- acterization of idiopathic ovarian failure. Fertil Steril 1996; 65: 337-41 https://doi.org/10.1016/S0015-0282(16)58095-9
  11. Neufeld M, Maclaren NK, Blizzard RM. Two types of autoimmune Addison's disease associated with different polyglandular autoimmune syndromes. Me- dicine 1981; 60: 355-9
  12. May ME, Carey RM. Rapid adrenocorticotropic hor- mone test in practice. Am J Med 1985; 79: 679-84 https://doi.org/10.1016/0002-9343(85)90517-0
  13. Dal Pra C, Chen S, Furmaniak J, Smith BR, Pedini B, Moscon A, et al. Autoantibodies to steroidogenic enzymes in patients with premature ovarian failure with and without Addison's disease. Eur J Endo- crinol 2003; 148: 565-70 https://doi.org/10.1530/eje.0.1480565
  14. Miyake T, Sato Y, Takeuchi S. Implications of cir- culating autoantibodies and peripheral blood lym-phocyte subsets for the genesis of premature ovarian failure. J Reprod Immunol 1987; 12: 163-71 https://doi.org/10.1016/0165-0378(87)90021-0
  15. Belvisi L, Bombelli F, Sironi L, Doldi N. Organ-specific autoimmunity in patients with premature ovarian failure. J Endocrinol Invest 1993; 16: 889 -92 https://doi.org/10.1007/BF03348951
  16. Ishizuka B, Kudo Y, Amemiya A, Yamada H, Ma- tsuda T, Ogata T. Antinuclear antibodies in patients with premature ovarian failure. Hum Reprod 1999; 14: 70-5 https://doi.org/10.1093/humrep/14.1.70
  17. Mignot MH, Schoemaker J, Kleingeld M, Rao BR, Drexhage HA. Premature ovarian failure: the asso- ciation with autoimmunity. Eur J Obstet Gynecol Reprod Biol 1989; 30: 59-66 https://doi.org/10.1016/0028-2243(89)90094-4
  18. Blumenfeld Z, Golan D, Halachmi S, Makler A, Pe- retz BA, Brandes JM, et al. Premature ovarian failure-the prognostic application of autoimmunity on conception after ovulation induction. Fertil Steril 1993; 59: 750-5 https://doi.org/10.1016/S0015-0282(16)55854-3