Autoimmune oophoritis as a mechanism of follicular dysfunction in women with 46,XX spontaneous premature ovarian failure.
OBJECTIVE
To assess the association between serum adrenal cortex autoantibodies and histologically confirmed autoimmune lymphocytic oophoritis.


METHODS
Controlled, prospective.


METHODS
Tertiary research center.


METHODS
Two hundred sixty-six women with 46,XX spontaneous premature ovarian failure.


METHODS
Ovarian biopsy in 10 women.


METHODS
Serum adrenal cortex autoantibodies assessed by indirect immunofluorescence and autoimmune oophoritis assessed by immunohistochemical lymphocyte markers.


RESULTS
We obtained a histologic diagnosis of autoimmune oophoritis in four women who tested positive for adrenal cortex autoantibodies and excluded this diagnosis in ovarian biopsies from six women who tested negative for adrenal cortex autoantibodies (4/4 vs. 0/6). Women with histologically confirmed autoimmune oophoritis had a greater total ovarian volume as assessed by transvaginal sonography (11.4 +/- 5.6 mL vs. 1.5 +/- 0.4 mL) (mean +/- SEM). They were also more likely to have subclinical adrenal insufficiency and clinical signs of androgen deficiency (3/4 vs. 0/6). Overall, 10/266 women tested positive for adrenal cortex autoantibodies (3.8%, 95% confidence interval: 1.8%-6.5%).


CONCLUSIONS
In women who present with 46,XX spontaneous premature ovarian failure as their primary concern there is a clear association between serum adrenal cortex autoantibodies and the presence of histologically confirmed autoimmune oophoritis.
Bakalov
Vladimir K
VK
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
Anasti
James N
JN
Calis
Karim A
KA
Vanderhoof
Vien H
VH
Premkumar
Ahalya
A
Chen
Shu
S
Furmaniak
Jadwiga
J
Smith
B Rees
BR
Merino
Maria J
MJ
Nelson
Lawrence M
LM
D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000097:blood / Q000235:genetics* / Q000473:pathology; D002869:Chromosome Aberrations; D025063:Chromosome Disorders / Q000097:blood / Q000235:genetics / Q000473:pathology; D041321:Chromosomes, Human, X / Q000235:genetics*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D009869:Oophoritis / Q000097:blood / Q000235:genetics* / Q000473:pathology; D006080:Ovarian Follicle / Q000378:metabolism / Q000473:pathology*; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000235:genetics* / Q000473:pathology; D011446:Prospective Studies