title: Autoimmune oophoritis as a mechanism of follicular dysfunction in women with 46,XX spontaneous premature ovarian failure.
abstract: 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.
authors.affiliation: Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
authors.forename: Vladimir K
authors.initials: VK
authors.lastname: Bakalov
authors.forename: James N
authors.initials: JN
authors.lastname: Anasti
authors.forename: Karim A
authors.initials: KA
authors.lastname: Calis
authors.forename: Vien H
authors.initials: VH
authors.lastname: Vanderhoof
authors.forename: Ahalya
authors.initials: A
authors.lastname: Premkumar
authors.forename: Shu
authors.initials: S
authors.lastname: Chen
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Furmaniak
authors.forename: B Rees
authors.initials: BR
authors.lastname: Smith
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Nelson
mesh_terms: 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