Menstrual and hormonal alterations in juvenile systemic lupus erythematosus.
Menstrual cycles of 30 patients with juvenile systemic lupus erythematosus (JSLE) were compared with 30 age-matched controls. The mean age of patients with JSLE and controls was similar (17.4 +/- 3.2 vs 17.06 +/- 2.08 years, P = 0.66). The mean menarche age was higher in JSLE than controls (13.13 +/- 1.4 vs 11.56 +/- 1.5 years, P = 0.0008). On the contrary, the mean maternal menarche age was similar in both groups (P = 0.62). Menstrual abnormalities and longer length cycles were more frequently observed in JSLE than controls (63% vs 10%, P = 0.0001; 23% vs 0%, P = 0.0105, respectively). The median of follicle stimulating hormone was significantly higher in patients with JSLE compared with controls (4.6 vs 3.4 IU/L, P = 0.0207), and the median of progesterone was lower (32.5 vs 70 ng/mL, P = 0.0033). The median of luteinizing hormone was lower in patients with JSLE with menstrual abnormalities versus normal cycles (2.9 vs 5.5 IU/L, P = 0.019) and both had a high percentage of decreased progesterone levels (63% vs 73%, P = 0.70). Our findings support the notion that menstrual disturbances are frequent and may be associated with pituitary dysfunction leading to a decreased progesterone production. We also reported that in spite of premature ovarian failure being a rare event in JSLE the follicular reserve seems to be low regardless of intravenous cyclophosphamide treatment.
Medeiros
P B
PB
Paediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
Febrônio
M V
MV
Bonfá
E
E
Borba
E F
EF
Takiuti
A D
AD
Silva
C A A
CA
D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D007986:Luteinizing Hormone / Q000097:blood; D008572:Menarche / Q000502:physiology; D008597:Menstrual Cycle / Q000378:metabolism*; D010900:Pituitary Diseases / Q000209:etiology / Q000503:physiopathology; D011374:Progesterone / Q000097:blood*; D055815:Young Adult
D007166:Immunosuppressive Agents; D011374:Progesterone; D003520:Cyclophosphamide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone