title: Reduced ovarian reserve in patients with Takayasu arteritis.
abstract: OBJECTIVE
  To assess ovarian reserve markers in patients with Takayasu arteritis (TA).
  
  
  METHODS
  Twenty patients with TA and 24 healthy controls were evaluated for ovarian reserve by follicle-stimulating hormone, luteinizing hormone, and estradiol, and antral follicle count (AFC). Anti-Müllerian hormone (AMH) was measured by ELISA using 2 different kits. Demographical data, menstrual abnormalities, disease variables, and treatment were also analyzed.
  
  
  RESULTS
  The median current age was similar in patients with TA and controls (31.2 ± 6.1 vs 30.4 ± 6.9 yrs, p = 0.69). The frequencies of decreased levels of AMH in patients with TA were identical using both kits and higher when compared to controls (50% vs 17%, p = 0.02; 50% vs 19%, p = 0.048). A positive correlation was observed between the 2 kits in patients with TA (r = +0.93, p < 0.0001) and in healthy controls (r = +0.93, p < 0.0001). The apparent lower AFC (11 vs 16, p = 0.13) and the higher frequency of low AFC (41% vs 22%, p = 0.29) in TA compared to controls did not reach statistical significance. Other hormones were similar in both groups (p > 0.05). Further evaluation of patients with TA with low AMH levels (< 1.0 ng/ml) versus normal AMH levels (> 1.0 ng/ml) revealed that the frequency of current disease activity (p = 1.0) and the median of erythrocyte sedimentation rate (p = 0.6), C-reactive protein (p = 0.4), prednisone cumulative dose (p = 0.8), and methotrexate cumulative dose (p = 0.8) were comparable in both groups. Cyclophosphamide use was reported in only 1 patient with reduced ovarian reserve, whereas none of the remaining patients received gonadotoxic drugs.
  
  
  CONCLUSIONS
  To the best of our knowledge, our present study was the first to suggest that patients with TA may have diminished ovarian reserve.
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Andrea Rocha S
authors.initials: AR
authors.lastname: Mont'Alverne
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo. rosamariarp@yahoo.com.
authors.forename: Rosa Maria R
authors.initials: RM
authors.lastname: Pereira
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Lucas Yugo S
authors.initials: LY
authors.lastname: Yamakami
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Vilma Santos T
authors.initials: VS
authors.lastname: Viana
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Edmund Chada
authors.initials: EC
authors.lastname: Baracat
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfá
authors.affiliation: From the Division of Rheumatology, the Gynecology Department, and the Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.A.R.S. Mont'Alverne, MD; R.M.R. Pereira, MD, PhD, Division of Rheumatology; L.Y.S. Yamakami, MD, PhD, Gynecology Department; V.S.T. Viana, PhD, Division of Rheumatology; E.C. Baracat, MD, PhD, Gynecology Department; E. Bonfá, MD, PhD, Division of Rheumatology; C.A. Silva, MD, PhD, Division of Rheumatology, Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Clovis Artur
authors.initials: CA
authors.lastname: Silva
mesh_terms: D000328:Adult; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000502:physiology*; D065851:Ovarian Reserve / Q000502:physiology*; D013625:Takayasu Arteritis / Q000097:blood / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: ANTI-MÜLLERIAN HORMONE; ANTRAL FOLLICLE COUNT; FERTILITY; OVARIAN RESERVE; TAKAYASU ARTERITIS