ECE2017 Eposter Presentations: Reproductive Endocrinology Female Reproduction (62 abstracts)
Natural history of autoimmune primary ovarian insufficiency progresses through several stages from normal ovary function to clinically overt ovary dysfunction
Giuseppe Bellastella 1 , Ofelia Casciano 1 , Mariluce Barrasso 1 , Maria Ida Maiorino 1 , Dario Giugliano 1 , Katherine Esposito 2 , Lorenzo Scappaticcio 1 & Annamaria De Bellis 1
1Endocrinology and Metabolic Diseases Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania ‘L. Vanvitelli’, Naples, Campania, Italy; 2Diabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania, ‘L. Vanvitelli’, Naples, Campania, Italy.
Context: Women with autoimmune Addison’s disease with normally ovulatory cycles but positive for steroid cells antibodies (StCA) have been considered at risk of premature ovarian insufficiency (POI).
Design: Thirty-three women younger than 40 years, with subclinical-clinical Addison’s disease but with normally ovulatory menses, were followed-up for 10 years to evaluate the long-term time-related variations of StCA, ovarian function and follicular reserve. All patients and 27 control women were investigated at start and every year for the presence and titer of StCA (by indirect immunofluorescence), serum concentrations of anti-Mullerian hormone (AMH) and ovarian function along four consecutive menses every year.
Results: At start of the study StCA were present in 16 women (group 1), at low/middle titer (≤1:32) in seven of them (43.75%, group 1A), at high titer (>1:32) in the remaining nine patients (group 1B, 56.2%), while they were absent in 17 patients (group 2). During the follow-up period, all women in group 1A persisted StCA positive at low/middle titer with normal ovulatory menses and normal gonadotropin and AMH levels, while all patients in group 1B showed a further increase of StCA titers (1:128–1:256) and progressed through three stages of ovarian function. None of patients in group 2 and controls showed appearance of StCA or ovary dysfunction during the follow-up.
Conclusions: The presence of StCA at high titers could be considered a good predictive marker of subsequent development of autoimmune POI. To single out the stages of autoimmune POI may allow a timely therapeutic choice in subclinical and early clinical stage.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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