Endocrine Abstracts

A 36-year-old woman in follow-up due to early ovarian failure of idiopathic origin. No family history of interest. History of menarche at 12 years of age with regular menses until 18 years of age, when it begins with amenorrheic spells lasting up to 8 months. Laboratory tests revealed hypergonadotropic hypogonadism with negative ovarian autoantibodies, normal karyotype, and gynecological ultrasound showing a normal-looking uterus with slight bilateral ovarian atrophy. Negative antiadrenal and anti-TPO antibodies. She has undergone treatment with combined contraceptives since the diagnosis, only temporarily interrupted for 9 months to start the insemination protocol with egg donation, which was not completed. After 10 years of hormone replacement therapy, she develops polyarthralgia that worsens in the first days of estrogen treatment. She associates dactylitis of the hands and feet and episodes of joint angioedema. No accompanying fever. He also does not present joint deformities, abdominal pain or edema at the easy or genital level. In the study requested by Rheumatology, the following was observed: X-rays and bone scintigraphy without significant findings, densitometric study within normal limits, and the autoimmunity study revealed positive levels of ANA antibodies with a homogeneous pattern and a titer of 1/320. Other antibodies (anti-histone, anti-dsDNA, anti-nucleosome, anti-ribosome, anti-phospholipid, ENA, anti-adrenal, anti-ovarian, anti-citrullinated peptides, ANCA-MPO, ANCA-PR3 and those associated with polyglandular syndromes autoimmune) are negative. Likewise, angioedema due to hereditary or acquired defects of proteins of the complement system is ruled out. After discontinuation of estrogen treatment, the symptoms disappear. Finally, it is classified as a picture of angioedema and ANA induced by estrogen without criteria for systemic lupus erythematosus. She is currently asymptomatic and without hormone replacement therapy.