Autoimmune oophoritis as a mechanism of follicular dysfunction in women with 46,XX spontaneous premature ovarian failure

• Published in: Fertility and sterility Vol. 84; no. 4; pp. 958 - 965
• Main Authors: Bakalov, Vladimir K., Anasti, James N., Calis, Karim A., Vanderhoof, Vien H., Premkumar, Ahalya, Chen, Shu, Furmaniak, Jadwiga, Smith, B. Rees, Merino, Maria J., Nelson, Lawrence M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2005; Elsevier Science
• Subjects: Addison disease; Adolescent; Adrenal cortex autoantibodies; adrenal insufficiency; Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Adult; Autoimmune Diseases - blood; Autoimmune Diseases - genetics; Autoimmune Diseases - pathology; autoimmune oophoritis; Biological and medical sciences; Chromosome Aberrations; Chromosome Disorders - blood; Chromosome Disorders - genetics; Chromosome Disorders - pathology; Chromosomes, Human, X - genetics; Confidence Intervals; Endocrinopathies; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; hypergonadotropic amenorrhea; hypergonadotropic hypogonadism; Medical sciences; Non tumoral diseases; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Oophoritis - blood; Oophoritis - genetics; Oophoritis - pathology; Ovarian Follicle - metabolism; Ovarian Follicle - pathology; ovarian insufficiency; premature ovarian failure; Primary Ovarian Insufficiency - blood; Primary Ovarian Insufficiency - genetics; Primary Ovarian Insufficiency - pathology; Prospective Studies; ovarian insufficiency; adrenal insufficiency; autoimmune oophoritis; hypergonadotropic amenorrhea; Addison disease; Adrenal cortex autoantibodies; premature ovarian failure; hypergonadotropic hypogonadism; Endocrinopathy; Autoimmunity; Premature; Adrenal cortex diseases; Spontaneous; Mechanism; Genital diseases; Hypergonadotropic hypogonadism; Ovarian failure; Fertility; Female genital system; Adrenal gland diseases; Amenorrhea; Adult; Female; Human; Menstruation disorders; Antibody; Autoantibody; Female genital diseases; Ovarian diseases; Adrenal insufficiency; Hypocorticism; Dysfunction; Ovarian follicle
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2005.04.060

To assess the association between serum adrenal cortex autoantibodies and histologically confirmed autoimmune lymphocytic oophoritis. Controlled, prospective. Tertiary research center. Two hundred sixty-six women with 46,XX spontaneous premature ovarian failure. Ovarian biopsy in 10 women. Serum adrenal cortex autoantibodies assessed by indirect immunofluorescence and autoimmune oophoritis assessed by immunohistochemical lymphocyte markers. 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%). 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.