Hormone profile in juvenile systemic lupus erythematosus with previous or current amenorrhea
Abstract
To identify the underlying mechanism of amenorrhea in juvenile systemic lupus erythematosus (JSLE) patients, thirty-five (11.7%) JSLE patients with current or previous amenorrhea were consecutively selected among the 298 post-menarche patients followed in 12 Brazilian pediatric rheumatology centers. Pituitary gonadotrophins [follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] and estradiol were evaluated in 32/35 patients, and prolactin and total testosterone in 29/35 patients. Patient's medical records were carefully reviewed according to demographic, clinical and therapeutic findings. The mean duration of amenorrhea was 7.2 ± 3.6 months. Low FSH or LH was observed in 7/32 (22%) JSLE patients and normal FSH or LH in 25 (78%). Remarkably, low levels of FSH or LH were associated with higher frequency of current amenorrhea (57% vs. 0%, P = 0.001), higher median disease activity (SLEDAI) and damage (SLICC/ACR-DI) (18 vs. 4, P = 0.011; 2 vs. 0, P = 0.037, respectively) and higher median current dose of prednisone (60 vs. 10 mg/day, P = 0.0001) compared to normal FSH or LH JSLE patients. None of them had decreased ovarian reserve and premature ovarian failure. Six of 29 (21%) patients had high levels of prolactin, and none had current amenorrhea. No correlations were observed between levels of prolactin and SLEDAI, and levels of prolactin and SLICC/ACR-DI scores (Spearman's coefficient). We have identified that amenorrhea in JSLE is associated with high dose of corticosteroids indicated for active disease due to hypothalamic-pituitary-ovary axis suppression.
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Chronic inflammatory diseases can lead to loss of reproduction potential because affected individuals are at strong disadvantage in competition for food, social status, and sexual partners, and intense inflammation can inhibit the hypothalamic-pituitary-gonadal axis.
“Chronic inflammatory diseases can lead to loss of reproduction potential because affected individuals are at strong disadvantage. Such individuals can be excluded or impaired in the competition for food; they can also have low social status in the group and limited choice or availability of sexual partners.”
From Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology (2012) · cites this paper as [17]
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Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology
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- Authors
- Silva, C. A., Deen, M. E. J., Febrônio, M. V., Oliveira, S. K., Terreri, M. T., Sacchetti, S. B., Sztajnbok, F. R., Marini, R., Quintero, M. V., Bica, B. E., Pereira, R. M., Bonfá, E., Ferriani, V. P., Robazzi, T. C., Magalhães, C. S., & Hilário, M. O.
- Affiliations
- University of Groningen (NL)
- Universidade Federal do Rio de Janeiro (BR)
- Universidade Federal de São Paulo (BR)
- Irmandade da Santa Casa de Misericórdia de São Paulo (BR)
- Universidade Estadual de Campinas (UNICAMP) (BR)
- Grupo Santa Casa de Belo Horizonte (BR)
- Universidade de São Paulo (BR)
- Hospital São Rafael (BR)
- ORCID
- Venue
- Rheumatology International
- Published
- 2010-03-21
- Volume
- 31
- Issue
- 8
- Pages
- 1037-1043
- ISSN
- 0172-8172 (ISSN-L)
- 1437-160X
- OpenAlex
- W1983454200
- Semantic Scholar
- cd563154ac5152f3711daf4f410ac8a5ab8a9019
- Cited by
- 38
- References
- 35
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 4 · 2012: 5
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Rheumatology International (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- Acervo Digital da Universidade Estadual Paulista (Universidade Estadual Paulista) (submittedVersion)
- UNESP Institutional Repository (São Paulo State University) (submittedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- pediatric lupus, amenorrhea, hypothalamic-pituitary-ovarian axis, follicle-stimulating hormone, luteinizing hormone, estradiol, prolactin, testosterone, corticosteroid dose, prednisone, disease activity, organ damage, ovarian reserve, premature ovarian failure
- MeSH terms
- Adolescent, Amenorrhea, Child, Child, Preschool, Estradiol, Female, Follicle Stimulating Hormone, Glucocorticoids, Hormones, Humans, Luteinizing Hormone, Lupus Erythematosus, Systemic, Menarche, Prednisone, Retrospective Studies, Testosterone, Young Adult
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