期刊
CLINICAL RHEUMATOLOGY
卷 37, 期 10, 页码 2869-2873出版社
SPRINGER LONDON LTD
DOI: 10.1007/s10067-018-4208-x
关键词
Fertility; Juvenile idiopathic arthritis; Luteinized unruptured follicle syndrome; Non-steroidal anti-inflammatory drugs
类别
资金
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [CNPq 305068/2014-8, 303422/2015-7]
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [FAPESP 2014/14806-0, 2015/03756-4]
- Federico Foundation
- Nucleo de Apoio a Pesquisa Saude da Crianca e do Adolescente da USP (NAP-CriAd)
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [15/03756-4] Funding Source: FAPESP
To assess prospectively luteinized unruptured follicle (LUF) syndrome in juvenile idiopathic arthritis (JIA) patients with and without non-steroidal anti-inflammatory drugs (NSAIDs) and healthy controls. Twenty-three adolescent and young adult female JIA patients (ILAR criteria) and 11 female healthy subjects were studied by pelvic ultrasound monitoring for follicular development and ovulation in one menstrual cycle. LUF syndrome was prospectively investigated by pelvic ultrasound with a dominant ovarian follicle without signs of follicular rupture, with elevation of serum progesterone in the luteal phase of the menstrual cycle and luteinizing hormone (LH) detected in the urine. Comparison between JIA patients with (n = 8) vs. without NSAIDs (n = 15) and healthy controls (n = 11) revealed that LUF syndrome was significantly higher in the former group (2 (25%) vs. 0% vs. 0%, p = 0.049). These two patients with LUF syndrome had normal menstrual cycles without reduced ovarian reserve, and they were under naproxen 500 mg bid during the menstrual cycle. Disease duration was comparable in JIA with and without NSAIDs [19.8 (4.4-25) vs. 13 (3.1-33) years, p = 0.232]. Further comparison between JIA patients with and without NSAIDs and healthy controls showed similar mean anti-Mullerian hormone levels (p = 0.909), estradiol (p = 0.436), FSH (p = 0.662), LH (p = 0.686), and mean antral follicle count (p = 0.240) and ovarian volume (p = 0.363). No differences were evidenced in three groups regarding Caucasian race, body mass index, duration, and length of menstrual cycles (p > 0.05). This is the first study to identify that JIA patients have a high frequency of LUF without impaired ovarian reserve. Future prospective studies are necessary to determine if chronic/continuous use of NSAIDs in JIA will have an impact in these patients' fertility.
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