Session Type: Abstract Submissions (ACR)
Background/Purpose: Dermatomyositis (DM) affects female gender during reproductive age, in which ovarian reserve and future fertility are major topics of interest. However, there is no systematic study assessing these abnormalities in patients with DM. Therefore, the aim of the present study was to evaluate ovarian reserve markers and anti-corpus luteum (anti-CoL) antibodies in patients with DM.
Methods: All 40 female patients with DM (Bohan e Peter criteria, 1975), aged between 18 and 42 years, followed at our tertiary center, from March 2011 to December 2012, were invited to participate. Exclusion criteria were hormonal contraceptive use in the last six months (n=13), neoplasia (n=3), overlap systemic autoimmune diseases (n=3), pregnancy (n=2), gynecological surgery (n=1) and did not agree to participate (n=2). The remaining sixteen DM patients and 23 healthy controls were evaluated at early follicular phase of menstrual cycle. IgG anti-CoL (immunoblotting), follicle stimulating hormone (FSH), estradiol, inhibin B, anti-Müllerian hormone (AMH) serum levels (ELISA) and sonographic antral follicle count (AFC) were determined.
Results: DM patients and controls had comparable mean age (33.4±6.8 vs. 31.4±6.8 years, P=0.337), ethnicity and socioeconomic class (P>0.05). DM mean age of onset was 29.1±4.7 years and disease duration of 5.6±3.2 years. Comorbidities and life style were similar in both groups (P>0.05). Menstrual cycles were alike in both groups with a similar frequency of age at menarche, gynecological age, duration and length of menstrual cycle (P>0.05). Of note, AMH ≤ 1 ng/mL (50% vs. 13%, P=0.027) and number of the AFC (10.5±5.6 vs. 17.3±0.7, P=0.017) were significantly reduced in DM patients compared to controls. Serum FSH (6.2±2.0 vs. 6.6±3.8 IU/L, P=0.617) and inhibin B levels (49.8±31.5 vs. 45.2±29.0 ng/mL, P=0.616) were comparable to controls whereas serum estradiol level [45.0 (29-126) vs. 34 (24-128) pg/mL, P<0.001] was higher in DM patients. Ovarian volumes [6.2 (4.7-8.2) vs. 5.5 (1.4-15.8) mm3, P=0.214], and the frequency of anti-CoL antibody (6.5% vs. 0%, P=0.398) were also alike in both groups (P>0.05).
Conclusion: The present study was the first to identify that patients with DM may have a shortened reproductive lifespan. Further studies are necessary to assess the possible role of disease and treatment related factors underlying ovarian impairment in these patients.
F. H. C. de Souza,
S. K. Shinjo,
L. Y. S. Yamakami,
V. D. S. T. Viana,
E. C. Baracat,
C. A. A. Silva,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/reduction-of-ovarian-reserve-in-adult-patients-with-dermatomyositis/