Advances in the management of endometriosis: an update for clinicians

Crosignani, P. G.; Olive, David L.; Bergqvist, Agneta; Luciano, Anthony A.

doi:10.1093/humupd/dmi049

Cited by 217 publications

(143 citation statements)

References 82 publications

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“…The primary therapy for treating endometriosis has been suppression of the hypothalamic-pituitary axis with GnRH analogs creating a hypoestrogenic state, or the use of oral contraceptive pills or progestins (Fedele et al, 2008). The success achieved with these therapies is unsatisfactory due to high recurrence rate and inability to improve fertility rate of women affected (Crosignani et al, 2006). Antide, a GnRH antagonist, and TBP-1 have been shown to regress endometriosis in rodent as well as baboon models of endometriosis (D'Antonio et al, 2000;D'Hooghe et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

A Long-Acting Tumor Necrosis Factor α-Binding Protein Demonstrates Activity in Both In Vitro and In Vivo Models of Endometriosis

Altan¹,

Denis²,

Kagan³

et al. 2010

J Pharmacol Exp Ther

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Endometriosis is characterized by the presence of elevated proinflammatory cytokines such as tumor necrosis factor (TNF) ␣ in the peritoneal cavity. Blocking interaction of TNF␣ with its receptor by the addition of excess TNF␣-binding protein (TBP)-1 (a soluble form of TNF receptor-1) was effective in animal models of endometriosis. Recently, a novel, high-affinity inhibitor of TNF␣, TNF-soluble high-affinity receptor complex (TNF-SHARC), was created by fusing TBP to both the ␣ and ␤ subunits of inactive human chorionic gonadotropin. This dimeric protein was effective in inhibiting collagen-induced arthritis in mice. In the present study, the efficacy of TNF-SHARC in cellular and in vivo models of endometriosis was examined. TBP and TNF-SHARC dose-dependently inhibited TNF␣-induced secretion of interleukin (IL)-6, IL-8, granulocyte macrophage-colony-

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Section: Discussionmentioning

confidence: 99%

A Long-Acting Tumor Necrosis Factor α-Binding Protein Demonstrates Activity in Both In Vitro and In Vivo Models of Endometriosis

Altan¹,

Denis²,

Kagan³

et al. 2010

J Pharmacol Exp Ther

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“…This condition has been described in approximately 10 % of women of reproductive age [2], and has also been noted in postmenopausal women in a few studies [3]. Endometriosis may affect either pelvic or extra-pelvic sites.…”

Section: Discussionmentioning

confidence: 99%

A rare case of sigmoid colon obstruction in patient with ulcerative colitis: role of transabdominal ultrasound-guided biopsy

et al. 2014

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Introduction Endometriosis is a common chronic gynaecological disease affecting 10 % of women of reproductive age. Of these 5-12 % may present bowel endometriosis that may be asymptomatic or associated with aspecific symptoms even bowel obstruction. Case presentation The case of a 41-year-old woman with history of ulcerative colitis, previous diagnosis of ovarian endometriosis, recurrent abdominal pain not related to the menstrual cycle, with abdominal pain and obstinate constipation for 2 weeks was referred. The patient underwent colonoscopy, transabdominal ultrasound and ultrasoundguided fine-needle biopsy to have a diagnosis. Discussion Endometriosis should be considered in the differential diagnosis of every woman of childbearing age who presents with gastrointestinal or abdominal symptoms. As demonstrated in our case and by the burgeoning literature in this field, we believe that the role of transabdominal ultrasound should be reconsidered in the management of abdominal diseases because this examination associated with ultrasound-guided fine-needle biopsy allows, in expert hands, to obtain adequate histological samples avoiding patients to undergo more invasive tests to get a diagnosis.Keywords Transabdominal ultrasound Á Ultrasoundguided fine-needle biopsy Á Intestinal endometriosis Á Bowel obstruction Riassunto Introduzione L'endometriosi è una malattia ginecologica cronica comune che colpisce il 10 % delle donne in età riproduttiva. Nel 5-12 % si può presentare una localizzazione intestinale della malattia. Essa può presentarsi in svariati modi potendo essere asintomatica o potendosi manifestare con sintomi aspecifici includendo perfino l'occlusione intestinale. Caso clinico presentiamo il caso di una donna di 41 anni affetta da colite ulcerosa, con storia di precedente diagnosi di endometriosi ovarica e ricorrenti dolori addominali non correlati al ciclo mestruale. Riferisce da circa due settimane il peggioramento dei dolori addominali cui si associa stipsi ostinata. È stata quindi sottoposta a colonscopia, ecografia transaddominale e biopsia ecoguidata per via transaddominale prima di poter fare una diagnosi. Discussione L'endometriosi dovrebbe essere considerata nella diagnosi differenziale in ogni donna in età fertile che si presenta con sintomi gastrointestinali o addominali vaghi. Come nel caso clinico illustrato e alla luce della fiorente letteratura in questo campo, riteniamo che il ruolo dell'ecografia transaddominale dovrebbe essere riconsiderato nella gestione delle malattie addominali. Infatti, l'ecografia transaddominale associata alla possibilità di poter eseguire in corso dello stesso esame una biopsia ecoguidata, permetterebbe di poter ottenere un adeguato campione istologico evitando al paziente esami più invasivi per raggiungere una diagnosi.

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“…Hormonal manipulation and surgery have been found to be efficient in the management of pelvic pain associated to endometriosis (Vercellini et al, 2011). Oral contraceptives, GnRH agonists, danazol and progestins have been shown to reduce the production of PGs, which are responsible in large part for pelvic pain (Crosignani et al, 2006;Venturini et al, 1997).…”

Section: Prostaglandins and Pelvic Painmentioning

confidence: 99%