Gonadal function in adolescents and young women with juvenile systemic lupus erythematosus

Silva, C A A; Leal, Marta Miranda; Leone, Cláudio; Simone, Valentina; Takiuti, Albertina Duarte; Saito, Maria Ignez; Kiss, Maria Augusta P. D.

doi:10.1191/0961203302lu219oa

Cited by 92 publications

(129 citation statements)

References 25 publications

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“…There is, however, no systematic study in the literature assessing the overall gonad function in male SLE patients and its relevance for sperm abnormalities. In a recent case report of 4 young male patients with SLE, we identified abnormal sperm morphology (teratozoospermia) in 2 patients and reduced sperm concentration (oligozoospermia/azoospermia) in the other 2 patients, both of which were associated with current IV CYC treatment (11).…”

Section: Objective To Assess Gonad Function In Male Patients With Symentioning

confidence: 79%

Gonad evaluation in male systemic lupus erythematosus

Soares¹,

Borba²,

Bonfá³

et al. 2007

Arthritis & Rheumatism

108

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Objective. To assess gonad function in male patients with systemic lupus erythematosus (SLE).Methods. Thirty-five consecutive male patients with SLE according to the criteria of the American College of Rheumatology were prospectively evaluated for demographic and clinical features as well as previous and current treatment. Patients underwent urologic evaluation and testicular Doppler ultrasound. We obtained a hormone profile and performed a semen analysis including morphology and testing for the presence of antisperm antibodies. Patients were compared with 35 age-matched healthy controls.Results. Compared with controls, SLE patients had lower median testicular volumes in both testes, a lower median total sperm count, and a lower median total motile sperm count. The mean sperm volume and percentage of normally formed sperm were lower in SLE patients than in controls. Since all SLE patients had semen alterations, they were further subdivided into 2 groups according to the severity of these abnormalities (group 1, with teratozoospermia [n ‫؍‬ 18], and group 2, with azoospermia or teratozoospermia in combination with oligozoospermia and/or asthenozoospermia [n ‫؍‬ 17]). The frequency of treatment with intravenous cyclophosphamide (IV CYC) after the first ejaculation was higher in group 2 than in group 1. The median testicular volumes measured by ultrasound in both testicles were lower in group 2 than in group 1. Follicle-stimulating hormone levels were higher in group 2 than in group 1. The overall frequency of antisperm antibodies in SLE patients was 40%. The apparent higher frequency of antisperm antibodies in group 1 than in group 2 did not reach significance.Conclusion. SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume. Postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.

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Section: Objective To Assess Gonad Function In Male Patients With Symentioning

confidence: 79%

Gonad evaluation in male systemic lupus erythematosus

Soares¹,

Borba²,

Bonfá³

et al. 2007

Arthritis & Rheumatism

108

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“…cerebrovascular vasculitis and transverse myelitis) in both adults and children. Again, however, potential side effects of infertility, 149 nausea, alopecia, mucosal ulceration and extravasation can complicate it's use and make the younger patient and their parents hesitant to use it, again with risk of delay of therapy. Subsequent use of disease modifying agents for maintenance therapy, including Hydroxychloroquine, Mycophenolate Mofetil and Azathioprine are often used but without clinical trial evidence base for efficacy in NSPLE.…”

Section: Pharmacological Therapiesmentioning

confidence: 99%

Pathogenesis of neurocognitive and neuropsychiatric manifestations in childhood-onset lupus: an overview

2014

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This review explores current understanding of neuropsychiatric systemic lupus erythematosus (NPSLE) of childhood onset, in particular neurocognitive impairment. As yet, fewer studies have focused on childhood onset NPSLE compared to adult onset NPSLE and diagnosis still involves the 1999 American College of Rheumatology case definitions of neuropsychiatric syndromes, which were developed for adults. Although a validated core set of neuropsychometric tests exist for childhood onset NPSLE, these still have limitations and possible biomarkers and newer neuroimaging modalities remain mostly experimental. Important differences exist between childhood and adult onset SLE and specifically with NPSLE, outlined in this review. Normal adolescent brain development also involves significant differences from adults, particularly in executive function and social cognition. These issues may impact on the pathogenesis of NPSLE during this vulnerable period and also influence their management options.

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“…2,3,16 Sabe-se, entretanto, que doenças diferentes têm impacto distinto sobre diferentes órgãos e sistemas e ao agrupar pacientes com doenças distintas sob a denominação de doenças crônicas, informações mais específicas podem ser perdidas. Os estudos em adolescentes com lúpus eritematoso sistêmico, de Silva et al, 13,15 ilustram este fato. Meninas com lúpus eritematoso sistêmico têm função gonadal preservada 15 enquanto meninos com lúpus eritematoso sistêmico apresentam altas taxas de infertilidade.…”

Section: Conclusãounclassified

“…Os estudos em adolescentes com lúpus eritematoso sistêmico, de Silva et al, 13,15 ilustram este fato. Meninas com lúpus eritematoso sistêmico têm função gonadal preservada 15 enquanto meninos com lúpus eritematoso sistêmico apresentam altas taxas de infertilidade. 13 Nosso estudo demonstrou que adolescentes com epilepsia representam um grupo especial, pois a despeito de sua doença, têm vida sexualmente ativa, sendo que 51,4% das adolescentes referiram sua primeira relação sexual, e 37,1% era sexualmente ativa no momento da entrevista.…”

Section: Conclusãounclassified

A sexualidade nas adolescentes com epilepsia

Vincentiis

Febrônio

Silva

et al. 2007

J. epilepsy clin. neurophysiol.

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RESUMOObjetivo: Mulheres com epilepsia apresentam com maior freqüência alterações relacionadas à sexualidade. O conhecimento adquirido com as adultas tem sido usado para as adolescentes, pressupondo-se que elas também sofram influência semelhante. Este estudo teve como objetivo avaliar aspectos relacionados à sexualidade nas adolescentes com epilepsia. Métodos: Foram estudadas 35 pacientes do sexo feminino, com epilepsia, com idades entre 10 a 20 anos. Os critérios de exclusão foram: pacientes que ainda não apresentaram a menarca, com doença crônica associada, ou deficiência mental moderada a grave. As informações sobre a função sexual das adolescentes foram avaliadas através de um questionário padrão. Resultados: Não foi observada diferença entre a idade da primeira relação sexual, atividade sexual, libido e orgasmo entre as adolescentes com epilepsia e o grupo controle. Observaram-se índices de gravidez superiores entre as adolescentes com epilepsia. Conclusão: Adolescentes com epilepsia têm vida sexualmente ativa, não apresentando as mesmas disfunções que a mulher adulta. Nesta série, nós observamos freqüência elevada de gestação, sugerindo a falta de aconselhamento adequado. Os aspectos relacionados à sexualidade requerem atenção especial por parte dos profissionais de saúde que atendem adolescentes com epilepsia.Unitermos: adolescentes, epilepsia, doenças crônicas, sexualidade. ABSTRACT Sexuality in adolescents with epilepsyObjectives: Women with epilepsy have higher rates of sexual dysfunction. However, knowledge acquired with adult populations has been extrapolated to teenagers, by surmising that these patients are submitted to similar factors. This study aims to evaluate aspects related to sexuality in female adolescents with epilepsy. Methods: We studied 35 female adolescents, with epilepsy, ages from 10 to 20 years. The criteria of exclusion were: patients that had not yet presented a first period, patients with previous endocrine or clinical chronic disorders, and patients with moderate to severe mental deficiency. Information on sexual behavior of adolescents with epilepsy was evaluated by use of a standard questionnaire. Results: No differences were observed between age at first sexual intercourse, sexual activity, libido and orgasm of adolescents with epilepsy when compared to controls. Higher rates of pregnancy occurred in adolescents with epilepsy when compared to controls. Conclusion: Adolescents with epilepsy have an active sexual life, without the dysfunctions presented by adults. In this series, we observed high rates of pregnancy suggesting lack of proper counseling. Therefore, aspects related to sexuality require special attention by health professionals when attending to adolescents with epilepsy.

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Gonadal function in adolescents and young women with juvenile systemic lupus erythematosus

Cited by 92 publications

References 25 publications

Gonad evaluation in male systemic lupus erythematosus

Gonad evaluation in male systemic lupus erythematosus

Pathogenesis of neurocognitive and neuropsychiatric manifestations in childhood-onset lupus: an overview

A sexualidade nas adolescentes com epilepsia

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