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Menstrual and hormonal alterations in juvenile systemic lupus erythematosus

Paediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil

MV Febrônio

Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil

E Bonfá

Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil

EF Borba

Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil

AD Takiuti

Gynecology Division, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil

CAA Silva

Paediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil clovis.silva{at}icr.usp.br

Menstrual cycles of 30 patients with juvenile systemic lupus erythematosus (JSLE) were compared with 30 age-matched controls. The mean age of patients with JSLE and controls was similar (17.4 ± 3.2 vs 17.06 ± 2.08 years, P = 0.66). The mean menarche age was higher in JSLE than controls (13.13 ± 1.4 vs 11.56 ± 1.5 years, P = 0.0008). On the contrary, the mean maternal menarche age was similar in both groups (P = 0.62). Menstrual abnormalities and longer length cycles were more frequently observed in JSLE than controls (63% vs 10%, P = 0.0001; 23% vs 0%, P = 0.0105, respectively). The median of follicle stimulating hormone was significantly higher in patients with JSLE compared with controls (4.6 vs 3.4 IU/L, P = 0.0207), and the median of progesterone was lower (32.5 vs 70 ng/mL, P = 0.0033). The median of luteinizing hormone was lower in patients with JSLE with menstrual abnormalities versus normal cycles (2.9 vs 5.5 IU/L, P = 0.019) and both had a high percentage of decreased progesterone levels (63% vs 73%, P = 0.70). Our findings support the notion that menstrual disturbances are frequent and may be associated with pituitary dysfunction leading to a decreased progesterone production. We also reported that in spite of premature ovarian failure being a rare event in JSLE the follicular reserve seems to be low regardless of intravenous cyclophosphamide treatment.

Key Words: adolescent • hormone • juvenile systemic lupus erythematosus • menarche • menstrual abnormalities

Lupus, Vol. 18, No. 1, 38-43 (2009)
DOI: 10.1177/0961203308094652


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