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

The authors analysed the gonadal function and age of menarche of 23 female adolescents and young women with SLE, and correlated these with clinical, SLEDAI and therapeutic parameters. the presence of one or more clinical and laboratory parameters defined normal gonadal function: normal menstrual cycles with or without dysmenorrhea; elevated cervical mucus length; normal levels of plasma FSH, LH, estradiol, progesterone, prolactin and testosterone; normal urinary hormonal cytology; serial pelvic ultrasound compatible with ovulatory pattern; and present or previous pregnancy. the mean age of menarche (13.5 +/- 1.4 years) was greater than that found among 2578 healthy Brazilian adolescents (12.5 +/- 1.3 years; P = 0.0002). the delay in menarche correlated with an increase in the duration of the disease (P = 0.0085) and the cumulative dose of prednisone (P = 0.0013) used until the appearance of the menarche. the mean phase length in SLE was 31.5 +/- 10.3. Sixteen female (70%) patients showed normal and seven (30%) abnormal gonadal function. Gonadal function was not correlated with parameters of SLE. These results suggest that the patients of this study reach adulthood with a high chance of fertility.Univ São Paulo, Sch Med, Dept Pediat, Pediat Rheumatol Unit,Childrens Inst, São Paulo, BrazilUniv São Paulo, Sch Med, Adolescent Gynaecol Serv, São Paulo, BrazilUniv São Paulo, Sch Med, Dept Pediat, Adolescent Gynecol Serv,Childrens Inst, São Paulo, BrazilWeb of Scienc

Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette's syndrome, Sydenham's chorea, and autoimmune disorders

Background: Some cases of Tourette's syndrome (TS) are hypothesized to be caused by autoantibodies that develop in response to a preceding group A beta hemolytic streptococcal infection

Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette's syndrome, Sydenham's chorea, and autoimmune disorders

Background: Some cases of Tourette's syndrome (TS) are hypothesized to be caused by autoantibodies that develop in response to a preceding group A beta hemolytic streptococcal infection.Methods: To test this hypothesis, we looked for the presence ot total and IgG antibodies against neural, nuclear, cytoskeletal and streptococcal epitopes using indirect immunofluorescent assays and Western blot techniques in three patient groups: TS (n = 81), SC (n = 27), and a group of autoimmune disorders (n = 52) and in normal controls (n = 67). Subjects were ranked after titrations of autoantibodies from 0 to 227 according to their level of immunoreactivity.Results: TS patients had a significantly higher mean rank for total antineural and antinuclear antibodies, as well as antistreptolysin 0 titers. However, among children and adolescents, only the total antinuclear antibodies were increased in TS patients compared to age matched controls. Compared to SC patients, TS patients had a significantly lower mean rank for total and IgG class antineural antibodies, significantly lower IgG class anticytoskeletal antibodies, and a significantly higher rank for total antinuclear antibodies. Compared to a mixed group of autoimmune disorders, the TS patients had a significantly lower mean rank for total and IgG class antineural antibodies, total and IgG class antinuclear antibodies, IgG class anticytoskeletal antibodies, and a significantly higher rank for antistreptococcal antibodies.Conclusions: TS patients had significantly higher levels of total antineural and antinuclear antibodies than did controls. Their relation to IgG class antineural and antinuclear antibodies, markers for prior streptococcal infection, and other clinical characteristics, especially chronological age, was equivocal. (C) 2001 Society of Biological Psychiatry.Yale Univ, Sch Med, Yale Child Study Ctr, New Haven, CT 06520 USAYale Univ, Sch Med, Childrens Clin Res Ctr, New Haven, CT 06520 USAYale Univ, Sch Med, Dept Psychiat, New Haven, CT 06520 USAYale Univ, Sch Med, Dept Pediat, New Haven, CT 06520 USAYale Univ, Sch Med, Dept Diagnost Radiol, New Haven, CT 06520 USAYale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06520 USAYale Univ, Sch Nursing, New Haven, CT 06536 USAUniv São Paulo, Sch Med, Dept Psychiat, São Paulo, BrazilUniv São Paulo, Sch Med, Dept Pediat, São Paulo, BrazilIstanbul Univ, Marmara Hosp, Dept Psychiat, Istanbul, TurkeyKeio Univ, Sch Med, Dept Internal Med, Tokyo, JapanWeb of Scienc