High Serum Inhibin Concentration Discriminates Autoimmune Oophoritis from Other Forms of Primary Ovarian Insufficiency

Department of Pediatrics, Obstetrics, and Reproductive Medicine, Universityof Siena, Siena, Italy.
Journal of Clinical Endocrinology & Metabolism (Impact Factor: 6.21). 05/2008; 93(4):1263-9. DOI: 10.1210/jc.2007-1675
Source: PubMed


Primary ovarian insufficiency (POI) is defined by hypergonadotropic amenorrhea occurring before the age of 40 yr. In 4-5% of women with POI, an ovarian autoimmune process can be demonstrated.
We have determined the serum concentrations of total inhibin and inhibin B by sensitive ELISAs in 22 women with autoimmune POI (aPOI), 71 women with non-autoimmune idiopathic POI (iPOI), 77 postmenopausal women, and 90 healthy, fertile women (HW). Diagnosis of aPOI was made according to the presence of steroid cell autoantibodies and/or 17alpha-hydroxylase autoantibodies and/or cytochrome P450 side-chain cleavage autoantibodies. All aPOI patients were also positive for adrenal autoantibodies.
Total inhibin levels were significantly higher in women with aPOI (median, 281 pg/ml) than in women with iPOI (median, 74 pg/ml) or HW (median, 133.5 pg/ml) (P < 0.001). Levels of inhibin B were also significantly higher in women with aPOI (median, 109 pg/ml) than in women with iPOI (median, 18 pg/ml) (P < 0.001) or HW (median, 39 pg/ml) (P < 0.05). Serum concentrations of total inhibin and inhibin B were significantly higher in women with POI than in postmenopausal women (P < 0.001), irrespective of the presence/absence of autoantibodies. At receiver-operating characteristic analysis, cutoff values of 133 pg/ml for total inhibin and 60.5 pg/ml for inhibin B ensured 86.4% sensitivity and 81-84.5% specificity for aPOI vs. iPOI.
We conclude that a variable degree of ovarian function is preserved in women with POI and that aPOI is characterized by increased inhibin production resulting from a selective theca cell destruction, with initial preservation of granulosa cells.

18 Reads
  • Source
    • "Ovarian biopsy is not recommended for the confirmation of the diagnosis in APOF. In one study (22), highly elevated total inhibin and inhibin B serum levels were reported in patients with APOF compared to patients with idiopathic POF and natural menopause. Increased inhibin B level was thought to be a result of the initial preservation of granulosa cell functions. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Myasthenia gravis (MG) is an autoimmune disorder characterized by autoantibodies against acetylcholine receptors. MG is generally an isolated disorder but may occur concomitantly with other autoimmune diseases. We describe an eighteen-year-old girl with MG who was admitted to our clinic with secondary amenorrhea and diagnosed as autoimmune oophoritis. Since her myasthenic symptoms did not resolve with anticholinesterase therapy, thymectomy was performed. After thymectomy, her menses have been regular without any hormonal replacement therapy. To our knowledge, this is the first report on a patient with autoimmune ovarian insufficiency and MG in whom premature ovarian insufficiency resolved after thymectomy, without hormonal therapy. Conflict of interest:None declared.
    Full-text · Article · Dec 2011 · Journal of Clinical Research in Pediatric Endocrinology
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper presents a multiagent based wide area stabilization control of electric power systems. Two types of intelligent agents are proposed to realize the proposed wide area stabilization control system: a monitoring agent for gathering required information to stabilize the target power system, a control agent which perform the actual stabilization control on the selected unit. To demonstrate the efficiency of the proposed multiagent based wide area stabilization control, experimental studies have been performed on the analog power system simulator at the research laboratory of the Kyushu Electric Power Co.
    No preview · Conference Paper · Dec 2004
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Revise role of hormonal basal and dynamic tests, as well as ultrasonographic measures as ovarian reserve markers, in order to provide better counseling to subfertile couples. Review of publications on the topic, with an emphasis on recent well designed articles. Currently available ovarian reserve tests do not provide sufficient evidence to be solely considered ideal, even for premature ovarian senescence patients who do not present subfertility complaints. However, these markers occupy important place in initial approach to treatment of subfertile couples, predicting unsatisfactory results that could be improved by differentiated induction schemes and reducing excessive psychological and financial burdens, and adverse effects. In order to remedy the limitations due to the scarcity of strong evidence about this topic, future studies should try to clarify predictive value of markers in groups of specific diseases-related subfertility and pay special attention to propaedeutic multivariate models including anti-Müllerian hormone and antral follicle count.
    Full-text · Article · Aug 2008 · Journal of Assisted Reproduction and Genetics
Show more