Effect of Corticosteroids and Cyclophosphamide on Sex Hormone Profiles in Male Patients With Systemic Lupus Erythematosus or Systemic Sclerosis

Arnaud, Laurent; Nordin, Annika; Lundholm, Hannes; Svenungsson, Elisabet; Hellbacher, Erik; Wikner, Johan; Zickert, Agneta; Gunnarsson, Iva

doi:10.1002/art.40057

Cited by 37 publications

(42 citation statements)

References 29 publications

(36 reference statements)

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“…Glucocorticoids suppress the hypothalamic‐pituitary axis and may lead to hypogonadism. A study in male patients with lupus found that current dosage of prednisolone was inversely related to bioactive testosterone levels . Shabanova et al found that menstrual irregularities and hormonal imbalances in women were associated with higher SLEDAI score .…”

Section: Discussionmentioning

confidence: 99%

“…A study in male patients with lupus found that current dosage of prednisolone was inversely related to bioactive testosterone levels. 24 Shabanova et al found that menstrual irregularities and hormonal imbalances in women were associated with higher SLEDAI score. 25 Hence both disease activity and medication may affect gonadal function and contribute to sexual dysfunction in lupus.…”

Section: Discussionmentioning

confidence: 99%

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Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus

et al. 2019

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Background This study aimed to evaluate sexual functioning and its association with disease activity, damage, marital satisfaction, fatigue and psychiatric comorbidity in married women with systemic lupus erythematosus (SLE). Methods One hundred and twelve premenopausal married women with SLE were included in the study. Disease activity and damage were assessed using Safety of Estrogens in Lupus Erythematosus National Assessment Systemic Lupus Erythematosus Disease Activity Index (SELENA‐SLEDAI) and Systemic Lupus International Collaborating Clinics/ American College of Rheumatology Damage Index (SDI) respectively. Female sexual function index (FSFI) and couple satisfaction index (CSI) were used to evaluate sexual function and marital satisfaction respectively. Depression, anxiety and fatigue were assessed using Patient Health Questionnaire 9 (PHQ9), Generalized Anxiety Disorder 7 (GAD7) and fatigue severity scale (FSS) respectively. Results The mean age of the study group was 34.0 (SD 6.8) years. Mean SELENA‐SLEDAI was 3.67 (SD 4.2) and mean SDI was 0.25 (SD 0.62). Median steroid dose at the time of evaluation was 7.5 mg/d of prednisolone. Based on FSFI total score, impaired sexual functioning was found in 60.7%. However, when the cut‐off of different domains was considered, more than 90% of the participants reported problems in desire, arousal and lubrication. The mean CSI score was 130.39 ± 26.17. Eighteen patients (16.1%) had CSI lower than the cut‐off score (104.5) suggestive of marital distress. On univariate analysis sexual function showed a correlation with marital satisfaction (r = .34, P < .001), dose of steroids(r = −.26, P = .008), disease activity (r = −.21, P = .027), depression (r = −.19, P = .039) and anxiety (r = −.201, P = .034). Conclusion Sexual dysfunction is highly prevalent in premenopausal married females with SLE. Higher dose of steroids, disease activity, depression,anxiety and marital satisfaction were associated with poor sexual functioning in one or more domains.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus

et al. 2019

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“…The mechanisms behind hypogonadism are still unclear. Treatment with glucocorticoids and cyclophosphamide suppresses the hypothalamic-pituitary-gonadal axis (14). Other hormonal pathologies in GPA-associated pituitary dysfunction are not as common as hypogonadism and DI.…”

Section: Discussionmentioning

confidence: 99%

Granulomatosis Polyangiitis Presented with Diabetes Insipidus

Koca¹,

Tarhan²,

Elibol³

et al. 2020

Turk J Endocrinol Metab

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“…Several factors can affect the hypothalamic-pituitary-gonadal axis, including hyperprolactinemia, the chronic disease itself and pharmacologic treatment. It is well known that treatment with both glucocorticoids and cyclophosphamide can provoke hypothalamic-pituitary-gonadal axis suppression [ 19 ]. The high rate of hypogonadism due to GPA itself may therefore be overestimated.…”

Section: Discussionmentioning

confidence: 99%

Pituitary dysfunction in granulomatosis with polyangiitis

et al. 2017

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PurposeGranulomatosis with polyangiitis (GPA) is a multisystem disease, characterized by necrotizing small-vessel vasculitis, which mainly affects the respiratory tract and the kidneys. Pituitary involvement in GPA is rare, present in about 1% of all cases of GPA. To date, only case reports or small case series have been published. Herein we report clinical features, imaging findings, treatment and outcomes in three patients with GPA-related pituitary dysfunction (PD).MethodsA retrospective analysis of three cases of GPA-related PD was conducted, followed by systematic review of the English medical literature using PubMed.ResultsThe three cases include three women aged between 32 and 37 years. PD was the presenting feature in one and two developed PD in the course of the disease. All patients had a pituitary lesion on MRI. Conventional treatment with high doses of glucocorticoids and cyclophosphamide led to resolution or improvement of the MRI abnormalities, whereas it was not effective in restoring PD. A systematic review identified 51 additional patients, showing that GPA can lead to partial or global PD, either at onset or, during the course of the disease. Secondary hypogonadism is the predominant manifestation, followed by diabetes insipidus (DI). Sellar mass with central cystic lesion is the most frequent radiological finding.ConclusionGPA should be carefully considered in patients with a sellar mass and unusual clinical presentation with DI and systemic disease. Although conventional induction-remission treatment improves systemic symptoms and radiological pituitary abnormalities, hormonal deficiencies persist in most of the patients. Therefore, follow-up should include both imaging and pituitary function assessment.

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Effect of Corticosteroids and Cyclophosphamide on Sex Hormone Profiles in Male Patients With Systemic Lupus Erythematosus or Systemic Sclerosis

Cited by 37 publications

References 29 publications

Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus

Sexual functioning and its correlates in premenopausal married Indian women with systemic lupus erythematosus

Granulomatosis Polyangiitis Presented with Diabetes Insipidus

Pituitary dysfunction in granulomatosis with polyangiitis

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