Recurrent pregnancy loss and autoantibody profile in autoimmune diseases

Mavragani, C P; Ioannidis, John P. A.; Tzioufas, A G; Hantoumi, I. E.; Moutsopoulos, H. M.

doi:10.1093/rheumatology/38.12.1228

Cited by 33 publications

(16 citation statements)

References 29 publications

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“…In subjects without SLE, autoantibodies have been described to occur in association with premature ovarian failure 22 and anti-nuclear antibodies have been proposed actually as a marker of a specific subtype of premature ovarian failure occurring before age 30. 23 Interestingly, anti-Ro is the strongest predictor of fetal wastage in SLE 24 and of neonatal congenital heart block. 25 Anti-U1RNP associations are less clear-cut, although this antibody has been associated with neonatal lupus without congenital heart block.…”

Section: Gonadal Toxicitymentioning

confidence: 99%

Ovarian failure in systemic lupus erythematosus patients treated with pulsed intravenous cyclophosphamide

Katsifis

Tzioufas

2004

Lupus

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Pulsed intravenous cyclophosphamide is considered as standard therapy for lupus nephritis and several other severe manifestations of systemic lupus erythematosus (SLE). While the response rate to intravenous cyclophosphamide is substantial, concern has arisen about its toxicity. In addition to increased susceptibility to infection, bone marrow suppression, alopecia, hemorrhagic cystitis and malignancy, ovarian failure is an important side effect associated with the use of cyclophosphamide. Prior research on cyclophosphamide-treated women has consistently demonstrated that the risk of sustained amenorrhea depends on the age of the patient and the cumulative dose received. Sustained amenorrhea is difficult to avoid in women 32 years or older, even with very short intravenous cyclophosphamide courses. Younger women seem to have a substantially lower incidence of ovarian failure, but this side effect may be far more problematic for these patients. In these young women the risk may be modulated by the prior SLE disease duration, the presence of anti-U1RNP antibodies and anti-Ro antibodies. Co-treatment with gonadotropin-releasing hormone agonists may preseserve the future fertility and ovarian function in young women. Ovarian banking before administration of cyclophosphamide should be considered in selected patients.

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Section: Gonadal Toxicitymentioning

confidence: 99%

Ovarian failure in systemic lupus erythematosus patients treated with pulsed intravenous cyclophosphamide

Katsifis

Tzioufas

2004

Lupus

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“…Unfortunately, despite extensive investigation, an etiology is demonstrated in only 50% of recurrent aborters. To date, only one autoantibody, the anticardiolipin antibody, has been shown to correlate with pregnancy loss in women with recurrent abortion (8)(9)(10)(11)(12)(13)(14). Treatment with heparin and aspirin, in women with three or more pregnancy losses, has been shown to improve the pregnancy success rate in anticardiolipin positive women (36)(37)(38).…”

Section: Thyroid Autoantibodies and Habitual Abortionmentioning

confidence: 99%

“…This factor was later coined the lupus anticoagulant. Subsequently, multiple studies have confirmed a correlation between circulating nonorgan-specific autoantibodies, particularly the lupus anticoagulant (5-7) and the anticardiolipin antibody (8)(9)(10)(11)(12)(13)(14) and recurrent abortion. A recent study reported three additional nontissue-specific autoantibodies, those directed against Ro52, Ro60, and p57, which were also independently associated with pregnancy loss (15).…”

Section: Introductionmentioning

confidence: 99%

Thyroid Antibodies and Fetal Loss: An Evolving Story

Abramson

Stagnaro-Green

2001

Thyroid

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This article reviews the literature on thyroid antibodies and miscarriage. In 1990, in a study designed to determine the incidence and etiology of postpartum thyroiditis, a serendipitous finding emerged revealing an association between thyroid antibodies and spontaneous miscarriage. Subsequently, four other studies, performed on three different continents, have confirmed the correlation. Six studies have evaluated the relationship between thyroid antibodies and recurrent abortion, defined as three or more spontaneous miscarriages. The majority of the studies (67%) reported a statistically significant increase in the incidence of thyroid antibodies in the recurrent abortion group as compared to controls. Four intervention trials have evaluated the impact of immunosuppressive therapy in women with thyroid antibodies. Although all of the trials revealed a decrease in the incidence of recurrent abortion, each study was limited by methodological concerns. A recently developed murine model of pregnancy has also demonstrated increased fetal loss in female mice immunized with thyroglobulin when mated with allogeneic males. The implications of these data generated over the last decade are discussed.

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“…Recently, antibodies to ENA (anti‐ENA) have been considered to be associated with pregnancy loss. Mavragani et al 16 . found that in women with autoimmune disorders, a history of RM was independently associated with anti‐Ro/SSA.…”

Section: Introductionmentioning

confidence: 99%