Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure

被引:90
作者
Bachelot, Anne [1 ,2 ]
Rouxel, Agnes [1 ]
Massin, Nathalie [1 ]
Dulon, Jerome [1 ]
Courtillot, Carine [1 ]
Matuchansky, Christine [3 ]
Badachi, Yasmina [4 ]
Fortin, Anne [5 ]
Paniel, Bernard [6 ]
Lecuru, Fabrice [7 ]
Lefrere-Belda, Marie-Aude [8 ]
Constancis, Elisabeth [9 ]
Thibault, Elisabeth [10 ]
Meduri, Geri [11 ,12 ]
Guiochon-Mantel, Anne [11 ,12 ]
Misrahi, Micheline [12 ,13 ]
Kuttenn, Frederique [1 ,2 ]
Touraine, Philippe [1 ,2 ]
机构
[1] Univ Paris 06, Grp Hosp Pitie Salpetriere, AP HP,Dept Endocrinol & Reprod Med, Ctr Reference Malad Endocriniennes Rares Croissan, F-75013 Paris, France
[2] INSERM, U845, F-75015 Paris, France
[3] Grp Hosp Necker Enfants Malad, AP HP, Dept Radiol, F-75015 Paris, France
[4] Grp Hosp Pitie Salpetriere, AP HP, Dept Radiol, F-75013 Paris, France
[5] Grp Hosp Pitie Salpetriere, AP HP, Dept Obstet & Gynecol, F-75013 Paris, France
[6] Ctr Hosp Intercommunal, AP HP, Dept Gynecol Surg, F-94010 Creteil, France
[7] Hosp Europeen Georges Pompidou, AP HP, Dept Gynecol Surg, F-75015 Paris, France
[8] Hosp Europeen Georges Pompidou, AP HP, Dept Pathol, F-75015 Paris, France
[9] Ctr Hosp Intercommunal, AP HP, Dept Pathol, F-94010 Creteil, France
[10] Grp Hosp Necker Enfants Malad, AP HP, Dept Pediat, F-75015 Paris, France
[11] Hop Bicetre, Mol Genet Lab, F-94275 Le Kremlin Bicetre, France
[12] Fac Med Paris Sud 11, INSERM, U693, F-94275 Le Kremlin Bicetre, France
[13] Univ Paris 11, INSERM, U854, F-94275 Le Kremlin Bicetre, France
关键词
FOLLICLE-STIMULATING-HORMONE; ANTI-MULLERIAN HORMONE; FRAGILE-X PREMUTATION; YOUNG-WOMEN; AUTOIMMUNE OOPHORITIS; PRIMARY AMENORRHEA; BMP15; GENE; RECEPTOR; MUTATION; INSUFFICIENCY;
D O I
10.1530/EJE-09-0231
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Premature ovarian failure (POF) encompasses a heterogeneous spectrum of conditions. with phenotypic variability among patients. The etiology of POF remains unknown in most cases. We performed it global phenotyping of POF women with the aim of better orienting attempts at all etiological diagnosis. Design and methods: We performed it mixed retrospective and prospective study of clinical, biological, histological, morphological. and genetic data relating to 357 consecutive POF patients between 1997 and 2008. The study Was Conducted at a reproductive endocrinology referral center. Results: Seventy-six percent of the patients presented with normal puberty and secondary amenorrhea. Family history was present in 14% of the patients, clinical and/or biological atuoimmunity in 14.3%. Fifty-six women had it fluctuating form of POE. The presence of follicles was suggested at ultrasonography in 50% of the patients, and observed in 29% at histology; the negative predictive value of the presence of follicles at ultrasonography was 77%. Bone mineral density alterations were found in 58% of the women. Eight patients had X chromosomal abnormalities other than Turner's syndrome, eight other patients evidenced FMRI pre-mutation. Two other patients had autoimmune polyendocrine syndrome type 2 and 1. Conclusion: A genetic Cause of POF Was identified in 25 patients, i.e. 7% of the whole cohort. POF etiology, remains most often undiscovered. Novel strategies of POF phenotyping are in such content mandatory to improve the rate of POF patients for whom etiology is identified.
引用
收藏
页码:179 / 187
页数:9
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