Abstract

VELASQUEZ MENDEZ, Mónica Patricia; RAMIREZ RUIZ, Francisco Alejandro; VASQUEZ DUQUE, Gloria María  and  RAMIREZ GOMEZ, Luis Alberto. Prevalence of ovarian failure and risk factor in patients with systemic lupus erythematosus. Rev.Colomb.Reumatol. [online]. 2006, vol.13, n.3, pp.189-197. ISSN 0121-8123.

Background: premature ovarian failure is a cyclophosphamide (CYC) treatment adverse effect. The report of prevalence is among 11% and 59%, the variability depend on the route and dosage of CYC. There are few studies about gonadal toxicity with NHI CYC treatment protocol. We decided to establish the prevalence and risk factors associated with premature ovarian failure in a group of Latin-American lupus patients. Methods: 56 SLE patients under 40 years treated with intravenous CYC, with regular menstrual cycle at the beginning of the treatment, were compared with respect to the frequency of amenorrhea with 43 SLE patients without treatment with CYC as a control group. After that, we studied in the CYC group the differences between those who made amenorrhea and those that continued with regular cycles. This is a cross sectional and descriptive study. The data were analyzed by chi-square, Fisher’s exact test and Mann-Withney when it was necessary. P < 0.05 was considered significant. Results: 16.1% of SLE patients under intravenous CYC treatment get premature ovarian failure vs. 4.3% in the control group. With respect to CYC group, the mean age in the amenorrhea group was higher than the age in patients with regular menstrual cycles 35.2 vs. 26.7 years (p=0.03). We found than patients older than 28 years have a mayor risk for amenorrhea induced by intravenous CYC. The mean disease duration was higher in the amenorrhea group than in the regular menstrual cycle patients, p= 0.003 (10.2 vs. 4.4 years). No significant differences were observed in cumulative dosage, treatment duration or immunologic findings between groups. Conclusion: the prevalence of ovarian failure in Colombian women tends to appear at an early age and with a greater time of evolution of the disease in spite of inferior accumulated doses than those that are informed in the Literature, suggesting a mayor susceptibility to toxic effect of CYC.

Keywords : cyclophosphamide; premature ovarian failure; amenorrhea; systemic lupus erythematosus.

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