RESUMO
INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune disease that affects fertile-age women and of which treatment includes immunosuppressive agents that can affect the gonads. OBJECTIVE: To evaluate the frequency of menstrual alterations in lupus patient treated with immunosuppressive agents (ISA). PATIENTS AND METHODS: A total of 87 patients, aged < 40 years, were studied. The patients were followed by outpatient management and the treatment used was verified. Only organic causes of menstrual alterations were excluded from the study. The menstrual alterations were correlated with the type and time of use of different ISA. RESULTS: Age varied from 14 to 38 years, with a mean age of 28.01 ± 5.81 years; the mean age at menarche was 13.12 ± 1.77 years and the diagnosis of SLE was at 21.40 ± 5.75 years. Corticoids were used as single therapy by 63.2% of them, for a mean time of 6.11 ± 5.14 years and the use of other immunosuppressive agents occurred with a mean time of 5.60 ± 3.59 years. Menstrual alterations occurred in 37.9% and amenorrhea in 11.5%. There was an association between menstrual alterations with the use of ISA (P = 0.034). CONCLUSION: The frequency of menstrual alterations was higher than that found in the general population, similar to what was observed in other publications on lupus treatment. The higher frequency of menstrual alterations in these patients was significantly associated with the use of ISA. The results justify caution when prescribing these medications,research indication and the use of techniques for ovarian preservation means.
Assuntos
Imunossupressores/efeitos adversos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Distúrbios Menstruais/induzido quimicamente , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Distúrbios Menstruais/epidemiologia , Adulto JovemRESUMO
INTRODUÇÃO: O lúpus eritematoso sistêmico (LES) é uma doença autoimune que afeta mulheres em idade fértil. Em seu tratamento são utilizados imunossupressores que podem afetar as gônadas. OBJETIVO: Avaliar a frequência de alterações menstruais de pacientes lúpicas tratadas com imunossupressores. MÉTODOS: Foram estudadas 87 pacientes, com idade inferior a 40 anos, com LES em seguimento ambulatorial e verificado o esquema terapêutico utilizado. Excluiu-se do estudo outras causas orgânicas de alteração menstrual. Foi feita correlação de alterações menstruais com o tipo e o tempo de uso dos diferentes imunossupressores. RESULTADOS: A idade variou de 14 a 38 anos, com média de idade 28,01 ± 5,81 anos; a média de idade da menarca foi de 13,12 ± 1,77 anos e o diagnóstico de lúpus 21,40 ± 5,75 anos. O corticoide estava em uso de forma individual por 63,2 por cento, com média de tempo de 6,11 ± 5,14 anos e o uso de outros imunossupressores ocorreu com média de tempo de 5,60 ± 3,59 anos. Alterações menstruais ocorreram em 37,9 por cento e amenorreia em 11,5 por cento. Houve associação das alterações menstruais com o uso dos imunossupressores (IS) (P = 0,034). CONCLUSÃO: A frequência de alterações menstruais foi superior a encontrada na população em geral, semelhante ao observado em outras publicações sobre lúpus em tratamento. A maior frequência de alterações menstruais nessas pacientes foi significativamente associada ao uso de Imunesupressores. O resultado justifica a prudência no uso destes medicamentos, a orientação para pesquisa e uso de técnicas de meios de preservação dos ovários.
INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune disease that affects fertile-age women and of which treatment includes immunosuppressive agents that can affect the gonads. OBJECTIVE: To evaluate the frequency of menstrual alterations in lupus patient treated with immunosuppressive agents (ISA). PATIENTS AND METHODS: A totalof 87 patients, aged < 40 years, were studied. The patients were followed by outpatient management and the treatment used was verified. Only organic causes of menstrual alterations were excluded from the study. The menstrual alterationswere correlated with the type and time of use of different ISA. RESULTS: Age varied from 14 to 38 years, with a mean age of 28.01 ± 5.81 years; the mean age at menarche was 13.12 ± 1.77 years and the diagnosis of SLE was at 21.40 ±5.75 years. Corticoids were used as single therapy by 63.2 percent of them, for a mean time of 6.11 ± 5.14 years and the use of other immunosuppressive agents occurred with a mean time of 5.60 ± 3.59 years. Menstrual alterations occurred in 37.9 percent and amenorrhea in 11.5 percent. There was an association between menstrual alterations with the use of ISA (P = 0.034). CONCLUSION: The frequency of menstrual alterations was higher than that found in the general population, similar to what was observed in other publications on lupus treatment. The higher frequency of menstrual alterations in thesepatients was significantly associated with the use of ISA. The results justify caution when prescribing these medications,research indication and the use of techniques for ovarian preservation means.