COVID 19 vaccination as a trigger of acute genital ulcers in an immunocompromised adolescent-case study and literature review.

Acute genital ulcers can affect females of all ages. In children, they often appear as an emergency and remain a diagnostic challenge for pediatricians, gynecologists and dermatologists. Prompt diagnosis and identification of disease- related factors help to implement appropriate treatment. Firstly, it is crucial to properly compile the past medical history of the patient. Past infectious, autoimmune, malignant or traumatic conditions, as well as vaccinations may contribute to the occurrence of acute genital ulcers. Moreover, new infectious agents, such as severe acute respiratory syndrome coronavirus 2 and vaccinations against Coronavirus disease of 2019, may play a significant role in the development of atypical clinical symptoms. Here we present a case of a 12-year-old girl with acute genital ulcers. Additional symptoms accompanying the ulcer included: abdominal pain, nausea, vomiting, dysuria, vulvar pain and fever. Blood test showed leukocytosis, especially neutrophilia and monocytosis and increased levels of c-reactive protein and procalcitonin. Serological tests for the most common infections were negative. Moreover, the patient had a history of autoimmune diseases. She had periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, and IgA vasculitis, also known as Henoch-Schönlein purpura in her past medical history. Additionally, she was vaccinated against SARS-CoV-2 shortly before the lesions appeared.

Beckwith-Wiedemann Syndrome in Newborn of Mother with HELLP Syndrome/Preeclampsia: An Analysis of Literature and Case Report with Fetal Growth Restriction and Absence of CDKN1C Typical Pathogenic Genetic Variation.

Beckwith-Wiedemann Syndrome (BWS) is an imprinting disorder, which manifests by overgrowth and predisposition to embryonal tumors. The evidence on the relationship between maternal complications such as HELLP (hemolysis, elevated liver enzymes, and low platelet count) and preeclampsia and the development of BWS in offspring is scarce. A comprehensive clinical evaluation, with genetic testing focused on screening for mutations in the CDKN1C gene, which is commonly associated with BWS, was conducted in a newborn diagnosed with BWS born to a mother with a history of preeclampsia and HELLP syndrome. The case study revealed typical clinical manifestations of BWS in the newborn, including hemihyperplasia, macroglossia, midfacial hypoplasia, omphalocele, and hypoglycemia. Surprisingly, the infant also exhibited fetal growth restriction, a finding less commonly observed in BWS cases. Genetic analysis, however, showed no mutations in the CDKN1C gene, which contrasts with the majority of BWS cases. This case report highlights the complex nature of BWS and its potential association with maternal complications such as preeclampsia and HELLP syndrome. The atypical presence of fetal growth restriction in the newborn and the absence of CDKN1C gene mutations have not been reported to date in BWS.

Maternal predictors and quality of umbilical cord blood units.

The aim of the study was to determine the relationship between the maternal age at delivery and selected properties of the cord blood stem cells. The study included 50 pregnant women aged between 18 and 38 years in which spontaneous labors or elective cesarean sections were performed. Umbilical cord blood was collected immediately after the women were delivered of newborns. The samples were analyzed in the Polish Stem Cells Bank in Warsaw. The highest mean WBC level (p < 0.05) was observed in the umbilical blood collected from patients aged 35 years and more. Similarly, the highest mean cell viability was observed in the umbilical cord blood collected from patients aged 35 and more. There were no statistically significant correlations between the CD34+ cells count and mean cell viability in the umbilical cord blood and the maternal age. With the significance level at p < 0.001, the females after spontaneous labor revealed a visibly higher WBC level than patients after a cesarean section. The higher mean WBC concentration (24.95 thousand/µl) was observed in the umbilical cord blood of patients aged 35 and more after spontaneous labors. In the same group, the umbilical cord blood was also characterized by the highest mean cell viability (98.72%). The number of nucleated cells in the umbilical cord blood collected in the perinatal period increases together with the maternal age. In the course of physiological spontaneous labors, the collected umbilical cord blood has more nucleated cells as compared with elective caesarian sections.

The influence of p02, BE, BB parameters of perinatally obtained cord blood on quantity of obtained cells and focus on the perfect donor criteria.

The aim of the study was to analyze the influence of oxygene partial pressure (p02), base excess (BE) and buffer base (BB) parameters of cord blood obtained perinatally on quantity of obtained cells and focus on the perfect donor criteria. The study included 50 pregnant women aged between 18 and 38 years in which spontaneous labors and elective cesarean sections were performed. Umbilical cord blood was collected immediately after the women were delivered of newborns. The cells were analyzed in the Polish Stem Cells Bank in Warsaw. In the study group of patients different stem cells viability levels did not differ significantly in terms of pO2, BB and BE level, however, there was a trend that the higher the viability the lower BE value. The experiment showed also that the cord blood (CB) oxygenation scope is vitally important for the CB cells viability.

Does anxiety modify sexuality of pregnant women?

OBJECTIVES: The aim of this study was to evaluate the influence of anxiety on women's sexuality during pregnancy. MATERIAL AND METHODS: The prospective study involved 520 pregnant women at the age of 18-45. 168 of them were quali¬fied for the final analysis. The research tools were: a self-designed questionnaire for women and standardized STAI scale. RESULTS: The state and trait anxiety in pregnant women was evaluated during all trimesters of pregnancy. State anxiety was stronger among women with a strong tendency to feelings of anxiety. The authors also tried to determine the correlation between women's assessment of their relationship with the partners and its impact on state and trait anxiety during all three trimesters of pregnancy. Self assessment of relations between partners had statistically significant impact on the increase in state anxiety (p = 0.04) in multiparous women, who reported impairment of their relations with the partner, and had statistically significant impact on the increase in the trait anxiety in primiparous women (p = 0.02) and multiparous (p = 0.05) women, who reported deterioration of partnership especially in the second trimester of their pregnancy. Lower anxiety level in the second trimester contributed to the increased sexual activity. CONCLUSIONS: Anxiety level during pregnancy significantly affected the quality of sexual activity. Lower anxiety level in the second trimester contributed to the increased sexual activity.

Sexual function and depressive symptoms in young women with thyroid autoimmunity and subclinical hypothyroidism.

OBJECTIVE: The results of few studies conducted to date suggest an increased prevalence of sexual dysfunction in patients with thyroid disorders. DESIGN: The aim of this study was to compare female sexual function and depressive symptoms between women with autoimmune thyroid disease and with mild thyroid failure. PATIENTS: The study included four groups of young women: euthyroid women with Hashimoto's thyroiditis (Group 1), women with nonautoimmune subclinical hypothyroidism (Group 2), women with autoimmune subclinical hypothyroidism (Group 3) and healthy euthyroid females without thyroid autoimmunity (Group 4). MEASUREMENTS: Beyond measuring serum hormone levels and thyroid antibody titres, all enrolled women completed questionnaires evaluating female sexual function (Female Sexual Function Index - FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II). RESULTS: The mean total FSFI score was lower in women with autoimmune hypothyroidism than in the remaining groups of women, as well as lower in Groups 1 and 2 than in Group 4. Compared to Group 4, three domains (sexual desire, lubrication and sexual satisfaction) were lower in Group 1, four domains (desire, arousal, lubrication and dyspareunia) in Group 2 and all FSFI domain scores in Group 3. The total BDI-II score was higher in Groups 1 and 2 than in Group 4, as well as higher in Group 3 than in the other groups of women. CONCLUSIONS: The obtained results suggest that both thyroid autoimmunity and mild thyroid failure, particularly if they occur together, may negatively affect female sexual function and depressive symptoms.

Sexual Function and Depressive Symptoms in Young Women With Nonclassic Congenital Adrenal Hyperplasia.

INTRODUCTION: Women with classic forms of congenital adrenal hyperplasia (CAH) or polycystic ovary syndrome have been found to have impaired sexual function. AIM: This study investigated sexual activity in young women with nonclassic CAH (NC-CAH). METHODS: The study included 24 untreated women with NC-CAH and 24 age-matched healthy women. Plasma levels of free and total testosterone, androstenedione, and dehydroepiandrosterone sulfate were measured. Hirsutism was evaluated according to the modified Ferriman-Gallwey score. Questionnaires assessing female sexual function (Female Sexual Function Index) and the presence and severity of depressive symptoms (Beck Depression Inventory, Second Edition) were completed by each participant. MAIN OUTCOME MEASURES: Sexual function and depressive symptoms in young women with NC-CAH. RESULTS: Women with NC-CAH presented increased plasma levels of 17-hydroxyprogesterone, total and free testosterone, androstenedione, and dehydroepiandrosterone sulfate and higher hirsutism scores compared with healthy women. The study group also showed a lower total Female Sexual Function Index score and lower scores in four domains (sexual arousal, lubrication, sexual satisfaction, and dyspareunia). Scores for sexual desire and orgasm correlated with total hirsutism score and testosterone levels. The Beck Depression Inventory questionnaire showed that the total score was higher in women with NC-CAH than in healthy women, correlating with the hirsutism score and testosterone levels. CONCLUSION: The presence of NC-CAH in young women is associated with impaired sexual function and mild depressive symptoms.

Changes in the sexual function during pregnancy.

INTRODUCTION: The physiological changes during each trimester of pregnancy have a significant impact on women's sexual behavior. AIM: The aim of the work was to assess changes in the sexual function during pregnancy. METHODS: The prospective study encompassed 520 pregnant women aged between 18 and 45, of whom 168 were qualified for the final analysis. The research tool was a purpose-designed research questionnaire and the standardized Female Sexual Function Index. MAIN OUTCOME MEASURES: To assess changes in the sexual function among pregnant women aged 18-45 in the three pregnancy trimesters. RESULTS: All the studied parameters, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain, decreased significantly with the progression of pregnancy. Analyzing the frequency of sexual intercourse in the studied group before and during pregnancy, a statistically significant decrease (P<0.000001) was observed. Sexual desire changed statistically significantly (P=0.0004). The direction of change concerned decreased sexual desire in the three trimesters compared with the situation before pregnancy. Statistical significance was demonstrated for: decreased sexual desire (P=0.00007), partner's reluctance (P=0.002), and pregnancy-related changes in appearance (P=0.03). CONCLUSIONS: Sexual function was compromised and sexual activity decreased as the pregnancy progressed. Changes in the domains of arousal, lubrication, and orgasm were particularly notable in primaparae in the third trimester of pregnancy. Unsatisfying partner relationship was a significant factor affecting the quality of sexual life during pregnancy.

[Diagnosing polycystic ovary syndrome in adolescent girls]. / Rozpoznanie zespolu policystycznych jajników u dziewczat.

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies and it manifests itself in about 4-12% women of reproductive age. The Rotterdam, AES and NIH criteria can be used to diagnose PCOS in adults but there are no specific criteria to diagnose PCOS in adolescent girls. Most authors agree that applying criteria for adult to teenagers leads to overdiagnosis because of similarity in physiological changes during puberty and common PCOS symptoms. Tightening of the current criteria and including new, not widely accepted yet, was proposed. Currently it seems justifiable to diagnose PCOS in adolescent girls using the Rotterdam criteria, on condition that all three symptoms are present, hyperandrogenism is established in laboratory tests and pelvic ultrasound reveals an increased ovarian volume (> 10 ml). Nevertheless, the necessity of more research and establishing specific criteria for adolescent girls is emphasized.

[The influence of pH and pCO2 levels of umbilical cord blood obtained perinatally on selected parameters of stem cells]. / Wplyw pH i pCO2 krwi pepowinowej uzyskiwanej okoloporodowo na wybrane parametry komórek macierzystych.

OBJECTIVE: The aim of the study was to demonstrate a correlation between pH and pCO2 levels in umbilical cord blood and the quality of the harvested material. Additionally the effect of pH and pCO2 on the number of cord blood CD34+ cells and their vitality was analyzed. MATERIAL AND METHODS: The study included 50 pregnant women after vaginal delivery at term or elective cesarean section. Umbilical cord blood was collected immediately after birth. The probes were analyzed at the Polish Stem Cell Bank in Warsaw. RESULTS: The number of CD34+ cells ranged from 0.1-0.2 in white blood cells count over 12 thousand/ml and pH of > 7.3. If pH ranged between 7.35-7.40, the number of CD34+ was 0.3-0.4. The highest number of CD34+ cells was noted for pH of 7.30-7.35 and amounted to 0.4-0.5. Analysis of stem cell vitality showed that the highest level, over 98%, was obtained when pH was < 7.3 and > or = 7.4. The study revealed the viability of stem cells to drop to 97-98% at pH level of 7.3-7.4. Low values of CD34+ (0.01-0.09) were related to pCO2 of > 40.0 mmHg. For pCO2 < 38 mmHg, the value of CD34+ cells was 0.2-0.3%, which is relatively high. However when pCO2 was > or = 38 mmHg, the number of CD34+ ranged between 0.1-0.2. CONCLUSIONS: Viability of the umbilical cord stem cells increases along with the decrease of pH and pCO2 levels. The mode of delivery does not influence the viability of the stem cells.

Alpha-fetoprotein level in fetuses, infants, and children with ovarian masses: a literature review.

Alpha-fetoprotein (AFP) is a serum protein highly produced during the fetal period. It is also known as a biomarker of various pathologies. Commonly, tumors requiring diagnosis and monitoring through AFP determination appear during the first year of life, with poorer outcomes when presenting in fetal life. Due to advancements in imaging technology, the detectability of ovarian masses in infants is higher. However, the use of AFP as a biomarker could improve diagnosis in cases when imaging and histological examinations are not sensitive enough to detect tumors. From the outcome of our investigation, it is possible to conclude that there is evidence of an association between increased AFP levels and ovarian masses. However, previous studies have presented contradictory and unverified results, with the authors emphasizing that future research is needed. In this article, an analysis of the available literature on AFP as a biomarker of ovarian masses in children was performed. Two types of literature were reviewed: guidance and published studies (clinical trials, reviews, and systematic reviews). We searched the Embase, PubMed, ScienceDirect, and Web of Science databases to collect essential data.

Congenital malformations of the female genital organs.

Congenital malformations of the female genital organs are rare anomalies and their incidence is estimated to be up to 7% in the general population. Müllerian ducts abnormalities are one of the causes of infertility and occur in approximately 16% of women with recurrent miscarriages. Sex development disorders are diagnosed at different stages of the patient's life depending on the accompanying ailments. Alarming signs of genital malformations include primary amenorrhea or dysmenorrhea, dyspareunia, and periodic abdominal pain.

The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls.

INTRODUCTION: Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which can manifest in prepubertal or adolescent patients. The prevailing theories point to autoimmune and genetic factors. The primary symptoms of VLS typically include vulvar itching, discomfort, dysuria, and constipation. Physical examination often reveals a characteristic figure 8 pattern, involving the labia minora, clitoral hood, and perianal region. However, these symptoms and the age of onset are nonspecific and require differentiation from autoimmune dermatoses such as bullous diseases, pemphigus diseases, epidermolysis bullosa acquisita, and dermatitis herpetiformis. We performed this study to distinguish VLS from autoimmune dermatoses, and in doing so, uncover the underlying causes of chronic vulvar changes. This knowledge will enable healthcare providers to offer appropriate medical care to affected patients. METHODS: The study was conducted between July 2020 and February 2021, with a sample of 55 girls aged 2-18 years who did not have any systemic diseases. The study group was composed of 20 girls previously diagnosed with vulvar lichen sclerosus, while the control group included 35 girls without VLS. Questionnaires regarding the medical history of the children were completed by their legal guardians. Blood samples were collected and analyzed biochemically to assess human immunoglobulin A (IgA), IgG, and IgM antibodies against various substrates, including the desmosome of stratum spinosum, basement membrane zone, desmoglein 1 (DSG1), desmoglein 3 (DSG3), BP180-NC16A-4X, BP230gC, pemphigoid antigen, collagen type VII NC1, transitional epithelium, gliadin (GAF-3X), endomysium (EMA), and cellular nucleus (ANA). RESULTS: The analysis of the study group revealed that the most commonly observed signs and symptoms included: itching, soreness, burning sensations, and excoriation, as well as erythema or/and pallor of the skin and perineal mucosa. Among the assessed antibodies, only anti-GAF3x antibodies and ANA antibodies were detected. However, the results did not reach statistical significance (p > 0.5).

The Potential Coexistence of Autoimmune Thyroid Diseases and Pediatric Vulvar Lichen sclerosus.

INTRODUCTION: Vulvar lichen sclerosus (VLS), a chronic inflammatory skin disorder, often coexists with autoimmune thyroid disease (AITD). VLS presents with subtle symptoms including vulvar itching and discomfort. Clinically, a "Figure 8" pattern involving the labia minora, clitoral hood, and perianal region is often observed. It is prevalent both in pre-pubertal girls and women aged 40-60, and the link between VLS and AITD remains unclear, with proposed causes including autoimmune, hormonal or genetic factors, and environmental triggers. This study addresses the lack of research on the association in children, aiming to investigate the largest group of underage girls to date. AIM: This study aimed to investigate the coexistence of thyroid autoimmune diseases in girls diagnosed with vulvar lichen sclerosus (VLS) and to assess the presence of antibodies for specific thyroid autoimmune diseases. MATERIALS AND METHODS: Our study was conducted from July 2020 to February 2021, involving a sample of 55 girls aged 2-18 years old, all free from systemic diseases. The study group comprised 20 girls previously diagnosed with vulvar lichen sclerosus (VLS), while the control group included 35 girls without VLS. Legal guardians completed questionnaires detailing the medical history of their children. Blood samples were collected from all participants and subjected to biochemical analysis. The presence of human IgG antibodies against thyroid peroxidase and IgG antibodies against thyroglobulin was assessed using the immunoenzymatic method with commercially available ELISA kits. RESULTS: In the study group, common symptoms included itching, soreness, burning sensation, excoriation, and erythema or pallor of the skin and perineal mucosa. An evaluation of anti-thyroglobulin and anti-thyroid peroxidase antibodies revealed no statistical significance between the study and control groups (anti-TG p = 0.379, anti-TPO p = 0.96). Family history of autoimmune diseases showed no significant correlation with anti-thyroid antibodies in girls. Although no significant relation between VLS occurrence and antibody levels was found, it emphasizes the need for multidisciplinary medical care. Further research with larger patient groups is necessary.

Breastfeeding and fatty liver - is there any association?

The campaign to promote the natural feeding of infants, at least for the first six months of life, conducted over recent years has deep justification from a medical point of view. Numerous gynecological and pediatric societies around the world recommend breastfeeding as the most appropriate way of feeding infants. It has been proven that the benefits of this type of nutrition go beyond nutritional aspects, proper growth and development. The list of long-term metabolic benefits, which include reducing the incidence of obesity, allergies, infections and diabetes, is constantly growing. It has been shown that the method of feeding infants using various mechanisms may influence the tendency of the liver to accumulate fatty compounds and develop fatty liver disease with its metabolic consequences leading to liver failure, cirrhosis and hepatocellular carcinoma. This is an important discovery due to the growing obesity epidemic in adults and children. Metabolic dysfunction - associated fatty liver disease (MAFLD) has become the most common cause of chronic liver disease, affecting 25% of the global population. The results of studies conducted in recent years have shown the protective effect of breastfeeding on the risk of developing MAFLD later in life in both children and breastfeeding women. New scientific reports provide the basis for qualifying breastfeeding as a modifiable risk factor for MAFLD.

The effect of gonadoliberin analog treatment in precocious puberty on polycystic ovarian syndrome prevalence in adulthood.

Precocious puberty is diagnosed when pubertal characteristics appear before the age of 8 years in females. The most common form is gonadotropin-dependent, called axial. The primary method of treatment is administration of gonadotrophin-releasing hormone analogues (GnRHa). The aim of the study was to verify hypothesis that GnRHa therapy in the childhood may be of additive risk factor for polycystic ovary syndrome (PCOS) in adulthood. Material and Methods: The study group consists of 24 women (median age 22 88 years, median BMI 23.5) treated with GnRHa for central precocious puberty in childhood. The control group includes 40 women (median age 23 years, median BMI 25.6) diagnosed with isolated premature thelarche and not using GnRHa in the childhood. Anthropometric measurements, ultrasound examination of minor pelvis and hormonal profile were performed. PCOS diagnosis was based on Rotterdam criteria. Results: The study confirmed a higher prevalence of PCOS in the study group (50%) than in the control group (10%); p=0.0006. Significant, linear correlation between free testosterone levels and ovarian size was found in the study group (R=0.45 p= 0.03). Conclusions: GnRHa therapy during childhood may have a potential influence on incidence of PCOS in the adulthood. Therefore, in this group of patients long-term follow-up focused on screening for PCOS would seem beneficial.

Laparoscopic Uterine Preservation and Vaginal Reconstruction in a 13-Year-Old Girl with Uterus Didelphys, Bilateral Vesicovaginal Fistulas, and Transverse Vaginal Septum.

BACKGROUND: Complex female genital tract malformations account for 1.2% of all female genitourinary malformations. Although exceedingly rare, they can cause severe gynecologic symptoms in young women and lead to fertility problems. CASE: We present the case of a 13-year-old girl with primary amenorrhea referred for cyclic abdominal lower pain and menouria. Detailed diagnostics revealed uterus didelphys, transverse vaginal septum, and bilateral vesicovaginal fistulas. Laparoscopic left hemi-hysterectomy and salpingectomy were performed. The vesicovaginal fistula on the right side was excised, and the proximal vagina was anastomosed with the distal dimple. Since the operation, the patient has been pain-free and menstruating regularly from the right uterus. SUMMARY AND CONCLUSION: Preservation of the uterus should be considered in any case of complex female genital tract malformation and, as successful laparoscopic treatment advocates, a minimally invasive approach is feasible.

Long-term impact of surgical repair for stress urinary incontinence on female sexual functions, distress and behaviours.

AIMS AND OBJECTIVES: To evaluate sexual functions, distress and behaviours in women who underwent surgical repair of stress urinary incontinence (SUI) in long-term follow-up. BACKGROUND: Contemporary management of SUI includes conservative therapy and surgical repair - the choice of treatment modality depends on the severity of symptoms. If conservative treatment fails, surgical correction is necessary. The outcomes of the surgery for SUI and their influence on sexual functions are satisfactory in short-term follow-up. DESIGN: A total of 50 women diagnosed with SUI according to International Continence Society standards were included in the study. The patients were qualified for surgical procedures such as: transobturator suburethral tape (TOT) (n = 35), Perigee (n = 6) or MiniArc (n = 9). METHODS: Sexual functions and behaviours were evaluated prior to the operation and 1-3 years postoperatively in all patient using Female Sexual Function Index (FSFI) and non-validated questions. RESULTS: The mean time after the operation was 1·96 ± 0·83 years. Postoperatively, all women reported significant reduction of urinary incontinence symptoms. According to DSM-IV criteria, female sexual dysfunctions were diagnosed in 12% of females after the urogenital operation. However, sexual complaints (FSFI scores equal or <26·55 points) without distress were reported by 62% of the patients. The comparison of sexual complaints declared prior to and after the operation showed significant differences in the prevalence of decreased desire, decreased arousal and decreased orgasm frequency. In addition, we documented significant improvement of sexual attractiveness and sexual life evaluation after the SUI operation. CONCLUSIONS: Surgical repair for SUI improves female sexual functions and reduces sexual distress, as observed in a long-term follow-up. RELEVANCE TO CLINICAL PRACTICE: Sexual functions, distress and behaviours in women who underwent surgical repair of SUI; the impact of SUI female quality of life as well as on sexual functions.

Does body mass index affect anti-mullerian hormone levels in girls and adolescents?

Anti-mullerian hormone (AMH) is a dimeric glycoprotein which belongs to the transforming growth factor-beta superfamily. In women, it is produced by granulosa cells in pre-antral and small antral follicles. In recent years, there has been a continuous increase in obesity among children and adolescents. There are few studies that present AMH concentrations in premenarcheal and early postmenarcheal girls. The purpose of this work is to assess whether AMH levels were associated with body mass index (BMI) in adolescent girls before and after menarche. The study was performed at the Pediatric Endocrinology Department and Outpatient Clinic at Upper Silesian Child Health Center. 82 girls were enrolled to the study. Body mass index seems not to affect the AMH levels in adolescents, however a special attention must be given when interpreting AMH levels in girls with irregular menstrual cycles and observed for PCOS.

Selected cytokines and glycodelin A levels in serum and peritoneal fluid in girls with endometriosis.

AIM: The aim of this study was to determine the role of serum and peritoneal interleukin (IL)-6, tumor necrosis factor (TNF)-α and glycodelin A levels as diagnostic markers of endometriosis in adolescent girls. MATERIAL AND METHODS: The study encompassed 50 adolescent girls, aged 13-19 years, after menarche and with chronic pelvic pain who qualified for diagnostic laparoscopy. The patients were allocated into two groups: group I (endometriosis group) consisted of subjects with diagnosed endometriosis (n = 33, 66%) and group II (control group) included those whose laparoscopic examinations revealed no evidence of endometriosis (n = 17, 34%). IL-6, TNF-α and glycodelin A concentrations in serum and peritoneal samples were assessed using commercially available human enzyme-linked immunosorbent assay kits. The value of P < 0.05 was adopted as the level of statistical significance. RESULTS: Compared with the control group, adolescent girls with endometriosis had significantly higher peritoneal fluid levels of: IL-6 (525.10 ± 1168.53 pg/mL vs 62.96 ± 82.35 pg/mL), TNF-α (5.79 ± 5.60 pg/mL vs 1.68 ± 1.24 pg/mL) and glycodelin A (94.24 ± 60.97 ng/mL vs 53.52 ± 41.43 ng/mL). Peritoneal IL-6, TNF-α and glycodelin A provided a good method of discrimination between subjects with endometriosis and controls. Using cut-off points for peritoneal fluid IL-6 (90.00 pg/mL), TNF-α (3.00 pg/mL) and glycodelin A (60.0 ng/mL), exceptionally high odds ratios (10.2; 14.6; 2.2) were obtained in the prediction of endometriosis in adolescents. CONCLUSIONS: At the cut-off value of 3.00 pg/mL, peritoneal TNF-α can be a reliable screening marker for the prediction of endometriosis in adolescents, giving a 14.6-fold higher probability of endometriosis detection in girls with chronic pelvic pain.