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Immunopathogenesis and Therapy of Gonadal Disorders and Infertility
Published in George S. Eisenbarth, Immunotherapy of Diabetes and Selected Autoimmune Diseases, 2019
One patient in Irvine’s 1968 study had an ovarian biopsy which demonstrated a lymphocytic and plasma cell infiltrate, destruction of developing follicles, and sparing of primordial follicles. Few reported cases of autoimmune oophoritis have included histologic studies of the ovaries. Immunologic characterization of the lymphocytic infiltrate has been performed on only two occasions.15,23 In only one of those instances was nonembedded tissue used for analysis. The lymphoplasmacytic infiltrate in that case was confined to developing, cystic, and atretic follicles, sparing primordial follicles. The mononuclear infiltrate included B cells and plasma cells, T cells of both CD4 + (helper) and CD8 + (suppressor-cytotoxic) phenotype, and a small number of natural killer (NK) cells and macrophages.
Viruses and Antiviral Agents
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Richard B. Townsley, Camille A. Huser, Chris Hansell
Mumps (Parotitis) is highly infectious and spreads through saliva. The virus probably penetrates the body via the mouth and can be detected in the oral cavity 1–6 days prior to the appearance of swollen salivary glands (especially parotid glands), a symptom that typifies the disease.7 Other symptoms include fever and complications include oophoritis, orchitis, pancreatitis and viral meningitis. Transient hearing loss is a common symptom (approximately 1 in 20), but in extremely rare cases (1 in 20 000) can become permanent. Although the illness can occur at any age, most cases present in children between the ages of 5 and 10. The disease is self-limiting and in most children the symptoms are generally not severe. There is no cure for mumps and therefore treatment is restricted to symptom relief. Clearance of the virus leads to lifelong immunity and immunization with the live virus MMR vaccine between the ages of 12 to 15 months provides a similar level of immunity and protection from subsequent infection.
Endocrinology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Hypogonadism in females:1 Gonadotrophin failure: a Hypothalamic–pituitary disease.b Kallman’s syndrome.2 Complete ovarian failure: a Dysgenesis; Turner’s syndrome; Swyer’s syndrome.12b Autoimmune oophoritis; oophorectomy/radiotherapy/chemotherapy.3 Partial ovarian failure: a PCOS.b Resistant ovary syndrome.4 Adrenal pathology: 17a-hydroxylase deficiency.5 Iatrogenic: cytotoxic drug therapy.
The effects and molecular mechanism of heat stress on spermatogenesis and the mitigation measures
Published in Systems Biology in Reproductive Medicine, 2022
Yuanyuan Gao, Chen Wang, Kaixian Wang, Chaofan He, Ke Hu, Meng Liang
The mumps virus can cause a range of complications. These include orchitis, oophoritis, encephalitis, and meningitis. Studies have shown that the mumps virus is highly testicular tendentious, inducing a testicular cell immune response, and damaging testicular function. Mumps orchitis is a rare complication, and is mainly seen in post-pubertal males with mumps (Wu et al. 2021). It often occurs in young men and is characterized by headache and fever in the early stages and swelling and pain in the testicles in the later stages. The mumps virus damages testicular tissue and causes substantial edema in testicular tissue. Increased pressure on the seminiferous tubules due to parenchymal edema can lead to necrosis of the seminiferous tubules and atrophy of the spermatogenic epithelium, eventually resulting in testicular atrophy (Yang et al. 2020).
Successful live birth after in vitro maturation treatment in a patient with autoimmune premature ovarian failure: a case report and review of the literature
Published in Gynecological Endocrinology, 2021
Lucie Chansel-Debordeaux, Elisabeth Rault, Chloé Depuydt, Volcy Soula, Claude Hocké, Clément Jimenez, Hélène Creux, Aline Papaxanthos-Roche
Since controlled ovarian hyperstimulation alone gives poor results in such a situation, various approaches have been used to increase pregnancy rates, including immunosuppressive therapy and DHEA supplementation, with or without IVF. Some studies showed the value of corticosteroids for improving the pregnancy success rate in a subset of patients with previous IVF failures and high serum AOA levels [33,50]. Indeed, decreasing the high, endogenous, ineffective FSH, by gonadotropin releasing hormone agonist associated to controlled ovarian hyperstimulation and corticosteroids were sometimes effective in generating conceptions in patients with POF [51]. The release of the FSH receptors occupancy from the endogenous FSH, may give way to receptor stimulation by exogenous FSH, combined with amelioration of the autoimmune disturbance by glucocorticoids cotreatment. The mechanism of action of corticosteroids is thought to involve a reduction in perifollicular inflammatory macrophages around follicles, which can then restore folliculogenesis in dormant small follicles [15]. In another study, corticosteroids did not influence ovarian responsiveness to gonadotropins in patients with POF [52]. Some studies noted higher pregnancy rates with DHEA supplementation in patients with diminished ovarian function [53,54]. Estrogens have also proven beneficial for the recovery of ovarian function via the restoration of receptor sensitivity to gonadotropins, thus promoting folliculogenesis [9]. However, to date no treatment for autoimmune oophoritis has demonstrated efficacy and safety in prospective randomized placebo-controlled studies.
Impact of early surgical management on tubo-ovarian abscesses
Published in Journal of Obstetrics and Gynaecology, 2021
Stephanie Zhu, Emma Ballard, Akram Khalil, David Baartz, Akwasi Amoako, Keisuke Tanaka
This was a retrospective study of all patients who were treated for a TOA at a university-affiliated tertiary hospital between January 2013 and December 2017. A list of patients with ICD diagnoses coded as ‘Chronic salpingitis and oophoritis’, ‘Salpingitis and oophoritis unspecified’ and ‘“Acute salpingitis and oophoritis’ was provided by health information services. The electronic medical records were reviewed to identify patients with a TOA. All patients with TOA were included in the study, and TOA was diagnosed in patients who presented with lower abdominal or pelvic pain and had adnexal masses radiologically indicating a TOA on pelvic ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI). There were no exclusion criteria. Patient demographics, obstetric, gynaecological and medical histories, vital signs on presentation and investigation findings were collected.