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Endometriosis With Iron Excess

Lousse JC, Defrère S, Van Langendonckt A, Gras J, González-Ramos R,
Colette S, Donnez J
Iron storage is significantly increased in peritoneal macrophages of
endometriosis patients and correlates with iron overload in peritoneal
fluid. [JOURNAL ARTICLE]
Fertil Steril 2008 Apr 5.



OBJECTIVE: To further investigate peritoneal iron disruption in
endometriosis by studying iron storage in peritoneal macrophages of
patients with endometriosis compared with controls.
DESIGN: Cross-sectional study.
SETTING: Academic gynecology research unit in a university hospital.
PATIENT(S): Fifty patients undergoing laparoscopy. INTERVENTION(S):
Collection of peritoneal fluid samples (N = 50) from patients with (n
= 27) and without (n = 23) endometriosis undergoing laparoscopy.
MAIN OUTCOME MEASURE(S): Quantification of peritoneal macrophage
ferritin by immunocytochemical staining and immunodensitometry and
measurement of peritoneal iron, transferrin, ferritin, and prohepcidin
concentrations.
RESULT(S): The optical density of peritoneal macrophage ferritin
staining was statistically significantly higher in endometriosis
patients than in controls. Higher iron concentrations, transferrin
saturations, and ferritin concentrations were also detected in case of
endometriosis. A statistically significant positive correlation was
found between the optical density of macrophage ferritin staining and
peritoneal iron concentrations in endometriosis and control patients.
CONCLUSION(S): Iron storage is statistically significantly increased
in peritoneal macrophages of patients with endometriosis and
correlates with iron overload in peritoneal fluid. The potential
implications of iron accumulation in peritoneal macrophages in case of
endometriosis are discussed.

Fertility and sterility [Fertil Steril]
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Immunotherapy Weekly


October 23, 2002


ENDOMETRIOSIS: Disorder associated with wide range of diseases


U.S. researchers report in the journal Human Reproduction that women
with
endometriosis are significantly more likely than other women to suffer
from
a number of additional distressing or disabling conditions.


These include a variety of autoimmune diseases, allergies, asthma,
hypothyroidism, chronic fatigue syndrome and fibromyalgia.


Their findings are from the first population-based study in the world
to
investigate whether a range of other disorders are more prevalent in
women
with endometriosis, which affects an estimated 8-10% of women of
reproductive age.


The results - which confirmed there was typically a 10-year delay
between
onset of symptoms and a diagnosis of endometriosis - have prompted
the
researchers to urge doctors, especially those taking care of
adolescents, to
consider a diagnosis of endometriosis in girls and women complaining
of
pelvic pain and to watch out for other potentially serious conditions
in
these patients. The research team from the National Institute of
Child
Health and Human Development in Bethesda, Maryland, the School of
Public
Health and Health Services at George Washington University in
Washington,
DC, and the Endometriosis Association in Milwaukee, carried out and
analyzed
a survey of 3680 members of the Endometriosis Association, 90% of whom
were
of reproductive age. All the women had surgically diagnosed
endometriosis.


They found that among these women:


*20% had more than one other disease.


*Up to 31% of those with coexisting diseases had also been diagnosed
with
either fibromyalgia or chronic fatigue syndrome and some of these
additionally had other autoimmune or endocrine disease.


*Chronic fatigue syndrome was more than a hundred times more common
than in
the female U.S. population generally.


*Hypothyroidism (under-active thyroid gland) was seven times more
common.


*Fibromyalgia was twice as common.


*The autoimmune inflammatory diseases - systemic lupus erythematosus,
Sjogren syndrome and rheumatoid arthritis, and also multiple
sclerosis,
occurred more frequently.


*Rates of allergic and atopic conditions such as asthma and eczema
were
higher - e.g., 61% of the endometriosis sufferers had allergies
compared
with 18% of the U.S. general population, and 12% had asthma compared
with
5%. If a woman had endometriosis plus an endocrine disease the figure
rose
to 72% and it was 88% if she had endometriosis plus fibromyalgia or
chronic
fatigue syndrome.


*Two-thirds of the survey subjects reported that relatives also had
either
diagnosed or suspected endometriosis, confirming research that
suggested
there was a familial tendency.


"As well as finding an increased prevalence of this wide range of
diseases
and conditions among women with endometriosis, we found that they
reported
significant pain and disability and, very worryingly, that there was
typically a 10-year delay between the onset of pelvic pain and
diagnosis,"
said lead investigator Ninet Sinaii, from the National Institute of
Child
Health and Human Development.


Coinvestigator Dr. Pamela Stratton pointed out that, "Since women
appear to
develop symptoms shortly after the onset of their periods and are not
diagnosed for years, we don't know whether endometriosis actually
occurs at
menarche as others have reported or whether it develops over time.
It's also
unclear whether early treatment could prevent chronic pelvic pain
from
taking hold. It is vital, therefore, that attempts should be made to
diagnose and treat endometriosis in adolescents."


Sinaii said there were a number of limitations to the study, which
could
potentially introduce bias, including the relatively young age of the
respondents, the fact that they were predominantly white, well-
educated and
members of a support group (therefore possibly atypical), problems
with
misinterpreting questions, recognizing disease names, and so on.


Therefore, the researchers carried out a sensitivity analysis. This
confirmed that even if the disease prevalence was underestimated in
the
general population and overestimated in the study sample, the rates
reported
in women with endometriosis were still significantly higher.


"These differences appear real," said Sinaii.


She said the study was the first to provide data on the
characteristics and
coexisting states of women with pain from endometriosis.


"Women with endometriosis frequently suffer from autoimmune
inflammatory
diseases, hypothyroidism, fibromyalgia, chronic fatigue syndrome,
allergies
and asthma. It is evident that women with pelvic pain are not
diagnosed as
having endometriosis for many years, suggesting that physicians,
especially
those taking care of adolescents, should consider the diagnosis (High
rates
of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue
syndrome and atopic diseases among women with endometriosis: a survey
analysis. Hum Reprod, 2002;17(10):2715-2724).


"These findings also suggest a strong association between
endometriosis and
autoimmune disorders and indicate the need to consider the coexistence
of
other conditions in women with endometriosis," she concluded.


This article was prepared by Immunotherapy Weekly editors from staff
and
other reports.

Copyright 2002 Immunotherapy Weekly via NewsRx.com http://www.NewsRx.net



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Tom


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