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Background. The prevalence of premature ovarian failure (POF) of 1 % has important psychosocial consequences and impact on general health. Besides known etiology (genetic, chromosomal, infections, iatrogenic) autoimmunity can be the pathologic mechanism for POF. Material and methods. Eleven women with POF, with excluded other reasons for the disease except autoimmunity were included in this study. The control group consisted of 13 healthy normo-ovulatory women. In both groups targeted family and personal history was taken and determinations of: FSH, LH, TSH, prolactin, antimüllerian hormone (AMH), inhibin B, thyroid antibodies TG and TPO. At the cellular level periferal blood T-lymphocytes were analyzed by flow cytometry, on humoral level ovarian antibodies were detected with indirect immunofluorescence on human ovary sections. Quick ACTH test was performed in study group only. Results. In 9 patients POF was associated with another autoimmune disease. Six patients of the study group (55 %) presented very elevated thyroid autoantibodies TG and TPO, in the control group the levels of both autoantibodies were within normal range. Hormonal analyses in the study group exhibited the values of hypergonadotropic hypogonadism and consequently low levels of inhibin B and AMH. Lymphocyte subset in study group namely CD4+, CD19+ and CD8+ was significantly higher, while natural killer cells and regulatory T cells were significantly lower then in the control. group. In 4 patients (36 %) antiovarian autoantibodies were detected. Results of the quick ACTH test in the study group were normal. Conslusions. POF is frequently associated with autoimmune disorders. The presence of antithyroid and antiovarian antibodies together with abnormalities of the cellular immunity can potentionally represent an autoimmune mechanism of POF. The question of immunomodulatory therapy in selected patients with POF is open.

Background: Endometriosis is often defined as heterogeneous immune abnormality. In accordance with the data, women with endometriosis are more frequently affected by Hashimoto’s thyroiditis, systemic lupus erythematosus, Sjögren syndrome, rheumatoid arhritis, asthma, eczema and have increased activity of policlonal B-cells, abnormal acitvity of T- and B-lymphocytes, decreased activity of natural killer cells and presence of antiendometrial antibodies. In our study, we tried to define the disease in the context of other autoimmune diseases and determine the type of immune abnormality. Methods: In the prospective study 60 females with endometriosis were inluded in the study group and 49 healthy females in the control group. The presence of endometriosis in the complex of other autoimmune diseases was evaluated by targeted family, personal and reendomeproductive history. The type of immune abnormality was evaluated by immunological analysis on the cell level: subtypisation of lymphocytes, cytotoxic and regulatory T cells and NK cells. On the humoral level, we defined antiovary, antiendometrial and antiendothelial antibodies. The results were statistically evaluated using the Pearson’s Chi-square test and Mann – Whitney test. Results: Patients with endometriosis are more frequently affected by allergies (p = 0.039). Five serums of endometriosis patients were positive for antiendothelial antibodies specifically reacting with vascular endothelium. There was statistically significant diference between the study and the control group in the proportion of regulated T lymphocytes (CD3+ CD25++) in the pherypheral blood (p = 0.025). Conclusions: We have not fully confirmed the hypothesis that women with endomeriosis have alterations in the immune response. However, the present study supports and adds important infomation to the views that immune abnormality plays an important role in the etiopathogenesis of endometriosis. On the humoral level, we showed the presence of antiendothelial antibodies reacting with vascular endothelium.

Background Cutaneous vasculitis may be limited to the skin or may appear as part of systemic vasculitides. The type and intensity of changes depend on vessel size and the severity of involvement. The most common manifestation of small vesel vasculitis is palpable purpura, while vasculitis of medium-sized and large vessels usually express as livide noduses and ulcers. Cutaneous vasculitis may also manifest as bruises, erythema multiforme, papules, pustules, livedo and vesiculo-bullous lesions. The diagnostic procedure, in addition to clinical and laboratory investigations, frequently includes skin biopsy. Evaluation of tissue specimen includes standard histological examination of formalin fixed tissue and direct immunofluorescence of non-fixed fresh samples. The commonest histologic type of skin vasculitis is leukocytoclastic, which involves venules and capillaries and is a consequence of deposition of immune com plexes with complement activation. Typical representatives are Henoch-Schönlein purpura, cryoglobulinemic vasculitis and vasculitis in systemic lupus erythematosus. Necrotizing arteriolitis and arteritis of small arteries are usually found in ANCA positive vasculitides. Medium-sized arteries can be involved in both ANCA positive vasculitides and polyarteritis nodosa. Conclusions This article presents the clinical picture, histopathologic characteristics, pathogenetic mechanisms and treatment of some clinicopathologic entities of vasculitides, such as Henoch-Schönlein purpura, urticarial vasculitis, cryoglobulinemic vasculitis, microscopic polyangiitis, Wegener\'s granulomatosis, Churg-Strauss syndrome and polyarteritis nodosa.