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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: To evaluate the involvement of immune abnormality in patients with idiopathic premature ovarian insufficiency (POI). In addition to the known etiology, autoimmune disorders may be a pathologic mechanism for POI. Materials and Methods: Our study was a prospective controlled trial. Twenty women with POI, reasons other than autoimmune excluded, were enrolled in this study. The control group consisted of 17 healthy women. In both groups, family and personal history were taken and the levels of follicle stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, prolactin, anti-Müllerian hormone, inhibin B, antithyroglobulin and antithyroid peroxidase antibodies were determined. Antiovarian antibodies and subpopulations of peripheral blood T-lymhocytes were also determined. Results: Participants in the study group exhibited hypergonadotropichypogonadism, while high levels of follicle stimulating hormone and low levels of inhibin B and anti-Müllerian hormone were observed. In 16 (80%) patients, POI was associated in their personal and familial history with another autoimmune disease. Fifty percent of patients presented highly elevated antithyroid antibodies. The lymphocyte subset, especially B cells, was significantly higher (p=0.014), and peripheral regulatory lymphocytes CD25+ high were significantly lower (p=0.015) in the study group than in the control group. Anti- ovarian antibodies were detected in 20% of patients with POI. Conclusion: We presume that the presence of anti-ovarian antibodies together with abnormalities of cellular immunity may in some cases potentially represent the involvement of an autoimmune mechanism in idiopathic POI.

BACKGROUND: The aim of our study was to evaluate the prognostic value of glomerular and tubular proteinuria and tubular enzymuria as early indicators of therapeutic response to induction therapy with i.v. pulse cyclophosphamide (CyC) and methylprednisolone (MP) in patients with antineutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis. METHODS AND FINDINGS: An observational single-center study was conducted in 30 patients with ANCA-associated glomerulonephritis. Patients were divided into subgroups with good or poor response to CyC therapy according to clinical and laboratory parameters. The diagnosis of ANCA-associated glomerulonephritis was based on the Chapel-Hill disease definitions. Good response to induction therapy was significantly associated with higher absolute values of urine N-acetyl-beta-D-glucosaminidase (NAG) to creatinine ratio (above 14.83 microcat/mol) and urine immunoglobulin G (IgG) to albumin ratio (above 0.09) at the time of diagnosis, while albuminuria or proteinuria did not have any early predictive value. The remission of renal disease was anticipated as early as 3 months after introduction of induction therapy in patients with reduction of urine NAG to creatinine ratio below the baseline value and in patients with at least 24% rise in eGFR. CONCLUSIONS: Urine IgG to albumin and urine NAG to creatinine ratio are better early predictors of treatment response in patients with ANCA-associated glomerulonephritis than proteinuria or albuminuria.

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.