Pregnancy after azathioprine therapy for ulcerative colitis in a woman with autoimmune premature ovarian failure and Addison's disease: HLA haplotype characterization

Abstract

Objective: To present a case of fertility restored by azathioprine treatment in a woman with autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis, and to study the genetic background of the three autoimmune diseases.

Design: Case report.

Setting: Endocrinology and Immunology Units of an university hospital.

Patient(s): A 30-year-old woman with autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis.

Intervention(s): Azathioprine has been administered as immunosuppressive treatment.

Main outcome measure(s): We performed analysis of human leukocyte antigens expression on lymphocytes and genomic haplotype of the patient.

Result(s): The human leukocyte antigen haplotype of the patient was consistent with the haplotypes predisposing for the three autoimmune diseases, as reported in the literature. The administration of azathioprine restored regular menses and allowed uneventful pregnancy.

Conclusion(s): This is the first clinical evidence of association of immunosuppressive azathioprine treatment and restored ovarian function and fertility in a woman with autoimmune premature ovarian failure. In this patient, the haplotype was associated with susceptibility to autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis.