Impact Of Immune Dysfunction And Stress Related Disorders In Endometriosis – A Case-Control Study

IMPACT OF IMMUNE DYSFUNCTION AND STRESS RELATED DISORDERS IN ENDOMETRIOSIS – A CASE-CONTROL STUDY Simone Subtil, Inu00eas Ramalho, Sara Campos, Maria Jou00e3o Carvalho, Margarida Figueiredo-DiasGynecology Department, Coimbra University Hospital Center, Portugal. Faculty of Medicine, University of Coimbra, PortugalProblem statement: Endometriosis has been linked to significant emotional distress. Nevertheless the pathophysiology of this gynecological condition is not yet established and the contribution of higher stress levels is not clear enough. Moreover women with endometriosis are at increased risk for second disease as chronic fatigue syndrome, multiple sclerosis, lupus, rheumatoid arthritis and other autoimmune inflammatory related disorders. Allergies, asthma and eczema has been also reported as more prevalent among endometriosis patients.Methods: A case-control study of 418 medical files of patients with surgical-diagnosed endometriosis treated and followed at Gynaecology Department of Coimbra University Hospital Center was designed to study the prevalence of auto-immune diseases, stress-related disorders, specific allergies and educational level. Control group included 300 age-stratified healthy women participating in a family planning programme. Statistical analysis was performed using SPSS 20.0 (p<0.05).Results: The average age at the time of endometriosis diagnosis was 37.2±8.1 years and body mass index was lower among endometriosis group (p<0.001). Clinical reports included 44 (10,7%) endometriosis patients that reported auto-immune diseases, 53 (12.9%) with severe allergies and 90 (21.9%) suffering from depression, anxiety or fibromyalgia. Women with endometriosis were significantly more likely to have higher educational level and severe allergies (p<0.001) when compared to control group but no significant differences were observed when comparing auto-immune diseases or stress-related disorders. Conclusion: We observed a possible link between endometriosis and higher educational level and severe allergies. Stress can lead to an immune dysfunction, promoting a favorable inflammatory environment for endometriotic implants survival and growth. However, we found no significant difference on what concerns autoimmune diseases or stress-related disorders. Further studies should be designed in order to confirm these results.