Endometriosis Flashcards
Prevalence of endometriosis in the US?
5-10%
Average age of a women who has endometriosis?
25-40
Most common age of beginning of menarche
13-14
Two hypothesis for the initiation of endometriosis?
- Retrograde mensturation
2. Impaired cell-mediated immunity
With impaired cell-mediated immunity, which cells are involved, and what type of cell response is involved?
T & NK cells; Type IV response
What two hypotheses might explain how endometrial tissue ends up in different locations?
- Cells spread through circulation like cancer
2. Stem cells outside uterus become endothelial tissue
Explain the steps of endometriosis pathophysiology (5)
- Ectopic implants
2 Hormones increase, causing proliferation of ectopic tissue - Hormones decrease, causing breakdown and bleeding of ectopic tissue
- Release chemical mediators of inflammation which causes pain
- Recruit macrophages, neutrophils, etc, and attempt at repairing inflammation causes fibrosis
What are the specific chemical mediators that cause pain?
Prostaglandin, bradykinin
What are the most common sites of implantation?
Outside of ovaries, uterine ligaments
What are clinical symptoms of endometriosis?
Pain, menstrual cramps, and infertility
Is the extent of implantation related to the symptoms presented with endometriosis?
No; extent does not correlate with symptoms
What is the only definitive diagnosis of endometriosis?
Laproscopic surgery
What are imaging techniques such as MRI or transvaginal ultrasounds used for in diagnosis?
Rule out other conditions
Serologic techniques for endometriosis, which are used when treating endometriosis as an autoimmune disorder (2)
- Thomsen-Friedenrich antigen (structure similar to carbohydrate that stimulates immune system - looking for higher levels)
- CCR1 mRNA in WBCs (increased chemokine receptor expression in WBCs - WBCs are better at migrating to a site of injury)
True or False: Recurrences are common, even after surgery
True
