MENSTRUAL DISORDERS IN GIRLS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS TREATED WITH CYCLOPHOSPHAMIDE

To study the ovarian toxicity associated with cyclophosphamide in girl s with systemic lupus erythematosus (SLE), we retrospectively reviewed the charts of 30 SLE girls aged 16 yr or younger at diagnosis, follow ed at three university hospitals. Gynaecological history was extracted from the charts or obtained prospectively. Ten had not received cyclo phosphamide therapy, six were treated with daily oral cyclophosphamide , 10 with intravenous pulses and four with daily oral and intravenous pulses. Median oral cyclophosphamide dose was 38 g (inter-quartile ran ge 75) and median intravenous dose 12.95 g (inter-quartile range 6.2). Six girls had oligomenorrhoea (20%) and one amenorrhoea (3%). Two tre ated with oral cyclophosphamide had oligomenorrhoea (33%) and one amen orrhoea (17%), two treated with both oral and intravenous pulses had o ligomenorrhoea (50%), and none of those treated with intravenous pulse s alone had menstrual disturbances (50% oral vs 0% intravenous pulses; P = 0.016). Girls who had menstrual disturbances had received higher doses of cyclophosphamide than those who did not (medians: 63 vs 15 g; P < 0.05). In summary, menstrual disturbances in SLE girls treated wi th cyclophosphamide are related to the total dose and perhaps to the a dministration method.