[Studies on the secretion of gonadotropins in patients with collagen diseases]

It is well known that majority of patients with collagen diseases are women and that collagen diseases take turn for the worse or the better when the secretion of sex hormones changes greatly at menarche, pregnancy, delivery or menopause. These facts suggest that sex hormones are involved in the pathophysiology of collagen diseases. In the present study, the responses of plasma luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels following the intravenous injection of 100 mug luteinizing hormone-releasing hormone (LR-RH) were investigated in 34 patients with systemic lupus erythematosus (SLE) and in 15 patients with rheumatoid arthritis (RA). The results obtained were as follows: 1) The magnitude of plasma LH response to LH-RH in 29 mature female patients with SLE was significantly greater than that in normal subjects. 2) On the other hand, the magnitude of plasma FSH response to LH-RH in patients with SLE was comparable to that in control subjects. 3) In patients with RA who have normal menstrual cycles, the magnitude of increase in plasma LH and FSH levels after the injection of LH-RH was the almost same as that in normal subjects. Increased responses in plasma LH and FSH levels to LH-RH were observed in 7 patients with RA who were 3 menopausal females and 4 aged males. These findings suggest that the secretion of LH, but not FSH, in response to LH-RH might augment in patients with SLE. On the other hand, in RA patients the function of the pituitary-gonadal axis might maintain within normal limits. For that reason, I guess the following possibilities: 1) In patients with SLE the pathological changes of the disease reached to the ovary and ovarial function was slightly suppressed and then a hypersecretion of LH was observed, 2) the hypothalamus was attacked with the disease and then an unknown mechanism caused the hypersecretion of LH.