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Spontaneous pregnancy in a woman with lupus and thyroiditis despite imminent premature ovarian failure

We report a case of spontaneous pregnancy in a woman with lupus and clinical and hormonal changes suggesting imminent premature ovarian failure (POF).

A French woman born in 1962 had had Raynaud’s phenomenon, photosensitivity, and subacute cutaneous lupus since the age of 15 years, which was treated with hydroxychloroquine. She underwent abortions for unwanted pregnancies in 1986, 1987, and 1988. Various progestin contraceptives were prescribed but rapidly stopped. In 1990 she presented with giant cell thyroiditis with normal thyroxine, thyroid stimulating hormone 6.1 mU/l (normal 0.1–3.2), and negative antithyroperoxidase and antithyroglobulin antibodies. l-Thyroxine 100 μg daily was started. In August 1992 endometriosis was discovered.

In February 1997 she complained of polyarthritis and sustained climacteric symptoms. She had regular menses with a short luteal phase. Her mother became menopausal at the age of 50. Follicle stimulating hormone (FSH) was increased (95 U/l) with normal oestradiol and karyotype. She was …