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Anna Szeliga
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland

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Review
Published: 05 March 2021 in International Journal of Molecular Sciences
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Premature ovarian insufficiency (POI), previously known as premature ovarian failure or premature menopause, is defined as loss of ovarian function before the age of 40 years. The risk of POI before the age of 40 is 1%. Clinical symptoms develop as a result of estrogen deficiency and may include amenorrhea, oligomenorrhea, vasomotor instability (hot flushes, night sweats), sleep disturbances, vulvovaginal atrophy, altered urinary frequency, dyspareunia, low libido, and lack of energy. Most causes of POI remain undefined, however, it is estimated that anywhere from 4–30% of cases are autoimmune in origin. As the ovaries are a common target for autoimmune attacks, an autoimmune etiology of POI should always be considered, especially in the presence of anti-oocyte antibodies (AOAs), autoimmune diseases, or lymphocytic oophoritis in biopsy. POI can occur in isolation, but is often associated with other autoimmune conditions. Concordant thyroid disorders such as hypothyroidism, Hashimoto thyroiditis, and Grave’s disease are most commonly seen. Adrenal autoimmune disorders are the second most common disorders associated with POI. Among women with diabetes mellitus, POI develops in roughly 2.5%. Additionally, autoimmune-related POI can also present as part of autoimmune polyglandular syndrome (APS), a condition in which autoimmune activity causes specific endocrine organ damage. In its most common presentation (type-3), APS is associated with Hashomoto’s type thyroid antibodies and has a prevalence of 10–40%. 21OH-Antibodies in Addison’s disease (AD) can develop in association to APS-2.

ACS Style

Anna Szeliga; Anna Calik-Ksepka; Marzena Maciejewska-Jeske; Monika Grymowicz; Katarzyna Smolarczyk; Anna Kostrzak; Roman Smolarczyk; Ewa Rudnicka; Blazej Meczekalski. Autoimmune Diseases in Patients with Premature Ovarian Insufficiency—Our Current State of Knowledge. International Journal of Molecular Sciences 2021, 22, 2594 .

AMA Style

Anna Szeliga, Anna Calik-Ksepka, Marzena Maciejewska-Jeske, Monika Grymowicz, Katarzyna Smolarczyk, Anna Kostrzak, Roman Smolarczyk, Ewa Rudnicka, Blazej Meczekalski. Autoimmune Diseases in Patients with Premature Ovarian Insufficiency—Our Current State of Knowledge. International Journal of Molecular Sciences. 2021; 22 (5):2594.

Chicago/Turabian Style

Anna Szeliga; Anna Calik-Ksepka; Marzena Maciejewska-Jeske; Monika Grymowicz; Katarzyna Smolarczyk; Anna Kostrzak; Roman Smolarczyk; Ewa Rudnicka; Blazej Meczekalski. 2021. "Autoimmune Diseases in Patients with Premature Ovarian Insufficiency—Our Current State of Knowledge." International Journal of Molecular Sciences 22, no. 5: 2594.

Case report
Published: 18 June 2020 in International Journal of Environmental Research and Public Health
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Background: Many studies show the occurrence of several multiple endocrine neoplasia syndromes caused by different mutations, for example, in MEN1 and RET genes. Nevertheless, there are less common mutations causing multiple endocrine glands tumors. Examples of such mutations are CHEK2 gene mutations, causing breast, kidney, gastric, colorectal, prostate, lung, ovarian, and thyroid cancers. Case description: In 2005, a 30-year-old woman was admitted to the hospital due to uncontrolled hypertension and obesity. Performed tests have shown ACTH (adrenocorticotropic hormone)—independent micronodular adrenal hyperplasia (AIMAH) as a cause. In 2010, the further diagnostic analysis revealed Cushing’s disease caused by ACTH-secreting pituitary microadenoma. Additionally, in 2011, the patient underwent the strumectomy of multinodular struma. Papillary thyroid carcinoma was found in the excised tissue. In 2018, transvaginal ultrasonography revealed a tumor of the right ovary. After a performed hysterectomy with bilateral salpingo-oophorectomy, the histopathology result has shown female adnexal tumors of probable Wolffian origin (FATWO) located in the broad ligament of the uterus. Due to the history of multiglandular diseases, the patient was referred to genetic testing. We found a positive pathogenic mutation in CHEK2-suppressor gene involved in DNA repair, cell cycle arrest, and apoptosis in response to DNA damage. Conclusion: CHEK2 variants may predispose to a range of endocrine glands tumors, including those identified in our patient. Multiple endocrine glands tumors, as in the presented patient, are a serious problem of public health, due to numerous hospitalizations and necessary repeated surgical treatments. Moreover, the association between CHEK2 and ovarian cancer can be a serious problem with reproductive health.

ACS Style

Anna Szeliga; Aleksandra Pralat; Wiktoria Witczak; Agnieszka Podfigurna; Cezary Wojtyla; Anna Kostrzak; Blazej Meczekalski. CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report. International Journal of Environmental Research and Public Health 2020, 17, 1 .

AMA Style

Anna Szeliga, Aleksandra Pralat, Wiktoria Witczak, Agnieszka Podfigurna, Cezary Wojtyla, Anna Kostrzak, Blazej Meczekalski. CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report. International Journal of Environmental Research and Public Health. 2020; 17 (12):1.

Chicago/Turabian Style

Anna Szeliga; Aleksandra Pralat; Wiktoria Witczak; Agnieszka Podfigurna; Cezary Wojtyla; Anna Kostrzak; Blazej Meczekalski. 2020. "CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report." International Journal of Environmental Research and Public Health 17, no. 12: 1.

Journal article
Published: 21 October 2018 in Journal of Clinical Medicine
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Premature ovarian insufficiency (POI) is hypogonadism associated with amenorrhea, increased levels of gonadotropins, and hypoestrogenism. Deficiency of estrogens may contribute to higher risk of cardiovascular diseases and death. POI patients present several risk factors for the development of cardiovascular diseases (CVD): endothelial dysfunction, abnormal lipid profile, insulin resistance, and insulin action disturbances. Therefore, patients present a higher risk of developing metabolic syndrome. Materials and methods: Follicle stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid stimulating hormone (TSH), thyroxine (fT4), fasting serum glucose and insulin concentrations, homeostatic model for insulin resistance (HOMA-IR), and lipid profiles were assessed in 56 women (mean age: 30.7 ± 6.9) suffering from POI diagnosed according to European Society of Human Reproduction and Embryology (ESHRE) criteria and 68 healthy age-and-weight matched women (mean age: 27.3 ± 4.5). Results: After regression analysis with BMI and age correction, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) serum concentrations were found to be significantly higher in the POI group, when compared to healthy subjects, whilst triglycerides, glucose, insulin serum concentrations, HOMA-IR, as well as systolic (SBP) and diastolic blood pressure (DBP) did not differ significantly between both groups. A significant positive correlation was identified between TC and LDL-C levels, regardless of BMI and age, whilst SBP correlated only with serum glucose concentration. Additionally, FSH correlated positively with fasting serum glucose concentration after BMI and age correction. Conclusions: Certain metabolic parameters appeared to correlate with POI and these correlations persisted after correction for BMI and age. More research is required to determine the influence of absent ovulatory function on metabolic profiles in POI women. This information may additionally help in early identification of CVD risk factors in those patients.

ACS Style

Agnieszka Podfigurna; Angelika Stellmach; Anna Szeliga; Adam Czyzyk; Blazej Meczekalski. Metabolic Profile of Patients with Premature Ovarian Insufficiency. Journal of Clinical Medicine 2018, 7, 374 .

AMA Style

Agnieszka Podfigurna, Angelika Stellmach, Anna Szeliga, Adam Czyzyk, Blazej Meczekalski. Metabolic Profile of Patients with Premature Ovarian Insufficiency. Journal of Clinical Medicine. 2018; 7 (10):374.

Chicago/Turabian Style

Agnieszka Podfigurna; Angelika Stellmach; Anna Szeliga; Adam Czyzyk; Blazej Meczekalski. 2018. "Metabolic Profile of Patients with Premature Ovarian Insufficiency." Journal of Clinical Medicine 7, no. 10: 374.

Review
Published: 14 June 2018 in Gynecological Endocrinology
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Women during perimenopausal period experience a range of symptoms, which interfere with physical, sexual, and social life. About 65-75% of symptoms connected with postmenopausal period are vasomotor symptoms (VMS), such as hot flushes and night sweats. Hot flushes are subjective sensation of heat associated with cutaneous vasodilatation and drop in core temperature. It is suspected that VMS are strongly correlated with pulsatile oversecretion of gonadotropin-releasing hormone (GnRH) and subsequently luteinizing hormone (LH). Evidence has accumulated in parallel showing that lack of negative feedback of steroid hormones synthesized in ovary causes overactivation of hypertrophied kisspeptin/neurokinin B/dynorphin (KNDy) neurons, located in infundibular nucleus. Oversecretion of both kisspeptin (KISS1) and neurokinin B (NKB), as well as downregulation of dynorphin, plays dominant role in creation of GnRH pulses. This in turn causes VMS. Administration of senktide, highly potent and selective NK3R agonist, resulted in increase of serum LH concentration, induction of VMS, increase in heart rate, and skin temperature in postmenopausal women. These finding suggest that modulation of KNDy neurons may become new therapeutic approach in the treatment of VMS.

ACS Style

Anna Szeliga; Adam Czyzyk; Agnieszka Podfigurna; Andrea R. Genazzani; Alessandro D. Genazzani; Blazej Meczekalski. The role of kisspeptin/neurokinin B/dynorphin neurons in pathomechanism of vasomotor symptoms in postmenopausal women: from physiology to potential therapeutic applications. Gynecological Endocrinology 2018, 34, 913 -919.

AMA Style

Anna Szeliga, Adam Czyzyk, Agnieszka Podfigurna, Andrea R. Genazzani, Alessandro D. Genazzani, Blazej Meczekalski. The role of kisspeptin/neurokinin B/dynorphin neurons in pathomechanism of vasomotor symptoms in postmenopausal women: from physiology to potential therapeutic applications. Gynecological Endocrinology. 2018; 34 (11):913-919.

Chicago/Turabian Style

Anna Szeliga; Adam Czyzyk; Agnieszka Podfigurna; Andrea R. Genazzani; Alessandro D. Genazzani; Blazej Meczekalski. 2018. "The role of kisspeptin/neurokinin B/dynorphin neurons in pathomechanism of vasomotor symptoms in postmenopausal women: from physiology to potential therapeutic applications." Gynecological Endocrinology 34, no. 11: 913-919.

Review
Published: 01 January 2018 in Menopausal Review
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Oestrogens exert an influence on skeletal homeostasis during growth and adulthood. Regulation of osteoclasts and osteoblasts generation and apoptosis and prolongation of the lifespan of osteocytes are some of their actions on bone metabolism. Premature ovarian insufficiency (POI) and associated...

ACS Style

Anna Szeliga; Marzena Maciejewska-Jeske; Błażej Męczekalski. Bone health and evaluation of bone mineral density in patients with premature ovarian insufficiency. Menopausal Review 2018, 17, 112 -116.

AMA Style

Anna Szeliga, Marzena Maciejewska-Jeske, Błażej Męczekalski. Bone health and evaluation of bone mineral density in patients with premature ovarian insufficiency. Menopausal Review. 2018; 17 (3):112-116.

Chicago/Turabian Style

Anna Szeliga; Marzena Maciejewska-Jeske; Błażej Męczekalski. 2018. "Bone health and evaluation of bone mineral density in patients with premature ovarian insufficiency." Menopausal Review 17, no. 3: 112-116.

Review
Published: 01 July 2017 in Minerva Ginecol
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Endometriosis is a chronic, inflammatory, condition of high incidence and serious reproductive and general health consequences. Understanding the pathogenesis of endometriosis is crucial for proper diagnostic and ordering the most effective treatment. Even though there is a large body of data regarding this pathology our understanding of the pathogenesis of this disease remains incomplete. The aim of this review is to summarize contemporary data regarding pathogenesis of endometriosis. Current data regarding endometrial origin, metaplastic and Mullerian embryonic rests theory will be reviewed here. Also genetic, epigenetic, environmental factors and immunological dysfunction role in endometriosis will be summarized. To conclude, a lot of effort must be put to integrate the abundant data from genetic, epigenetic and immunological studies to propose one coherent theory for the pathogenesis of endometriosis.

ACS Style

Adam Czyzyk; Agnieszka Podfigurna; Anna Szeliga; Blazej Meczekalski. Update on endometriosis pathogenesis. Minerva Ginecol 2017, 69, 447 -461.

AMA Style

Adam Czyzyk, Agnieszka Podfigurna, Anna Szeliga, Blazej Meczekalski. Update on endometriosis pathogenesis. Minerva Ginecol. 2017; 69 (5):447-461.

Chicago/Turabian Style

Adam Czyzyk; Agnieszka Podfigurna; Anna Szeliga; Blazej Meczekalski. 2017. "Update on endometriosis pathogenesis." Minerva Ginecol 69, no. 5: 447-461.