Ternavasio-de la Vega Hugo-Guillermo, Boronat Mauro, Ojeda Antonio, García-Delgado Yaiza, Ángel-Moreno Alfonso, Carranza-Rodríguez Cristina, Bellini Raquel, Francès Adela, Nóvoa Francisco Javier, Pérez-Arellano José-Luis
From Internal Medicine Service II (HGTV), Hospital Universitario of Salamanca, Salamanca; Endocrinology and Nutrition Section (MB, AO, YGD, FJN), and Infectious Diseases and Tropical Medicine Unit (AF, JLPA), Internal Medicine Service, Hospital Universitario Insular of Gran Canaria, Gran Canaria; Department of Medical and Surgical Sciences (MB, AAM, CCR, RB, FJN, JLPA), Health Sciences Faculty, University of Las Palmas of Gran Canaria, Gran Canaria; and Internal Medicine Service II (AAM), Clínica Puerta de Hierro, Madrid, Spain.
Medicine (Baltimore). 2010 Mar;89(2):96-116. doi: 10.1097/MD.0b013e3181d63191.
Since the introduction of the mumps vaccine, the age of appearance of mumps infection has shifted from children to adolescents and young adults, groups with a higher incidence of disease complications and sequelae. During the years 2000-2001, the Gran Canaria Island was part of an epidemic of mumps. In that period, our institution attended 67 cases of serologically confirmed acute mumps orchitis, the most serious complication of mumps infection in young postpubertal males. We conducted a descriptive and prospective study of this cohort and extensively reviewed the literature from 1967 (the year the first mumps vaccine was introduced) to 2009. Fifty-six patients were admitted because of general impairment and were treated with alpha-interferon. Sixty-six patients presented parotitis previous to orchitis (interval from parotitis to orchitis, 4.9 d). Orchitis was unilateral in 89.5% and bilateral in 10.4% of cases. More than 98% of patients had orchitis-associated fever. Nine patients had clinical and biochemical data showing acute mumps meningitis, and 11 had subclinical pancreatitis. The mean duration of symptoms was 4.6 days (range, 1-9). During the acute phase, more than 41% of the evaluated testes had a volume >25 mL. Acute hormonal disturbances were highly prevalent. These included decreased levels of testosterone and inhibin B with low or normal levels of gonadotropins in 35% of subjects, and, to our knowledge not previously reported, an atypical hormonal pattern consisting of low levels of free testosterone and inhibin B, along with increased measures of luteinizing hormone but low or normal follicle-stimulating hormone levels (11% of cases). During the follow-up period (mean, 331 d) a high incidence of sperm disturbance was found.
自腮腺炎疫苗引入以来，腮腺炎感染的发病年龄已从儿童转移至青少年和青年，这些人群疾病并发症和后遗症的发生率更高。在2000 - 2001年期间，大加那利岛是腮腺炎疫情的一部分。在此期间，我们机构诊治了67例血清学确诊的急性腮腺炎睾丸炎患者，这是青春期后年轻男性腮腺炎感染最严重的并发症。我们对该队列进行了描述性和前瞻性研究，并广泛回顾了1967年（第一种腮腺炎疫苗引入的年份）至2009年的文献。56例患者因全身不适入院，并接受了α干扰素治疗。66例患者在睾丸炎之前出现腮腺炎（从腮腺炎到睾丸炎的间隔时间为4.9天）。睾丸炎单侧发生的病例占89.5%，双侧发生的病例占10.4%。超过98%的患者伴有睾丸炎相关发热。9例患者有临床和生化数据显示急性腮腺炎脑膜炎，11例有亚临床胰腺炎。症状的平均持续时间为4.6天（范围为1 - 9天）。在急性期，超过41%的被评估睾丸体积>25 mL。急性激素紊乱非常普遍。其中包括35%的受试者睾酮和抑制素B水平降低，促性腺激素水平低或正常，据我们所知，此前未见报道的一种非典型激素模式为游离睾酮和抑制素B水平低，同时黄体生成素水平升高，但促卵泡激素水平低或正常（11%的病例）。在随访期（平均331天）发现精子紊乱的发生率很高。
