Akdeniz University, School of Medicine, Department of Pediatric Nephrology, Antalya, Turkey.
Akdeniz University, School of Medicine, Department of Pediatric Nephrology, Antalya, Turkey.
J Pediatr Urol. 2019 Aug;15(4):342.e1-342.e7. doi: 10.1016/j.jpurol.2019.04.001. Epub 2019 Apr 5.
Little is known about sperm health in male patients with familial Mediterranean fever (FMF). In this study, the authors aimed to search the frequency of sperm abnormalities of adolescent boys with FMF and also to investigate whether disease activity or colchicine treatment have negative effects on sperm parameters.
The male adolescents older than 14 years with a diagnosis of FMF were investigated retrospectively. Tel Hashomer and pediatric FMF clinical criteria were used for diagnosis of FMF. Patients who had semen analysis were included in the study.
Mean age at the diagnosis was 11.13 ± 3.82 years, and mean age at the study was 14.50 ± 0.70 years. The mean sperm concentration was found as 66.26 ± 41.02 million/ml (N > 15 million/ml), the mean total sperm count 113.42 ± 132.39 million (N > 39 million), and the mean sperm motility 51.78 ± 23.70% (N > 40%). Only 8 of 19 (42.1%) patients had normal sperm parameters. Sperm concentration was reduced in two cases, total sperm count was reduced in four patients, and motility was reduced in nine cases. The presence of FMF attacks under treatment was found to be a risk factor for decreased motility in the study group by multivariate regression analysis (odds ratio 0.076, [95% confidence interval 0.005-0.648], P = 0.031). Erythrocyte sedimentation rate at the time of diagnosis was high in patients with low sperm counts compared with those with normal sperm counts (56.00 ± 8.51 vs 24.35 ± 6.32, P: 0.03). Mean colchicine dose at the time of sperm analysis was higher in patients with low sperm motility than that with normal sperm motility (1.72 ± 0.18 vs 1.25 ± 0.08, P: 0.02).
Sperm abnormalities of male patients with FMF is not infrequent, and it is linked to both inflammation due to uncontrolled disease and colchicine therapy.
关于男性家族性地中海热（FMF）患者的精子健康状况知之甚少。在这项研究中，作者旨在研究 FMF 青少年男性精子异常的频率，并探讨疾病活动度或秋水仙碱治疗是否对精子参数有负面影响。
回顾性调查了年龄大于 14 岁、诊断为 FMF 的男性青少年。采用 Tel Hashomer 和儿科 FMF 临床标准诊断 FMF。纳入有精液分析的患者进行研究。
诊断时的平均年龄为 11.13±3.82 岁，研究时的平均年龄为 14.50±0.70 岁。平均精子浓度为 66.26±41.02 百万/ml（N＞15 百万/ml），总精子计数为 113.42±132.39 百万（N＞39 百万），精子活力为 51.78±23.70%（N＞40%）。仅 19 例（42.1%）患者的精子参数正常。在 2 例中发现精子浓度降低，在 4 例中发现总精子计数降低，在 9 例中发现活力降低。多元回归分析发现，治疗中存在 FMF 发作是研究组精子活力降低的危险因素（比值比 0.076，[95%置信区间 0.005-0.648]，P=0.031）。与精子计数正常的患者相比，精子计数较低的患者在诊断时的红细胞沉降率较高（56.00±8.51 与 24.35±6.32，P=0.03）。在进行精子分析时，精子活力较低的患者的秋水仙碱剂量高于精子活力正常的患者（1.72±0.18 与 1.25±0.08，P=0.02）。
FMF 男性患者的精子异常并不少见，这与疾病未得到控制引起的炎症和秋水仙碱治疗有关。
