Background Familial Mediterranean Fever (FMF) is a genetic disease that has characteristics like fever, sterile peritonitis, pleurisy, joint pain and rashes that are similar to erysipelas. In male patients, scrotal involvement is seen especially in children and adolescents with the frequency being below 5%.1 Colchicine is an agent which regulates microtubules in cell's structure, pauses metaphase stage in cell division and stops microtubule dependent cell movement2. Colchicine is principal for treatment of FMF. Colchicine has a negative effect on sperm count and motility as it effects microtubules.
Objectives We aimed to observe the relationship between sperm count and function with disease activity and colchicine usage in adolescent male patients with FMF.
Methods Male patients between the age of 14–19 years old with FMF investigated retrospectively. Tel Hashomer and Turkish FMF Pediatric Criteria were used for diagnosis of FMF. Genetic screening was performed in all patients at the time of diagnosis. Sperm analysis was performed in 19 patients on treatment with colchicine. Demographic and clinical parameters of patients were analyzed.
Results Mean age at the diagnosis was 11.13±3.82 years old, mean age at the study was 14.50±0.70 and mean follow-up period was 4.68±3.94 years. Homozygote, compound heterozygote and heterozygote mutations were found in eight, seven and one patients, respectively; no mutations in 3 patients. Mean colchicine dose was 1.16 mg/day at the start of treatment and 1.47 mg/day when sperm samples were collected. Mean sperm concentration was found as 66.26±41.02 million/ml (N>15), sperm count 113.42±132.39 million (N>35) and motility %51.78±23.70 (N>50%). Only 8 patients out of 19 had normal sperm parameters. Sperm concentration was reduced in two cases; sperm count was reduced in four patients whereas motility was reduced in nine cases. No relation was determined between sperm volume, count, concentration and motility results with age at diagnosis, follow-up period, symptoms on admission and inflammatory markers (CRP and erythrocyte sedimentation rate). Patients that had sedimentation values above 30 mm/hour during follow-up had sperm count below <35 million, with a specificity of 100% and sensitivity of 73.3% (AUC=0.858, p=0.032). It was found that patients who had FMF attacks during treatment had low sperm count and motility than patients without attacks (p: 0.034 and p: 0.02, respectively). There was an inverse relationship between the dose of colchicine with sperm motility (p: 0.025).
Conclusions A high number of adolescents with FMF had abnormal sperm parameters, mostly sperm motility. It seems that both colchicine and uncontrollable attacks of FMF may be the reason of abnormal sperm parameters. We suggest that all adolescents with FMF should be screened for semen analysis.
Disclosure of Interest None declared