Gonad evaluation in male systemic lupus erythematosus.
Pollyana Maria Ferreira Soares,Eduardo Ferreira Borba,Eloisa Bonfa,Jorge Hallak,André Luiz Corrêa,Clovis A. Silva +5 more
TLDR
SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume, and postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.Abstract:
Objective
To assess gonad function in male patients with systemic lupus erythematosus (SLE).
Methods
Thirty-five consecutive male patients with SLE according to the criteria of the American College of Rheumatology were prospectively evaluated for demographic and clinical features as well as previous and current treatment. Patients underwent urologic evaluation and testicular Doppler ultrasound. We obtained a hormone profile and performed a semen analysis including morphology and testing for the presence of antisperm antibodies. Patients were compared with 35 age-matched healthy controls.
Results
Compared with controls, SLE patients had lower median testicular volumes in both testes, a lower median total sperm count, and a lower median total motile sperm count. The mean sperm volume and percentage of normally formed sperm were lower in SLE patients than in controls. Since all SLE patients had semen alterations, they were further subdivided into 2 groups according to the severity of these abnormalities (group 1, with teratozoospermia [n = 18], and group 2, with azoospermia or teratozoospermia in combination with oligozoospermia and/or asthenozoospermia [n = 17]). The frequency of treatment with intravenous cyclophosphamide (IV CYC) after the first ejaculation was higher in group 2 than in group 1. The median testicular volumes measured by ultrasound in both testicles were lower in group 2 than in group 1. Follicle-stimulating hormone levels were higher in group 2 than in group 1. The overall frequency of antisperm antibodies in SLE patients was 40%. The apparent higher frequency of antisperm antibodies in group 1 than in group 2 did not reach significance.
Conclusion
SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume. Postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.read more
Citations
More filters
Journal ArticleDOI
2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases
Lisa R. Sammaritano,Bonnie L. Bermas,E. Chakravarty,Christina D. Chambers,Megan E.B. Clowse,Michael D. Lockshin,Wendy Marder,Gordon Guyatt,D. Ware Branch,Jill P. Buyon,Lisa Christopher-Stine,Rachelle Crow‐Hercher,John J. Cush,Maurice L. Druzin,Arthur Kavanaugh,Carl A. Laskin,Lauren A. Plante,Jane E. Salmon,Julia F. Simard,Emily C. Somers,Virginia D. Steen,Sara K. Tedeschi,Evelyne Vinet,C. Whitney White,Jinoos Yazdany,Medha Barbhaiya,Brittany Bettendorf,Amanda M Eudy,Arundathi Jayatilleke,Amit Aakash Shah,Nancy Sullivan,Laura Tarter,Mehret Birru Talabi,Marat Turgunbaev,Amy S. Turner,Kristen E. D'Anci +35 more
TL;DR: To develop an evidence‐based guideline on contraception, assisted reproductive technologies (ART), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy (HRT), pregnancy assessment and management, and medication use in patients with rheumatic and musculoskeletal disease (RMD).
Journal ArticleDOI
Lupus nephritis: A critical review
Andrea T. Borchers,Naama Leibushor,Stanley M. Naguwa,Gurtej S. Cheema,Yehuda Shoenfeld,M. Eric Gershwin +5 more
TL;DR: A detailed review of the trials that established the equivalency of these agents in the induction and/or maintenance therapy of lupus nephritis, culminating in the recent publication of new treatment guidelines by the American College of Rheumatology.
Journal ArticleDOI
The autoimmune bases of infertility and pregnancy loss.
TL;DR: This review article will illustrate and critically discuss the available data on the link between the breakdown of tolerance that characterizes autoimmune diseases and the changes in reproductive life that affect patients in real clinical setting and that often constitute the iatrotropic stimulus.
Journal ArticleDOI
Southwestern Internal Medicine ConferenceLupus Nephritis
TL;DR: With unfolding of molecular processes involved in disease pathogenesis, new targets for drug therapy have emerged and whether these medications will prove to be more efficacious and less toxic remains a matter of debate and will be answered by several ongoing trials and future studies.
Journal ArticleDOI
Review: Male systemic lupus erythematosus: a review of sex disparities in this disease
TL;DR: Findings and sex disparities in SLE that appear to be especially noteworthy and pertinent to the authors' understanding of male SLE are discussed.
References
More filters
Journal ArticleDOI
Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.
TL;DR: In 1992, Piette and colleagues suggested that the ACR revised criteria be reevaluated in light of the above discoveries, and the presence and clinical associations or antiphospholipid antibodies in patients with SLE was suggested.
Journal ArticleDOI
Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE.
TL;DR: The development of the SLEDAI is described, a validated model of experienced clinicians' global assessments of disease activity in lupus, which represents the consensus of a group of experts in the field of l upus research.
Book
Growth at Adolescence
TL;DR: This book is the expansion of a prize essay on the subject of obesity in childhood, with special reference to Hilde Bruch's theory on the causation of this condition, and is a useful summary of the statistical facts regarding obesity.
Book
Williams Textbook of Endocrinology
TL;DR: Williams textbook of endocrinology / , Williams textbooks of endocrineology /, کتابخانه دیجیتال جندی اهواز
Journal ArticleDOI
The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus.
Dafna D. Gladman,Ellen M. Ginzler,Charles H. Goldsmith,Paul R. Fortin,Matthew H. Liang,MB Urowitz,Paul A. Bacon,Stefano Bombardieri,John G. Hanly,Elaine M Hay,David A. Isenberg,Jones Jv,Kenneth C. Kalunian,Peter J. Maddison,Ola Nived,Michelle Petri,Martin Richter,Jorge Sanchez-Guerrero,M L Snaith,Gunnar Sturfelt,Deborah P M Symmons,Asad Zoma +21 more
TL;DR: This damage index for SLE records damage occurring in patients with SLE regardless of its cause and was demonstrated to have content, face, criterion, and discriminant validity.
Related Papers (5)
Review: Gonadal functioning and preservation of reproductive fitness with juvenile systemic lupus erythematosus:
Maintenance of fertility in patients with rheumatic diseases needing antiinflammatory and immunosuppressive drugs.
Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.
The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus.
Dafna D. Gladman,Ellen M. Ginzler,Charles H. Goldsmith,Paul R. Fortin,Matthew H. Liang,MB Urowitz,Paul A. Bacon,Stefano Bombardieri,John G. Hanly,Elaine M Hay,David A. Isenberg,Jones Jv,Kenneth C. Kalunian,Peter J. Maddison,Ola Nived,Michelle Petri,Martin Richter,Jorge Sanchez-Guerrero,M L Snaith,Gunnar Sturfelt,Deborah P M Symmons,Asad Zoma +21 more