Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Ankylosing Spondylitis: High Frequency of Varicocele Associated with Teratozoospermia.

Nukumizu5,  Lucia A., Saad5,  Carla G. S., de Almeida5,  Breno P., Carvalho5,  Jozélio F., Cocuzza2,  Marcello, Goncalves5,  Celio R., Saito1,  Osmar

Department of Radiology - Faculdade de Medicina da Universidade de São Paulo, Brazil
Department of Urology - Faculdade de Medicina da Universidade de São Paulo, Brazil
Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
Pediatric Reumatology Unit, Faculdade de Medicina da Universidade de São Paulo, Brazil
Rheumatology Division - Faculdade de Medicina da Universidade de São Paulo, Brazil

Purpose:

To assess testicular function in male ankylosing spondylitis (AS) patients and controls.

Methods:

20 consecutive post-pubertal AS patients (modified New York criteria) were prospectively assessed for demographic data, urologic examination, testicular Döppler ultrasound (US), standardized semen analysis according to World Health Organization (WHO) guidelines and Kruger strict criteria, and anti-sperm antibodies. Selection criteria never under biological agents were included; sulfasalazine and methotrexate wash-out period of at least 3 months and no restriction to the use of non-steroidal anti-inflammatory drugs and/or low dose prednisone (<= 10mg/day). The evaluation of AS included: clinical features, laboratory exams, treatment and scores (BASDAI, BASFI, BASMI and BASRIt). The control group consisted of 24 male healthy subjects.

Results:

The median of current age was similar in AS and controls (31.5(23–44) vs. 34(17–53)yrs, p=0.353). The frequencies of left or bilateral varicoceles by clinical examination and by US were significantly higher in AS patients compared to controls (30% vs. 4%, p=0.035; 40% vs. 8%, p=0.027). Likewise, the median of vein diameters of pampiniform plexus in left testicles were significantly higher in AS patients versus controls (0.25(0.16–0.49) vs. 0.2(0.2–0.37)cm, p=0.009). Of note, the median of normal sperm forms by Kruger strict criteria was significantly lower in AS patients versus controls [3.25(0–14.5) vs. 6.75(0–18), p=0.035) and the frequency of teratozoospermia (abnormal sperm morphology) was significantly higher (55% vs. 8% p=0.0001). Reinforcing these findings, the median of normal sperm morphology by WHO guidelines was significantly lower in AS patients with ultrasonographic varicoceles compared to patients without varicoceles [13.5(2–27) vs. 22(10–32.5)%, p=0.049]. In addition, the median of normal sperm morphology by WHO guidelines and by Kruger strict criteria were alike in AS patients versus controls without ultrasonographic varicoceles (p>0.05). No differences were observed in penis median length and circumference in AS patients and controls, and testicular (left and right) by way of US in both groups (p>0.05). The median and frequencies of other parameters of sperm analysis and anti-sperm antibodies were comparable (p>0.05) in AS patients and controls. The demographic data, clinical findings and laboratory exams were also similar in AS patients with ultrasonographic varicoceles compared to patients without varicoceles (p>0.05), likewise tem median of BASDAI (4.21(1.66–6) vs. 3.95(1.04–8.68), p=0.899), BASFI (4.06(1.4–7.79) vs. 3.77(0–8.41), p=0.819), BASMI (4.5(0–7) vs. 6(0–8), p=0.486) and BASRIt (9(6–16) vs. 10(5–16), p=0.463).

Conclusions:

This is the first demonstration that AS patients have a high frequency of varicoceles associated with isolated teratozoospermia. Further studies are necessary to determine if oxidative stress may underlie this testicular dysfunction in AS, since high levels of reactive oxygen species were reported to have a harmful effect in sperm quality of men with varicocele.

To cite this abstract, please use the following information:
Nukumizu, Lucia A., Saad, Carla G. S., de Almeida, Breno P., Carvalho, Jozélio F., Cocuzza, Marcello, Goncalves, Celio R., et al; Ankylosing Spondylitis: High Frequency of Varicocele Associated with Teratozoospermia. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :513
DOI: 10.1002/art.28282

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