Rheumatology (Oxford). 2026 Mar 24:keag127. doi: 10.1093/rheumatology/keag127. Online ahead of print.
ABSTRACT
OBJECTIVES: To systematically review the spectrum of urological manifestations and fertility outcomes reported in FMF patients, excluding renal amyloidosis-related involvement.
METHODS: A systematic search was conducted according to PRISMA 2020 Guidelines in PubMed, Web of Science, Google Scholar, and Cochrane Library, up to 4 July 2025. Studies include FMF patients with a confirmed urological pathology were eligible. Data was extracted and presented through descriptive statistics.
RESULTS: A total of 110 records were published between 1973 and 2025. Of which 38 met the inclusion criteria (14 case reports, 10 case series, 10 cross-sectional, and four cohort studies) and covered a total of 2,040 patients (mean age 23.35±16 years; 43.2% female). Results included acute scrotum (n = 64) with 75% of recurrence, testicular amyloidosis (n = 40) confirmed with biopsy, epididymo-orchitis (n = 25) with fever present in 84%, testicular torsion (n = 4), hydrocele (n = 4), and bladder amyloidosis (n = 2). Among 189 semen analyses reported, azoospermia and oligospermia were in 26.9% and 14.8% of cases. Infertility was reported in patients with testicular amyloidosis.
CONCLUSION: Our study results show that acute scrotum and epididymo-orchitis were the most frequent urological manifestations in FMF, and testicular amyloidosis and fertility impairment were also notable. These findings highlight the importance of considering urological involvement as part of the FMF spectrum in clinical practice.
PMID:41872020 | DOI:10.1093/rheumatology/keag127
