目的:家族性地中海热(FMF)是世界上最常见的遗传性自身炎性疾病。有已知的触发器来发起FMF攻击,然而,之前尚未评估宫内节育器(IUD)对育龄妇女的潜在影响.
方法:连续招募18岁以上使用过宫内节育器的女性FMF患者。FMF的女性患者根据他们使用的IUD类型进行分组。FMF攻击频率,严重程度,持续时间,痛经的存在,痛经的严重程度,在月经期间使用宫内节育器前后有发作的问题。从医院数据库收集人口统计学和临床数据。
结果:当评估所有使用宫内节育器的患者时,发现在第3个月和第12个月插入宫内节育器后,发作频率增加(第3个月的中位[min-max]发作频率,1(0-3)vs1(0-6),p=0.002,第12个月的中位[min-max]发作频率,2(0-12)vs3.5(0-18),p=0.028)。通过VAS疼痛测量的发作严重程度也显着增加。宫内节育器使用前后的发作持续时间和月经疼痛相似。第3个月和第12个月的攻击频率,铜宫内节育器使用者的发作严重程度和月经疼痛均显着增加,而这些参数在LNG-IUD组中没有恶化。
结论:宫内节育器使用,尤其是铜宫内节育器,可能会增加女性FMF患者的发作频率和严重程度。如果宫内节育器在FMF育龄妇女中被优选作为避孕方法,临床医生可能会从考虑LGN-宫内节育器中受益。
OBJECTIVE: Familial Mediterranean fever (FMF) is the most common inherited autoinflammatory disease in the world. There are known triggers to initiate an FMF
attack, yet potential effects of intrauterine devices (IUD) in women of reproductive age have not been evaluated before.
METHODS: Consecutive female patients with FMF who ever used IUD over the age of 18 were enrolled. Female patients with FMF were sub grouped according to the type of IUD they use. FMF
attack frequency, severity, duration, presence of dysmenorrhea, severity of dysmenorrhea, having attacks during menstruation before and after IUD use were questioned. Demographic and clinical data were collected from hospital database.
RESULTS: When all patients with IUD use were evaluated, it was found that the frequency of attacks increased after IUD insertion at 3rd and 12th months (median [min-max] attack frequency at 3rd month, 1 (0-3) vs 1 (0-6), p = 0.002, median [min-max] attack frequency at 12th month, 2 (0-12) vs 3.5 (0-18), p = 0.028).
Attack severity measured by VAS pain was also significantly increased.
Attack duration and menstrual pain was similar before and after IUD use.
Attack frequency at 3rd and 12th months,
attack severity and menstrual pain was all increased significantly in Cu-IUD users, whereas none of these parameters deteriorated in LNG-IUD group.
CONCLUSIONS: IUD use, especially Cu-IUD, may increase the frequency and severity of attacks in female patients with FMF. Clinicians may benefit from considering LGN-IUD if IUDs are preferred as contraception in women of childbearing age with FMF.