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Autoimmune Orchitis
Prepared by: Daniela Cihakova MD, PhD

Definition: Autoimmune orchitis is an autoimmune inflammation of the testis, resulting in infertility.

Description: Autoimmune orchitis is not very well described in literature, because it is very rare. It can manifest as enlargement of the testis. In some men, infertility antisperm antibody can be found.

Symptoms: Chronic orchitis may cause mild testicular pain or swelling, it may resemble a tumor.

Diagnosis: Distinguishing autoimmune orchitis from a tumor is the main challenge. This is determined by biopsy.

Treatment: A significantly lower incidence and severity relative to controls was found when mice were treated with phosphate buffered saline (PBS). The effects of deoxyspergualin were clearly dose-dependent, and the higher dose of the drug also markedly reduced the degree of delayed type hypersensitivity responses against testicular germ cells. These results suggest that deoxyspergualin might be useful for the prevention or treatment of human immunoinflammatory orchitis.

Pathogenesis: There is evidence that autoimmune orchitis is autoimmune disease:

Indirect evidence:

Existing murine models for experimental autoimmune orchitis (EAO):
  1. Murine experimental autoimmune orchitis (EAO) induced in C3H/He mice by immunization with freshly prepared syngeneic testicular germ cells (TGC) with the use of no adjuvant. The disease is CD4 T cell-dependent, as these cells, but not CD8 T cells, B cells, nor the sera transfer the disease to normal mice.

  2. “Sympathetic orchitis mice model" - unilateral testicular injury induce the contralateral EAO but also autoimmune infertility in mice.

  3. Autoimmune orchitis is established after unilateral bacterial (Listeria monocytogenes) infection of the testis.

  4. Some authors reports that vasectomy in guinea pigs can result in autoimmune orchitis. Others did not agree with this observation.

    There are case reports that after operation in testes area, some patient developed orchitis presumably autoimmune.



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