Leprosy
mailing list – December 6th, 2005
Ccn:
all.
From: L Schuler-Faccini, Porto
Alegre, Rio Grande do Sul, Brazil.
Dear Dr. Noto,
I got your e-mail by Artur Custodio Souza from
MORHAN, Brazil. I think
you will find interesting the enclosed paper
published in 2001. To my
knowledge it is the only publication measuring thalidomide
concentration in human semen after oral dosing.
They found a strict correlation between plasma and semen levels, both
decreasing after 8 weeks of treatment, most probably because hepatic
P450 induction.
The main question is that we really do not know the lower threshold
for thalidomide teratogenicity, then the advise of using of
preservatives during male treatment.
Theoretical issues: even knowing that thalidomide
is excreted in seminal fluid, we do not know exactly the amount of
thalidomide that goes to maternal circulation and the plasmatic levels
reached in the woman. So
we have to take the cautious principle.
I do not know any case of a definite paternal
exposure and teratogenesis mediated by seminal fluid. However, it would be
interesting to let you know about the recent case Artur and I have
evaluated.
This boy was born in May 2005, son of a young
couple. The father had leprosy and is under thalidomide treatment. The
mother is healthy and says that she did not take the medication. Our
first hypothesis was that she could not remember facts referring one
year ago. To support this hypothesis, she and her husband are almost
illiterate and they did not receive any information from their doctor
about teratogenic risks. As
they are very poor we supposed that she took by mistake thalidomide. But, considering this paper, I
think we have paternal exposure only as an alternative explanation.
I am sending enclosed a picture from the patient
(with family’s authorization) where we can see the clear diagnosis
of Foetal Thalidomide Syndrome. I
will be glad to hear from you and I am willing to discuss further this
issue.
Sincerely yours,
Lavinia Schuler-Faccini, MD PhD
Teratogen Information Service - Porto
Alegre, Brazil
Departamento de Genetica -
Universidade Federal do Rio Grande do Sul
Servico de Genetica Medica - Hospital
de Clinicas de Porto Alegre
revue de presse:
STEVE K. TEO et al
“THALIDOMIDE
IS DISTRIBUTED INTO HUMAN SEMEN AFTER ORAL DOSING”
DMD 29:1355–1357, 2001
Schuler-Faccini Thalidomide picture
