Youngʼs Syndrome. Obstructive Azoospermia and Chronic Sinopulmonary Infections

Abstract

Male infertility has been associated with chronic sinopulmonary infections, including immotile-cilia syndrome, cystic fibrosis, and Young's syndrome. The last-named infection differs from the immotile-cilia syndrome by the absence of ultrastructural cilial disorders and from cystic fibrosis by the presence of normal sweat and pancreatic functions (Table 1). Among 881 consecutive patients, the present authors identified 29 men with the diagnosis of Young's syndrome. A control group of 89 unselected, normal males was included in the study. Patients and controls are compared in Table 2. Of the 29 men with Young's syndrome, 27 had histories of recurrent cough and sputum production. The onset had occurred in early childhood, with frequent infections and loss of school time. In nearly all of the subjects, a considerable symptomatic improvement had been noted after adolescence. As adults, these men experienced infections requiring antibiotic treatment, and most of them took intermittent courses of amoxicillin (a trimethoprim-sulfa-methoxazole combination) or erythromycin. Of the 27 men with recurrent cough and sputum, 19 had either bronchographic or radiological evidence of bronchiectasis. Two men denied any regular cough or sputum, but each had chronic sinustis or obstructive azoospermia with characteristic epididymal appearances.