plasma-derived factor IX products in pediatric Pharmacokinetics of recombinant and patients with severe hemophilia

A 55-year-old man who had coronary artery disease was referred to our clinic with blood in the semen. He did not have any history of hypertension, hyperlipidemia, hypo/hyperthyroidism, urinary tract infections, sexually transmitted diseases, bleeding disorders, trauma or surgery, genital or urinary system malformation, and tumour. A bare metal stent implantation was performed to his circumflex coronary artery approximately 6 months ago. He was taking only 75 mg clopidogrel daily as antiplatelet therapy. We did not give him acetylsalicylic acid because of the history of peptic ulcer and gastrointestinal bleeding. On his genitourinary examination, external genitalia, testes, epididymis, cord and penile urethra were normal. Seminal vesicles were not palpable. The urethral meatus was normal. There were no masses in the scrotum, or nodularity, tenderness or enlargement of the prostate gland. On his biochemical analysis, haemoglobin was 14 g/dl, white blood count was 8.96 10/ml, platelet count was 305 10/ml, protrombin time was 11 s, partial tromboplastin time 22 s and international normalized ratio was 1.01. No urinary infection was detected with urine culture. There were no evidence of gonorrhoea and chlamydia. Transrectal ultrasound of the prostate and abdominopelvic sonography were normal. We thought that clopidogrel may cause the haematospermia and stopped clopidogrel. Three days later, the haematospermia completely stopped and was not seen within 3 weeks. Then, we restarted clopidogrel and haematospermia reappeared again after 3 days. So, we stopped clopidogrel again. After 1 year follow-up, no haematospermia was seen.