Familial forms of disorders of sex development may be common if infertility is considered a comorbidity

BMC Pediatrics

Research Article

Henri Lottmann¹  Flavia Picard-Dieval²  Sébastien Rouget²  Raja Brauner²  Ken McElreavey³  Joelle Bignon-Topalovic³  Anu Bashamboo³ 

[1] Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de chirurgie viscérale pédiatrique, Paris, France;Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France;Human Developmental Genetics, Institut Pasteur, Paris, France;

关键词: 46,XY disorders of sex development;    Anorchia;    Cryptorchidism;    DSD;    Infertility;    Hypospadias;    Premature menopause;    Premature ovarian insufficiency;   

DOI  :  10.1186/s12887-016-0737-0

 received in 2015-11-22, accepted in 2016-11-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundFamilies with 46,XY Disorders of Sex Development (DSD) have been reported, but they are considered to be exceptionally rare, with the exception of the familial forms of disorders affecting androgen synthesis or action. The families of some patients with anorchia may include individuals with 46,XY gonadal dysgenesis. We therefore analysed a large series of patients with 46,XY DSD or anorchia for the occurrence in their family of one of these phenotypes and/or ovarian insufficiency and/or infertility and/or cryptorchidism.MethodsA retrospective study chart review was performed for 114 patients with 46,XY DSD and 26 patients with 46,XY bilateral anorchia examined at a single institution over a 33 year period.ResultsOf the 140 patients, 25 probands with DSD belonged to 21 families and 7 with anorchia belonged to 7 families. Familial forms represent 22% (25/114) of the 46,XY DSD and 27% (7/26) of the anorchia cases. No case had disorders affecting androgen synthesis or action or 5 α-reductase deficiency. The presenting symptom was genital ambiguity (n = 12), hypospadias (n = 11) or discordance between 46,XY karyotyping performed in utero to exclude trisomy and female external genitalia (n = 2) or anorchia (n = 7). Other familial affected individuals presented with DSD and/or premature menopause (4 families) or male infertility (4 families) and/or cryptorchidism. In four families mutations were identified in the genes SRY, NR5A1, GATA4 and FOG2/ZFPM2. Surgery discovered dysgerminoma or gonadoblastoma in two cases with gonadal dysgenesis.ConclusionsThis study reveals a surprisingly high frequency of familial forms of 46,XY DSD and anorchia when premature menopause or male factor infertility are included. It also demonstrates the variability of the expression of the phenotype within the families. It highlights the need to the physician to take a full family history including fertility status. This could be important to identify familial cases, understand modes of transmission of the phenotype and eventually understand the genetic factors that are involved.

【 授权许可】

CC BY   
© The Author(s). 2016