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Peng L, Chen Y, Hu J, Zhao Y, Qin F. Clinical characteristics and surgical treatment of children with 45, X/46, XY differences of sex development. J Pediatr Urol 2024:S1477-5131(24)00148-7. [PMID: 38555233 DOI: 10.1016/j.jpurol.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE This study retrospectively analyzes the clinical data of 18 children with 45,X/46,XY differences of sex development (DSD), summarizes their clinical features and explores gonadal and Müllerian duct remnants surgical treatment methods. METHODS The clinical data of 18 children with karyotype 45,X/46,XY diagnosed in the Department of Urology of Hunan Children's Hospital from March 2011 to October 2021 were collected. All children underwent HCG stimulation testing, laparoscopic exploration, urethroscopy and bilateral gonadal biopsy. After DSD multidisciplinary team (MDT) meeting, some children underwent gonadectomy and genitalia reconstructive surgeries. RESULTS The median age at first diagnosis was 1 year and 4 months (range: 10 months ∼ 16 years and 3 months). 5 children presented with female gender; they all maintained their gender assignment. The external masculinisation score (EMS) of patients raised as female was 1 (0∼3) [median (range)]. 13 children presented with male gender, 10 maintained a male gender, 3 were assigned a neutral gender. The EMS of the children raised as male was 5 (2-8) [median (range)], the EMS of the children raised as neutral gender was 4 (3.5-9.5) [median (range)]. The HCG stimulation test was positive in 11 cases, partially positive in 2 case, and negative in 5 cases. There was no relationship between the percentage of chimerism (45X ratio) and the appearance and severity of genital abnormalities. (t=-1.08, P=0.298). There was 1 case of complete gonadal dysgenesis (CGD), 10 cases of mixed gonadal dysgenesis (MGD), 5 cases of partial gonadal dysgenesis (PGD), 1 case of bilateral normal testes and 1 case of ovotesticular DSD (split-lateral type). No gonadal specimen showed germ cell tumor changes. Five cases selected to maintain the female gender, among which 3 cases underwent bilateral gonadectomy and genitalia reconstructive surgeries. Among the 10 children who chose to maintain the male gender, unilateral streak gonadectomy was performed in 4 (57.1%) with MGD, unilateral dysgenetic orchiectomy in 1 (25%) with PGD, and right ovariectomy in 1 with OTDSD. Nine of them underwent genitalia reconstructive surgeries. Four of them preserved their uterus and vagina did not have any complications during the follow-up period. CONCLUSION Hypospadias combined with cryptorchidism and residual Müllerian duct structures is the most common phenotype of children with 45, X/46, XY DSD. Mixed gonadal dysgenesis (MGD) is the most common gonadal type. Gender assignment should be carefully selected after a thorough evaluation, while genitalia reconstructive surgery can be considered in selected patients. In children who choose the male gender, the Müllerian duct can be preserved.
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Affiliation(s)
- Liucheng Peng
- Department of Urology, College of Pediatrics, University of South China, Hunan Children's Hospital, No.86 Ziyuan Road, Yuhua District, Changsha, Hunan 410007, China.
| | - Yifu Chen
- Department of Urology, College of Pediatrics, University of South China, Hunan Children's Hospital, No.86 Ziyuan Road, Yuhua District, Changsha, Hunan 410007, China.
| | - Jianjun Hu
- Department of Urology, College of Pediatrics, University of South China, Hunan Children's Hospital, No.86 Ziyuan Road, Yuhua District, Changsha, Hunan 410007, China.
| | - Yaowang Zhao
- Department of Urology, College of Pediatrics, University of South China, Hunan Children's Hospital, No.86 Ziyuan Road, Yuhua District, Changsha, Hunan 410007, China.
| | - Feng Qin
- Department of Urology, College of Pediatrics, University of South China, Hunan Children's Hospital, No.86 Ziyuan Road, Yuhua District, Changsha, Hunan 410007, China.
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Fedder J, Fagerberg C, Jørgensen MW, Gravholt CH, Berglund A, Knudsen UB, Skakkebæk A. Complete or partial loss of the Y chromosome in an unselected cohort of 865 non-vasectomized, azoospermic men. Basic Clin Androl 2023; 33:37. [PMID: 38093178 PMCID: PMC10720143 DOI: 10.1186/s12610-023-00212-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Structural abnormalities as well as minor variations of the Y chromosome may cause disorders of sex differentiation or, more frequently, azoospermia. This study aimed to determine the prevalence of loss of Y chromosome material within the spectrum ranging from small microdeletions in the azoospermia factor region (AZF) to complete loss of the Y chromosome in azoospermic men. RESULTS Eleven of 865 azoospermic men (1.3%) collected from 1997 to 2022 were found to have a karyotype including a 45,X cell line. Two had a pure 45,X karyotype and nine had a 45,X/46,XY mosaic karyotype. The AZF region, or part of it, was deleted in eight of the nine men with a structural abnormal Y-chromosome. Seven men had a karyotype with a structural abnormal Y chromosome in a non-mosaic form. In addition, Y chromosome microdeletions were found in 34 men with a structural normal Y chromosome. No congenital malformations were detected by echocardiography and ultrasonography of the kidneys of the 11 men with a 45,X mosaic or non-mosaic cell line. CONCLUSIONS In men with azoospermia, Y chromosome loss ranging from small microdeletions to complete loss of the Y chromosome was found in 6.1% (53/865). Partial AZFb microdeletions may give a milder testicular phenotype compared to complete AZFb microdeletions.
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Affiliation(s)
- J Fedder
- Centre of Andrology & Fertility Clinic, Odense University Hospital, Kløvervænget 23, DK-5000, Odense, Denmark.
- Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark.
- Fertility Clinic, Horsens Hospital, Horsens, Denmark.
| | - C Fagerberg
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - M W Jørgensen
- Department of Clinical Genetics, Lillebaelt Hospital, Vejle, Denmark
| | - C H Gravholt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Berglund
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - U B Knudsen
- Fertility Clinic, Horsens Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Kawabe Y, Yamaguchi M, Miyagaki S, Ota T, Morimoto H, Hattori A, Fukami M, Mori J. 45,X/46,X,psu idic(Y)(q11.2) in a phenotypically normal male with short stature: a case report. Clin Pediatr Endocrinol 2020; 29:189-193. [PMID: 33088019 PMCID: PMC7534520 DOI: 10.1297/cpe.29.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/07/2020] [Indexed: 11/06/2022] Open
Abstract
We report a case of 15-yr-old phenotypically normal male with short stature associated
with the chromosomal abnormalities of 46,X,psu idic(Y)(q11.2)/45,X. At 3 yr of age, he
underwent urethroplasty for scrotal hypospadias. At 15 yr of age, he was referred to our
hospital due to short stature (–3.71 SD). The results of blood examination were mostly
normal. A radiological examination revealed his bone age was 15.7 yr (based on the TW2-RUS
method). Chromosome analysis of peripheral lymphocytes revealed 46,X,psu
idic(Y)(q11.2)[16]/45,X[14], and array comparative genomic hybridization (aCGH) showed a
large deletion of Yq which was located distal to the Y chromosome growth-control gene
(GCY) region. It is likely that these structural abnormalities in the Y
chromosome were responsible for the short stature. This case might provide new insights
regarding GCY and emphasizes the importance of chromosome analysis in not
only females but also males with short stature, especially when associated with genital
anomalies.
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Affiliation(s)
- Yasuhiro Kawabe
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mihoko Yamaguchi
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoshi Miyagaki
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Ota
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hidechika Morimoto
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Hattori
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Maki Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Jun Mori
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
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He S, Xi H, Chen J, Wang D, Pang J, Hu J, Liu Q, Jia Z, Wang H. Prenatal genetic analysis and differential pregnancy outcomes of two de novo cases showing mosaic isodicentric Y chromosome. Mol Cytogenet 2020; 13:7. [PMID: 32071615 PMCID: PMC7014639 DOI: 10.1186/s13039-020-0472-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/15/2020] [Indexed: 11/27/2022] Open
Abstract
Background Fetal cells collected from the amniotic fluid of two pregnant women indicated sex chromosome abnormalities. Therefore, we performed G-banded chromosome karyotype analysis, single nucleotide polymorphism array (SNP array), fluorescence in situ hybridization (FISH), and sequence-tagged sites (STS) analysis of the Y chromosome to determine the rare molecular genetics of the two fetuses. Case presentation The karyotypes of the fetuses from patients 1 and 2 were mos 45,X[92]/46,X,+idic(Y)(q11.21)[8] and mos 45,X[20]/46,X,+idic(Y)(q11.223)[80], respectively. Fetus 1 had a 7.76 Mb deletion in Yq11.222q11.23 and a 15.68 Mb duplication in Yp11.2q11.21. Fetus 2 had 21 Mb of repetitive segments in Yp11.3q11.223. Azoospermia factor (AZF) detection by STS analysis revealed a missing AZFb+c region in fetus 1 and three functional AZF regions in fetus 2. The isodicentric Y chromosome (idic (Y)) in both fetuses arose de novo. The pregnancy of patient 1 was terminated, whereas the fetus of patient 2 was delivered and is now 10 months old with normal appearance and growth. Conclusion A combination of technologies such as chromosome karyotyping, FISH, SNP arrays, and STS analysis of the Y chromosome is important in prenatal diagnosis to reduce birth defect rates and improve the health of the Chinese population.
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Affiliation(s)
- Si He
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Hui Xi
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Jing Chen
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Dan Wang
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Jialun Pang
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Jiancheng Hu
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Qin Liu
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Zhengjun Jia
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
| | - Hua Wang
- The prenatal diagnosis center of Hunan Province, The Maternal and Child Health Hospital of Hunan Province, 53 Xiangchun Road, Kaifu District, Changsha City, Hunan Province China
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Zheng J, Yang X, Lu H, Guan Y, Yang F, Xu M, Li M, Ji X, Wang Y, Hu P, Zhou Y. Prenatal diagnosis of sex chromosome mosaicism with two marker chromosomes in three cell lines and a review of the literature. Mol Med Rep 2018; 19:1791-1796. [PMID: 30592288 DOI: 10.3892/mmr.2018.9798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 11/21/2018] [Indexed: 11/06/2022] Open
Abstract
The present study described the diagnosis of a fetus with sex chromosome mosaicism in three cell lines and two marker chromosomes. A 24‑year‑old woman underwent amniocentesis at 21 weeks and 4 days of gestation due to noninvasive prenatal testing identifying that the fetus had sex chromosome abnormalities. Amniotic cell culture revealed a karyotype of 45,X[13]/46,X,+mar1[6]/46,X,+mar2[9], and prenatal ultrasound was unremarkable. The woman underwent repeat amniocentesis at 23 weeks and 4 days of gestation for molecular detection. Single nucleotide polymorphism (SNP) microarray analysis on uncultured amniocytes revealed that the fetus had two Y chromosomes and 7.8‑Mb deletions in Yq11.222q12. The deletion regions included DAZ, RBMY and PRY genes, which could cause spermatogenesis obstacle and sterility. Interphase fluorescence in situ hybridization (FISH) using centromeric probes DXZ1/DYZ3/D18Z1 was performed on uncultured amniocytes to verify the two marker chromosomes to be Y chromosome derivatives. According to these examinations, the mar1 was identified as a derivative of the Y chromosome with a deletion in Yq11.222q12, and the mar2 was identified as a dicentric derivative of the Y chromosome. The molecular karyotype was therefore 45,X,ish(DXZ1+, DYZ3‑,D18Z1++)[5]/46,X,del(Y)(q11.222),ish(DXZ1+,DYZ3+,D18Z1++)[11]/46, X,idic(Y)(q11.222),ish(DXZ1+,DYZ3++,D18Z1++)[14]. The comprehensive use of cytogenetic, SNP array and FISH detections was advantageous for accurately identifying the karyotype, identifying the origin of the marker chromosome and preparing effective genetic counseling.
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Affiliation(s)
- Jianli Zheng
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Xiaoyu Yang
- Department of Clinical Reproductive Medicine, State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Haiyan Lu
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Yongjuan Guan
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Fangfang Yang
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Mengjun Xu
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Min Li
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Xiuqing Ji
- Department of Prenatal Diagnosis, State Key Laboratory of Reproductive Medicine, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Yan Wang
- Department of Prenatal Diagnosis, State Key Laboratory of Reproductive Medicine, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Ping Hu
- Department of Prenatal Diagnosis, State Key Laboratory of Reproductive Medicine, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210004, P.R. China
| | - Yun Zhou
- Department of Prenatal Diagnosis, Laboratory of Clinical Genetics, Maternity and Child Health Care Hospital, Yancheng, Jiangsu 224001, P.R. China
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Lin SY, Lee CN, Peng AY, Yuan TJ, Lee DJ, Lin WH, Ma GC, Chen M. Application of molecular cytogenetic techniques to characterize the aberrant Y chromosome arising de novo in a male fetus with mosaic 45,X and solve the discrepancy between karyotyping, chromosome microarray, and multiplex ligation dependent probe amplification. J Formos Med Assoc 2018; 117:1027-1031. [PMID: 29752043 DOI: 10.1016/j.jfma.2018.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 01/10/2023] Open
Abstract
We present a rare male fetus with karyotype of mosaic 45,X that comprises two types of aberrant Y chromosomes arising de novo (Yq12 deletion and isodicentric Yq11.22). Both types of the aberrant Y chromosomes lack the AZFc region which are expected to result in oligospermia but unaffected male external genitalia. Genetic analyses by karyotyping, chromosome microarray (CMA), and multiplex ligation-dependent probe amplification (MLPA) for the fetus revealed conflicting results. Additional molecular cytogenetics tools including fluorescence in situ hybridization (FISH) and multicolor banding (mBAND) were performed, which help resolving the discrepancy and delineated the composition of the aberrant Y chromosomes. This report highlighted the importance of incorporating multiple genetic technologies for accurate characterization of complex chromosomal rearrangements, which aid in the prenatal diagnosis and genetic counseling.
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Affiliation(s)
- Shin-Yu Lin
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ai-Ying Peng
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ti-Jia Yuan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Dong-Jay Lee
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital, Changhua, Taiwan; Laboratory of Genetics, Development, and Systems Biology, Department of Medical Research, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Hsiang Lin
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital, Changhua, Taiwan
| | - Gwo-Chin Ma
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital, Changhua, Taiwan; Laboratory of Genetics, Development, and Systems Biology, Department of Medical Research, Changhua Christian Hospital, Changhua, Taiwan; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Ming Chen
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Genomic Science and Technology, Changhua Christian Hospital, Changhua, Taiwan; Laboratory of Genetics, Development, and Systems Biology, Department of Medical Research, Changhua Christian Hospital, Changhua, Taiwan; Department of Life Science, Tunghai University, Taichung, Taiwan; Department of Molecular Biotechnology, College of Biotechnology and Bioresources, Dayeh University, Changhua, Taiwan.
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7
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Castro A, Rodríguez F, Flórez M, López P, Curotto B, Martínez D, Maturana A, Lardone MC, Palma C, Mericq V, Ebensperger M, Cassorla F. Pseudoautosomal abnormalities in terminal AZFb+c deletions are associated with isochromosomes Yp and may lead to abnormal growth and neuropsychiatric function. Hum Reprod 2017; 32:465-475. [PMID: 28057878 DOI: 10.1093/humrep/dew333] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/23/2016] [Accepted: 12/07/2016] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Are copy number variations (CNVs) in the pseudoautosomal regions (PARs) frequent in subjects with Y-chromosome microdeletions and can they lead to abnormal stature and/or neuropsychiatric disorders? SUMMARY ANSWER Only subjects diagnosed with azoospermia factor (AZF)b+c deletions spanning to the end of the Y chromosome (i.e. terminal deletions) harbor Y isochromosomes and/or cells 45,X that lead to pseudoautosomal gene CNVs, which were associated with abnormal stature and/or neuropsychiatric disorders. WHAT IS KNOWN ALREADY The microdeletions in the long arm of the Y chromosome (Yq) that include the loss of one to three AZF regions, referred to as Yq microdeletions, constitute the most important known etiological factor for primary spermatogenic failure. Recently, controversy has arisen about whether Yq microdeletions are associated with gain or loss of PAR genes, which are implicated in skeletal development and neuropsychiatric function. STUDY DESIGN, SIZE, DURATION We studied a cohort of 42 Chilean patients with complete AZF deletions (4 AZFa, 4 AZFb, 23 AZFc, 11 AZFb+c) from a university medical center, diagnosed over a period of 15 years. The subjects underwent complete medical examinations with special attention to their stature and neuropsychiatric function. PARTICIPANTS/MATERIALS, SETTING, METHODS All subjects were characterized for Yq breakpoints by PCR, and for CNVs in PARs by multiplex ligation-dependent probe amplification (MLPA), followed by qPCR analysis for genes in PAR1 (SHOX and ZBED1), PAR2 (IL9R) and two single copy genes (SRY and DDX3Y, respectively located in Yp11.3 and AZFa). In addition, karyotypes revision and fluorescence in situ hybridization (FISH) for SRY and centromeric probes for X (DXZ1) and Y (DYZ3) chromosomes were performed in males affected with CNVs. MAIN RESULTS AND THE ROLE OF CHANCE We did not detect CNVs in any of the 35 AZF-deleted men with interstitial deletions (AZFa, AZFb, AZFc or AZFb+c). However, six of the seven patients with terminal AZFb+c deletions showed CNVs: two patients showed a loss and four patients showed a gain of PAR1 genes, with the expected loss of VAMP-7 in PAR2. In these patients, the Yq breakpoints localized to the palindromes P8, P5 or P4. In the four cases with gain of PAR1, qPCR analysis showed duplicated signals for SRY and DDX3Y and one copy of IL9R, indicating isodicentric Yp chromosomes [idic(Y)] with breakpoint in Yq11.22. The two patients who had loss of PAR1, as shown by MLPA, had an additional reduction for SRY and DDX3Y, as shown by qPCR, associated with a high proportion of 45,X cells, as determined by FISH and karyotype. In agreement with the karyotype analysis, we detected DYZ3++ and DYZ3+ cells by FISH in the six patients, confirming idic(Y) and revealing additional monocentric Y chromosome [i(Y)]. Five patients had a history of major depressive disorders or bipolar disorder, and three had language impairment, whereas two patients showed severe short stature (Z score: -2.75 and -2.62), while a man with bipolar disorder was very tall (Z score: +2.56). LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION The number of males studied with Y-chromosome microdeletions and normozoospermic controls with normal karyotypes may not be enough to rule out an association between AZF deletions and PAR abnormalities. The prevalence of Y isochromosomes and/or 45,X cells detected in peripheral blood does not necessarily reflect the variations of PAR genes in target tissues. WIDER IMPLICATIONS OF THE FINDINGS This study shows that CNVs in PARs were present exclusively in patients with terminal AZFb+c deletions associated with the presence of Y isochromosomes and 45,X cells, and may lead to neuropsychiatric and growth disorders. In contrast, we show that men with interstitial Yq microdeletions with normal karyotypes do not have an increased risk of PAR abnormalities and of phenotypical consequences. Moreover, our results highlight the importance of performing molecular studies, which are not considered in the usual screening for patients with Yq microdeletions. STUDY FUNDING/COMPETING INTERESTS This work was supported by the National Fund for Scientific and Technological Development of Chile (FONDECYT), grant no. 1120176 (A.C.). The authors declare that no conflicting interests exist.
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Affiliation(s)
- A Castro
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - F Rodríguez
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - M Flórez
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - P López
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - B Curotto
- Laboratorio de Genética y Enfermedades Metabólicas, Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago 7830490, Chile
| | - D Martínez
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - A Maturana
- Psychiatric Unit, Clínica Las Condes, Santiago 7591046, Chile
| | - M C Lardone
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - C Palma
- Department of Urology, José Joaquín Aguirre Clinical Hospital, School of Medicine, University of Chile, Santiago 8380453, Chile
- Department of Urology, Clínica Las Condes, Santiago 7591046, Chile
| | - V Mericq
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - M Ebensperger
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
| | - F Cassorla
- Institute of Maternal and Child Research, School of Medicine, University of Chile, Hospital San Borja Arriarán, Santiago 8360160, Chile
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8
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Mekkawy M, Kamel A, El-Ruby M, Mohamed A, Essawi M, Soliman H, Dessouky N, Shehab M, Mazen I. Isodicentric Y chromosomes in Egyptian patients with disorders of sex development (DSD). Am J Med Genet A 2012; 158A:1594-603. [DOI: 10.1002/ajmg.a.35487] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 04/26/2012] [Indexed: 11/07/2022]
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9
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Corduk N, Semiz S, Koltuksuz U, Semerci CN, Duzcan F, Duzcan E, Satiroglu-Tufan NL. Patient with 45,X karyotype and severe virilization occult Y sequences. Pediatr Int 2012; 54:140-4. [PMID: 22335325 DOI: 10.1111/j.1442-200x.2011.03473.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Nergul Corduk
- Department of Pediatric Surgery, Pamukkale University, Faculty of Medicine, Denizli, Turkey.
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