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The Klinefelter Syndrome and Testicular Sperm Retrieval Outcomes. Genes (Basel) 2023; 14:genes14030647. [PMID: 36980920 PMCID: PMC10048758 DOI: 10.3390/genes14030647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Klinefelter syndrome (KS), caused by the presence of an extra X chromosome, is the most prevalent chromosomal sexual anomaly, with an estimated incidence of 1:500/1000 per male live birth (karyotype 47,XXY). High stature, tiny testicles, small penis, gynecomastia, feminine body proportions and hair, visceral obesity, and testicular failure are all symptoms of KS. Endocrine (osteoporosis, obesity, diabetes), musculoskeletal, cardiovascular, autoimmune disorders, cancer, neurocognitive disabilities, and infertility are also outcomes of KS. Causal theories are discussed in addition to hormonal characteristics and testicular histology. The retrieval of spermatozoa from the testicles for subsequent use in assisted reproduction treatments is discussed in the final sections. Despite testicular atrophy, reproductive treatments allow excellent results, with rates of 40–60% of spermatozoa recovery, 60% of clinical pregnancy, and 50% of newborns. This is followed by a review on the predictive factors for successful sperm retrieval. The risks of passing on the genetic defect to children are also discussed. Although the risk is low (0.63%) when compared to the general population (0.5–1%), patients should be informed about embryo selection through pre-implantation genetic testing (avoids clinical termination of pregnancy). Finally, readers are directed to a number of reviews where they can enhance their understanding of comprehensive diagnosis, clinical care, and fertility preservation.
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Rojas AP, Vo DV, Mwangi L, Rehman S, Peiris AN. Oncologic manifestations of Klinefelter syndrome. Hormones (Athens) 2020; 19:497-504. [PMID: 33000452 DOI: 10.1007/s42000-020-00241-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
Klinefelter syndrome (47,XXY) has a prevalence of approximately 1 in 500 males. It is a condition characterized by an extra X chromosome and is an underdiagnosed clinical entity. Inactivation of genes enables their escape from regulatory mechanisms, which can result in such classic physical manifestations as hypogonadism, gynecomastia, infertility, and various hormonal and physical abnormalities. While the endocrine manifestations of 47,XXY are well-known, the oncologic manifestations have received less attention. An association between cancer and 47,XXY has not as yet been clearly defined, with variability noted in the prevalence of different malignancies in 47,XXY patients. The mechanisms underlying these altered oncologic risks are still under debate. Some of the proposed explanations include hormone imbalance, developmental malfunctions, and failed DNA repair mechanisms. However, the recognition of the oncological associations linked to 47,XXY could be helpful. Screening measures in certain malignancies may enable an earlier diagnosis of 47,XXY and the implementation of more customized care in 47,XXY and the mosaic variants.. The data for this review was compiled from relevant PubMed articles published within the last three decades and organized based on cancer type.
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Affiliation(s)
- Alexsandra P Rojas
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
- , Lubbock, TX, USA.
| | - Diana V Vo
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Lance Mwangi
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Shabnam Rehman
- Oncology Division of Internal medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Alan N Peiris
- Clinical Research Institute and Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Hussein TM, Abd Elmoaty Elneily D, Mohamed Abdelfattah Elsayed F, El-Attar LM. Genetic risk factors for venous thromboembolism among infertile men with Klinefelter syndrome. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2020; 20:100228. [PMID: 32577403 PMCID: PMC7303976 DOI: 10.1016/j.jcte.2020.100228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 11/13/2022]
Abstract
Infertile males with KS have sex-chromosome abnormalities, endocrinal disturbances and other health problems. Hereditary thrombophilia may exacerbate tendency to thrombosis in KS patients. Genotype and allele frequency of thrombophilic gene variants were remarkably high in men with KS. The coexistence of different mutant alleles was evident in infertile KS males.
Background Klinefelter syndrome (KS) is one of the commonest sex chromosome disorders. Affected males become infertile and highly susceptible to several health problems, including vascular thromboembolism (VTE). The risk of VTE may be exacerbated by an underlying genetically inherited thrombophilia. In this study, we aimed to investigate the genotype and allele frequencies of common gene polymorphisms related to hereditary thrombophilia in infertile males with KS compared to normal, fertile men. Methods Eighty-five infertile males with KS and 75 healthy control males were included in this case-control study. Genetic testing was done using an extended thrombophilia gene panel by Multiplex PCR reverse hybridization method. Results There was an increased frequency of mutant alleles and heterozygous genotypes of FV Leiden, FV H 1299R, Pro G20210A, MTHFR C677T and PAI-1 4G/5G thrombophilic gene polymorphisms in KS patients compared to the control group. It was shown that 10.7% of KS patients had the A3 haplotype of the EPCR gene in comparison to 5.3% of control patients. The A3/A3 genotype was found only in KS patients (7.1%). Carriers of more than one mutant allele in KS patients exceeded the control (p < 0.001). Conclusion A high prevalence of thrombophilic gene polymorphisms and the coexistence of different mutant alleles were evident in infertile KS males. These data highlight the importance of conducting further studies to understand the role of hereditary thrombophilia in predicting venous thrombosis in patients with Klinefelter syndrome.
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Key Words
- APC, activated protein C
- Allele frequency
- BMI, Body mass index
- EPCR, Endothelial protein C receptor
- FSH, Follicle stimulating hormone
- FV Leiden, Factor V leiden
- Genotype
- HDL, High density lipoprotein
- Hereditary thrombophilia
- Klinefelter syndrome
- LDL, Low density lipoprotein
- LH, Luteinizing hormone
- MAF, Minor Allele Frequency
- MTHFR, 5, 10-methylene tetrahydrofolate reductase
- PAI-1, plasminogen activator inhibitor 1
- PROCR, Protein C receptor gene
- PTH, Prothrombin
- Polymorphism
- SNP, Single Nucleotide Polymorphism
- VTE, Venous thromboembolism
- VTE, thrombosis
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Affiliation(s)
- Tarek M Hussein
- Dermatology and Andrology Department, Alexandria University, Alexandria, Egypt
| | - Dalia Abd Elmoaty Elneily
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Lama M El-Attar
- Department of Human Genetics, Medical Research Institute, Alexandria University, Alexandria, Egypt
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Xie L, Li X, Mo J, Li L, Chen X, Chen L, Ma L, Chen Y, Ge F, Zhao J, Ge RS. Delayed Puberty by Ziram Is Associated with Down Regulation of Testicular Phosphorylated AKT1 and SIRT1/PGC-1α Signaling. Chem Res Toxicol 2018; 31:1315-1322. [PMID: 30422632 DOI: 10.1021/acs.chemrestox.8b00201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Ziram is a dimethyldithiocarbamate fungicide, which may influence the male reproductive system as a potential endocrine disruptor. We interrogated the disruption of ziram on rat progenitor Leydig cell development. Prepubertal male Sprague-Dawley rats were orally treated with 0, 2, 4, or 8 mg/kg ziram for 2 weeks. We investigated the effects of ziram on serum testosterone levels, Leydig cell number, and Leydig and Sertoli cell gene and protein expression, SIRT1/PGC-1α levels, and phosphorylation of AKT1, ERK1/2, and AMPK in vivo. We also interrogated the effects of ziram on reactive oxidative species (ROS) level, apoptosis rate, and mitochondrial membrane potential of progenitor Leydig cells in vitro. Ziram decreased serum testosterone and follicle-stimulating hormone levels, the down-regulated Leydig cell-specific gene ( Lhcgr, Scarb1, Star, Cyp17a1, and Hsd17b3), and their protein expression. However, ziram stimulated anti-Müllerian hormone production. Ziram lowered SIRT1/PGC-1α and phosphorylated protein levels of AKT1. Ziram induced ROS and apoptosis and lowered the mitochondrial membrane potential of progenitor Leydig cells in vitro. In conclusion, ziram disrupts Leydig cell development during the prepubertal period potentially through the SIRT1/PGC-1α and phosphorylated AKT1 signaling.
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Affiliation(s)
- Lubin Xie
- Department of Obstetrics and Gynecology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Xiaoheng Li
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Jiaying Mo
- Department of Obstetrics and Gynecology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Linchao Li
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Xianwu Chen
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Lanlan Chen
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Leikai Ma
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Yong Chen
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Fei Ge
- Department of Anesthesiology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Junzhao Zhao
- Department of Obstetrics and Gynecology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
| | - Ren-Shan Ge
- Department of Obstetrics and Gynecology , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , 109 Xueyuan West Road , Wenzhou , Zhejiang 325027 , China
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Tremellen K. Gut Endotoxin Leading to a Decline IN Gonadal function (GELDING) - a novel theory for the development of late onset hypogonadism in obese men. Basic Clin Androl 2016; 26:7. [PMID: 27340554 PMCID: PMC4918028 DOI: 10.1186/s12610-016-0034-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/24/2016] [Indexed: 12/25/2022] Open
Abstract
Obesity is an increasing public health problem, with two-thirds of the adult population in many Western countries now being either overweight or obese. Male obesity is associated with late onset hypogonadism, a condition characterised by decreased serum testosterone, sperm quality plus diminished fertility and quality of life. In this paper we propose a novel theory underlying the development of obesity related hypogonadism- the GELDING theory (Gut Endotoxin Leading to a Decline IN Gonadal function). Several observational studies have previously reported an association between obesity related hypogonadism (low testosterone) and systemic inflammation. However, for the first time we postulate that the trans-mucosal passage of bacterial lipopolysaccharide (LPS) from the gut lumen into the circulation is a key inflammatory trigger underlying male hypogonadism. Obesity and a high fat/high calorie diet are both reported to result in changes to gut bacteria and intestinal wall permeability, leading to the passage of bacterial endotoxin (lipopolysaccharide- LPS) from within the gut lumen into the circulation (metabolic endotoxaemia), where it initiates systemic inflammation. Endotoxin is known to reduce testosterone production by the testis, both by direct inhibition of Leydig cell steroidogenic pathways and indirectly by reducing pituitary LH drive, thereby also leading to a decline in sperm production. In this paper we also highlight the novel evolutionary benefits of the GELDING theory. Testosterone is known to be a powerful immune-suppressive, decreasing a man's ability to fight infection. Therefore we postulate that the male reproductive axis has evolved the capacity to lower testosterone production during times of infection and resulting endotoxin exposure, decreasing the immunosuppressive influence of testosterone, in turn enhancing the ability to fight infection. While this response is adaptive in times of sepsis, it becomes maladaptive in the setting of "non-infectious" obesity related metabolic endotoxaemia.
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Affiliation(s)
- Kelton Tremellen
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia
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Kleiman SE, Yogev L, Lehavi O, Yavetz H, Hauser R. Distinctive pattern of expression of spermatogenic molecular markers in testes of azoospermic men with non-mosaic Klinefelter syndrome. J Assist Reprod Genet 2016; 33:807-14. [PMID: 26995389 DOI: 10.1007/s10815-016-0698-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 03/07/2016] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Mature sperm cells can be found in testicular specimens extracted from azoospermic men with non-mosaic Klinefelter syndrome (KS). The present study evaluates the expression of various known molecular markers of spermatogenesis in a population of men with KS and assesses the ability of those markers to predict spermatogenesis. METHODS Two groups of men with non-obstructive azoospermia who underwent testicular sperm-retrieval procedures were included in the study: 31 had non-mosaic KS (KS group) and 91 had normal karyotype (NK group). Each group was subdivided into mixed atrophy (containing some mature sperm cells) or Sertoli cell only syndrome according to testicular histology and cytology observations. Semi-quantitative histological morphometric analysis (interstitial hyperplasia and hyalinization, tubules with cells and abnormal thickness of the basement membrane) and expression of spermatogenetic markers (DAZ, RBM, BOLL, and CDY1) were evaluated and compared among those subgroups. RESULTS Clear differences in the histological morphometry and spermatogenetic marker expression were noted between the KS and NK groups. There was a significant difference in the expression of spermatogenetic markers between the subgroups of the NK group (as expected), while no difference could be discerned between the two subgroups in the KS group. CONCLUSION We conclude that molecular spermatogenetic markers have a pattern of expression in men with KS that is distinctively different from that of men with NK, and that it precludes and limits their use for predicting spermatogenesis in the former. It is suggested that this difference might be due to the specific highly abnormal histological morphometric parameters in KS specimens.
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Affiliation(s)
- Sandra E Kleiman
- Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906, Israel.
| | - Leah Yogev
- Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906, Israel
| | - Ofer Lehavi
- Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906, Israel
| | - Haim Yavetz
- Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906, Israel
| | - Ron Hauser
- Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906, Israel
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Cho BW, Kwon SE, Kim SK, Lee T, Han JY, Lee JE. Early onset of puberty in an obese boy with Klinefelter syndrome. Ann Pediatr Endocrinol Metab 2016; 21:39-42. [PMID: 27104178 PMCID: PMC4835560 DOI: 10.6065/apem.2016.21.1.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/23/2015] [Accepted: 12/07/2015] [Indexed: 11/20/2022] Open
Abstract
Klinefelter syndrome (KS) is one of the most common disease entities characterized by X-chromosomal aberration causing the primary hypogonadism in adult men. Patients with KS seem to be typically characterized by tall, slender bodies with delayed puberty and hypergonadotropic hypogonadism. However, it has been known that they have a broad spectrum of phenotype ranging from almost normal external appearances to typical phenotype. Only 25% KS Patients are ever diagnosed because KS remains unrecognized. Also, boys with KS have an onset of pubertal development within the normal range, not delayed onset of puberty. Adolescents with KS are generally diagnosed as having the lack of pubertal progress. Early detection of KS can be difficult without awareness. We report an unusual case of early onset of puberty in obese boy with KS who presented with a unilateral non-hormone secreting testicular teratoma.
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Affiliation(s)
- Byoung-Wook Cho
- Department of Pediatrics, Inha University Hospital, Inha University Graduate School of Medicine, Incheon, Korea
| | - Seung-Eun Kwon
- Department of Pediatrics, Inha University Hospital, Inha University Graduate School of Medicine, Incheon, Korea
| | - Soon-Ki Kim
- Department of Pediatrics, Inha University Hospital, Inha University Graduate School of Medicine, Incheon, Korea
| | - Taek Lee
- Department of Urology, Inha University Hospital, Inha University Graduate School of Medicine, Incheon, Korea
| | - Jee-Young Han
- Department of Pathology, Inha University Hospital, Inha University Graduate School of Medicine, Incheon, Korea
| | - Ji-Eun Lee
- Department of Pediatrics, Inha University Hospital, Inha University Graduate School of Medicine, Incheon, Korea
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8
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Stagi S, Di Tommaso M, Manoni C, Scalini P, Chiarelli F, Verrotti A, Lapi E, Giglio S, Dosa L, de Martino M. Bone Mineral Status in Children and Adolescents with Klinefelter Syndrome. Int J Endocrinol 2016; 2016:3032759. [PMID: 27413371 PMCID: PMC4927985 DOI: 10.1155/2016/3032759] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 11/17/2022] Open
Abstract
Objective. Klinefelter syndrome (KS) has long-term consequences on bone health. However, studies regarding bone status and metabolism during childhood and adolescence are very rare. Patients. This cross-sectional study involved 40 (mean age: 13.7 ± 3.8 years) KS children and adolescents and 80 age-matched healthy subjects. For both patient and control groups, we evaluated serum levels of ionised and total calcium, phosphate, total testosterone, luteinising hormone, follicle stimulating hormone, parathyroid hormone (PTH), 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D, osteocalcin, bone alkaline phosphatase, and urinary deoxypyridinoline concentrations. We also calculated the z-scores of the phalangeal amplitude-dependent speed of sound (AD-SoS) and the bone transmission time (BTT). Results. KS children and adolescents showed significantly reduced AD-SoS (p < 0.005) and BTT (p < 0.0005) z-scores compared to the controls. However, KS patients presented significantly higher PTH (p < 0.0001) and significantly lower 25(OH)D (p < 0.0001), osteocalcin (p < 0.05), and bone alkaline phosphatase levels (p < 0.005). Interestingly, these metabolic bone disorders were already present in the prepubertal subjects. Conclusions. KS children and adolescents exhibited impaired bone mineral status and metabolism with higher PTH levels and a significant reduction of 25-OH-D and bone formation markers. Interestingly, this impairment was already evident in prepubertal KS patients. Follow-ups should be scheduled with KS patients to investigate and ameliorate bone mineral status and metabolism until the prepubertal ages.
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Affiliation(s)
- Stefano Stagi
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, 50139 Florence, Italy
- *Stefano Stagi:
| | - Mariarosaria Di Tommaso
- Department of Health Sciences, University of Florence, Careggi Hospital, 50134 Florence, Italy
| | - Cristina Manoni
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, 50139 Florence, Italy
| | - Perla Scalini
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, 50139 Florence, Italy
| | | | - Alberto Verrotti
- Department of Paediatrics, University of L'Aquila, 67100 L'Aquila, Italy
| | - Elisabetta Lapi
- Genetics and Molecular Medicine Unit, Anna Meyer Children's University Hospital, 50139 Florence, Italy
| | - Sabrina Giglio
- Genetics and Molecular Medicine Unit, Anna Meyer Children's University Hospital, 50139 Florence, Italy
| | - Laura Dosa
- Genetics and Molecular Medicine Unit, Anna Meyer Children's University Hospital, 50139 Florence, Italy
| | - Maurizio de Martino
- Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, 50139 Florence, Italy
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Karagöz A, Dikbaş O, Teker E, Vural A, Günaydın ZY, Bektaş O. Sinus node dysfunction requiring permanent pacemaker implantation in a young adult with Klinefelter syndrome. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:136-9. [PMID: 25744562 PMCID: PMC4362339 DOI: 10.12659/ajcr.893065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patient: Male, 22 Final Diagnosis: Sinus node dysfunction Symptoms: Bradycardia • lassitude Medication: — Clinical Procedure: Pacemaker implantation Specialty: Cardiology
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Affiliation(s)
- Ahmet Karagöz
- Department of Cardiology, Giresun University, Giresun, Turkey
| | - Oğuz Dikbaş
- Department of Endocrinology, Giresun University, Giresun, Turkey
| | - Erhan Teker
- Cardiology Clinic, Prof. Dr. A. İlhan Özdemir State Hospital, Giresun, Turkey
| | - Aslı Vural
- Department of Cardiology, Giresun University, Giresun, Turkey
| | | | - Osman Bektaş
- Department of Cardiology, Ordu University, Ordu, Turkey
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Madureira C, Cunha M, Sousa M, Neto AP, Pinho MJ, Viana P, Gonçalves A, Silva J, Teixeira da Silva J, Oliveira C, Ferraz L, Dória S, Carvalho F, Barros A. Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children. Andrology 2014; 2:623-31. [DOI: 10.1111/j.2047-2927.2014.00231.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/30/2014] [Accepted: 05/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- C. Madureira
- Department of Genetics; Faculty of Medicine; University of Porto; Porto Portugal
| | - M. Cunha
- Center for Reproductive Genetics Alberto Barros (CGR); Porto Portugal
| | - M. Sousa
- Department of Microscopy; Laboratory of Cell Biology; Multidisciplinary Unit for Biomedical Research-UMIB; Institute of Biomedical Sciences Abel Salazar (ICBAS); University of Porto; Porto Portugal
| | - A. P. Neto
- Department of Genetics; Faculty of Medicine; University of Porto; Porto Portugal
| | - M. J. Pinho
- Department of Genetics; Faculty of Medicine; University of Porto; Porto Portugal
| | - P. Viana
- Center for Reproductive Genetics Alberto Barros (CGR); Porto Portugal
| | - A. Gonçalves
- Center for Reproductive Genetics Alberto Barros (CGR); Porto Portugal
| | - J. Silva
- Center for Reproductive Genetics Alberto Barros (CGR); Porto Portugal
| | | | - C. Oliveira
- Center for Reproductive Genetics Alberto Barros (CGR); Porto Portugal
| | - L. Ferraz
- Department of Urology; Hospital Center of Vila Nova de Gaia; Vila Nova de Gaia Portugal
| | - S. Dória
- Department of Genetics; Faculty of Medicine; University of Porto; Porto Portugal
| | - F. Carvalho
- Department of Genetics; Faculty of Medicine; University of Porto; Porto Portugal
| | - A. Barros
- Department of Genetics; Faculty of Medicine; University of Porto; Porto Portugal
- Center for Reproductive Genetics Alberto Barros (CGR); Porto Portugal
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11
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Hotaling J, Carrell DT. Clinical genetic testing for male factor infertility: current applications and future directions. Andrology 2014; 2:339-50. [PMID: 24711280 DOI: 10.1111/j.2047-2927.2014.00200.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 01/24/2014] [Accepted: 02/03/2014] [Indexed: 01/06/2023]
Abstract
Spermatogenesis involves the aggregated action of up to 2300 genes, any of which, could, potentially, provide targets for diagnostic tests of male factor infertility. Contrary to the previously proposed common variant hypothesis for common diseases such as male infertility, genome-wide association studies and targeted gene sequencing in cohorts of infertile men have identified only a few gene polymorphisms that are associated with male infertility. Unfortunately, the search for genetic variants associated with male infertility is further hampered by the lack of viable animal models of human spermatogenesis, difficulty in robustly phenotyping infertile men and the complexity of pedigree studies in male factor infertility. In this review, we describe basic genetic principles involved in understanding the genetic basis of male infertility and examine the utility and proper clinical use of the proven genetic assays of male factor infertility, specifically Y chromosome microdeletions, chromosomal translocations, karyotype, cystic fibrosis transmembrane conductance regulator mutation analysis and sperm genetic tests. Unfortunately, these tests are only able to diagnose the cause of about 20% of male factor infertility. The remainder of the review will be devoted to examining novel tests and diagnostic tools that have the potential to explain the other 80% of male factor infertility that is currently classified as idiopathic. Those tests include epigenetic analysis of the spermatozoa and the evaluation of rare genetic variants and copy number variations in patients. Success in advancing to the implementation of such areas is not only dependent on technological advances in the laboratory, but also improved phenotyping in the clinic.
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Affiliation(s)
- J Hotaling
- Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT, USA
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12
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Nahata L, Rosoklija I, Yu RN, Cohen LE. Klinefelter syndrome: are we missing opportunities for early detection? Clin Pediatr (Phila) 2013; 52:936-41. [PMID: 23836810 DOI: 10.1177/0009922813493831] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Klinefelter syndrome is a common condition that remains underdiagnosed, particularly prior to adulthood. Early detection could prevent morbidity and mortality, but the classic phenotype of small testes and tall stature may not be apparent until adolescence, and there is minimal guidance regarding whom to screen. We performed a retrospective study at Boston Children's Hospital in patients with the ICD-9 code for "Klinefelter syndrome" diagnosed prior to age 20 years, and determined age and reason for diagnosis, karyotype, heights, and comorbid conditions. Eighty percent had a 47,XXY karyotype, of whom half were diagnosed at age 11 to 19 years. The most common comorbidities were neurocognitive, including learning disabilities (67%), psychosocial problems (33%), and attention deficit disorder (27%). Subjects were only slightly taller than average in childhood (height standard deviation score = 0.64). These data show that Klinefelter syndrome is associated with long-standing comorbidities that frequently remain under-recognized; a karyotype should be considered in boys with neurocognitive problems.
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Sigman M. Klinefelter syndrome: how, what, and why? Fertil Steril 2012; 98:251-2. [DOI: 10.1016/j.fertnstert.2012.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 05/07/2012] [Indexed: 11/29/2022]
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