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Straub RH, Cutolo M. A History of Psycho-Neuro-Endocrine Immune Interactions in Rheumatic Diseases. Neuroimmunomodulation 2024; 31:183-210. [PMID: 39168106 DOI: 10.1159/000540959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/15/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND All active scientists stand on the shoulders of giants and many other more anonymous scientists, and this is not different in our field of psycho-neuro-endocrine immunology in rheumatic diseases. Too often, the modern world of publishing forgets about the collective enterprise of scientists. Some journals advise the authors to present only literature from the last decade, and it has become a natural attitude of many scientists to present only the latest publications. In order to work against this general unempirical behavior, neuroimmunomodulation devotes the 30th anniversary issue to the history of medical science in psycho-neuro-endocrine immunology. SUMMARY Keywords were derived from the psycho-neuro-endocrine immunology research field very well known to the authors (R.H.S. has collected a list of keywords since 1994). We screened PubMed, the Cochran Library of Medicine, Embase, Scopus database, and the ORCID database to find relevant historical literature. The Snowballing procedure helped find related work. According to the historical appearance of discoveries in the field, the order of presentation follows the subsequent scheme: (1) the sensory nervous system, (2) the sympathetic nervous system, (3) the vagus nerve, (4) steroid hormones (glucocorticoids, androgens, progesterone, estrogens, and the vitamin D hormone), (5) afferent pathways involved in fatigue, anxiety, insomnia, and depression (includes pathophysiology), and (6) evolutionary medicine and energy regulation - an umbrella theory. KEY MESSAGES A brief history on psycho-neuro-endocrine immunology cannot address all relevant aspects of the field. The authors are aware of this shortcoming. The reader must see this review as a viewpoint through the biased eyes of the authors. Nevertheless, the text gives an overview of the history in psycho-neuro-endocrine immunology of rheumatic diseases.
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Affiliation(s)
- Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Department of Internal Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Maurizio Cutolo
- Research Laboratories and Academic Division of Clinical Rheumatology, Department of Internal Medicine DIMI, Postgraduate School of Rheumatology, University of Genova, Genoa, Italy
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Wu XX, Cui J, Wang SY, Zhao TT, Yuan YF, Yang L, Zuo W, Liao WJ. Clinical evolution of antisynthetase syndrome-associated interstitial lung disease after COVID-19 in a man with Klinefelter syndrome: A case report. World J Clin Cases 2024; 12:1144-1149. [PMID: 38464923 PMCID: PMC10921298 DOI: 10.12998/wjcc.v12.i6.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/13/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND This study presents a case of rapidly developing respiratory failure due to antisynthetase syndrome (AS) following coronavirus disease 2019 (COVID-19) in a 33-year-old man diagnosed with Klinefelter syndrome (KS). CASE SUMMARY A 33-year-old man with a diagnosis of KS was admitted to the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in China for fever and shortness of breath 2 wk after the onset of COVID-19. Computed tomography of both lungs revealed diffuse multiple patchy heightened shadows in both lungs, accompanied by signs of partial bronchial inflation. Metagenomic next-generation sequencing of the bronchoalveolar lavage fluid suggested absence of pathogen. A biopsy specimen revealed organizing pneumonia with alveolar septal thickening. Additionally, extensive auto-antibody tests showed strong positivity for anti-SSA, anti-SSB, anti-Jo-1, and anti-Ro-52. Following multidisciplinary discussions, the patient received a final diagnosis of AS, leading to rapidly progressing respiratory failure. CONCLUSION This study underscores the clinical progression of AS-associated interstitial lung disease subsequent to viral infections such as COVID-19 in patients diagnosed with KS.
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Affiliation(s)
- Xiang-Xiang Wu
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
| | - Jian Cui
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
| | - Shi-Yao Wang
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Tian-Tian Zhao
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ya-Fei Yuan
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
| | - Long Yang
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
| | - Wei Zuo
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
| | - Wen-Jian Liao
- Department of Respiratory and Critical Care, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
- China-Japan Friendship Jiangxi Hospital, Nanchang 330006, Jiangxi Province, China
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Spaziani M, Carlomagno F, Tenuta M, Sesti F, Angelini F, Bonaventura I, Ferrari D, Tarantino C, Fiore M, Petrella C, Tarani L, Gianfrilli D, Pozza C. Extra-Gonadal and Non-Canonical Effects of FSH in Males. Pharmaceuticals (Basel) 2023; 16:813. [PMID: 37375761 PMCID: PMC10300833 DOI: 10.3390/ph16060813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Recombinant follicle-stimulating hormone (FSH) is commonly used for the treatment of female infertility and is increasingly being used in males as well, as recommended by notable guidelines. FSH is composed of an α subunit, shared with other hormones, and a β subunit, which confers specificity of biological action by interacting with its surface receptor (FSHR), predominantly located in granulosa and Sertoli cells. However, FSHRs also exist in extra-gonadal tissues, indicating potential effects beyond male fertility. Emerging evidence suggests that FSH may have extra-gonadal effects, including on bone metabolism, where it appears to stimulate bone resorption by binding to specific receptors on osteoclasts. Additionally, higher FSH levels have been associated with worse metabolic and cardiovascular outcomes, suggesting a possible impact on the cardiovascular system. FSH has also been implicated in immune response modulation, as FSHRs are expressed on immune cells and may influence inflammatory response. Furthermore, there is growing interest in the role of FSH in prostate cancer progression. This paper aims to provide a comprehensive analysis of the literature on the extra-gonadal effects of FSH in men, with a focus on the often-conflicting results reported in this field. Despite the contradictory findings, the potential for future development in this area is substantial, and further research is needed to elucidate the mechanisms underlying these effects and their clinical implications.
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Affiliation(s)
- Matteo Spaziani
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Francesco Carlomagno
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Marta Tenuta
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Francesco Angelini
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Ilaria Bonaventura
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Davide Ferrari
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Chiara Tarantino
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Rome, Italy
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Rome, Italy
| | - Luigi Tarani
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Roma, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Carlotta Pozza
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy
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Cutolo M, Straub RH. Sex steroids and autoimmune rheumatic diseases: state of the art. Nat Rev Rheumatol 2020; 16:628-644. [PMID: 33009519 DOI: 10.1038/s41584-020-0503-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2020] [Indexed: 12/16/2022]
Abstract
In autoimmune rheumatic diseases, oestrogens can stimulate certain immune responses (including effects on B cells and innate immunity), but can also have dose-related anti-inflammatory effects on T cells, macrophages and other immune cells. By contrast, androgens and progesterone have predominantly immunosuppressive and anti-inflammatory effects. Hormone replacement therapies and oral contraception (and also pregnancy) enhance or decrease the severity of autoimmune rheumatic diseases at a genetic or epigenetic level. Serum androgen concentrations are often low in men and in women with autoimmune rheumatic diseases, suggesting that androgen-like compounds might be a promising therapeutic approach. However, androgen-to-oestrogen conversion (known as intracrinology) is enhanced in inflamed tissues, such as those present in patients with autoimmune rheumatic diseases. In addition, it is becoming evident that the gut microbiota differs between the sexes (known as the microgenderome) and leads to sex-dependent genetic and epigenetic changes in gastrointestinal inflammation, systemic immunity and, potentially, susceptibility to autoimmune or inflammatory rheumatic diseases. Future clinical research needs to focus on the therapeutic use of androgens and progestins or their downstream signalling cascades and on new oestrogenic compounds such as tissue-selective oestrogen complex to modulate altered immune responses.
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Affiliation(s)
- Maurizio Cutolo
- Research Laboratories and Academic Division of Clinical Rheumatology, Postgraduate School of Rheumatology, Department of Internal Medicine DIMI, University of Genova, IRCCS San Martino Polyclinic, Genoa, Italy.
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Division of Rheumatology, Department of Internal Medicine, University Hospital of Regensburg, Regensburg, Germany
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Navarro-Cobos MJ, Balaton BP, Brown CJ. Genes that escape from X-chromosome inactivation: Potential contributors to Klinefelter syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:226-238. [PMID: 32441398 PMCID: PMC7384012 DOI: 10.1002/ajmg.c.31800] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/18/2022]
Abstract
One of the two X chromosomes in females is epigenetically inactivated, thereby compensating for the dosage difference in X-linked genes between XX females and XY males. Not all X-linked genes are completely inactivated, however, with 12% of genes escaping X chromosome inactivation and another 15% of genes varying in their X chromosome inactivation status across individuals, tissues or cells. Expression of these genes from the second and otherwise inactive X chromosome may underlie sex differences between males and females, and feature in many of the symptoms of XXY Klinefelter males, who have both an inactive X and a Y chromosome. We review the approaches used to identify genes that escape from X-chromosome inactivation and discuss the nature of their sex-biased expression. These genes are enriched on the short arm of the X chromosome, and, in addition to genes in the pseudoautosomal regions, include genes with and without Y-chromosomal counterparts. We highlight candidate escape genes for some of the features of Klinefelter syndrome and discuss our current understanding of the mechanisms underlying silencing and escape on the X chromosome as well as additional differences between the X in males and females that may contribute to Klinefelter syndrome.
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Affiliation(s)
- Maria Jose Navarro-Cobos
- Department of Medical Genetics, Molecular Epigenetics Group, Life Sciences Institute, Vancouver, British Columbia, Canada
| | - Bradley P Balaton
- Department of Medical Genetics, Molecular Epigenetics Group, Life Sciences Institute, Vancouver, British Columbia, Canada
| | - Carolyn J Brown
- Department of Medical Genetics, Molecular Epigenetics Group, Life Sciences Institute, Vancouver, British Columbia, Canada
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Kyritsi EM, Kanaka-Gantenbein C. Autoimmune Thyroid Disease in Specific Genetic Syndromes in Childhood and Adolescence. Front Endocrinol (Lausanne) 2020; 11:543. [PMID: 32973676 PMCID: PMC7466763 DOI: 10.3389/fendo.2020.00543] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
Autoimmune thyroid disease (ATD) is the most frequent cause of acquired thyroid dysfunction, most commonly presenting either as Hashimoto's thyroiditis or Graves' Disease. Hashimoto's thyroiditis is characterized by the presence of thyroid-specific autoantibodies, more commonly anti-thyroperoxidase antibodies in the serum and the typical inhomogeneous echostructure of the thyroid on a thyroid ultrasound examination. Hashimoto's thyroiditis can for a long time be accompanied by normal thyroid function and hypothyroidism can only progressively be established. Graves' disease is much less frequent in childhood and adolescence and presents with overt hyperthyroidism. After the onset of puberty, ATD affects females with a higher incidence than males, while during the prepubertal period there is not such a clear preponderance of affected females. ATD can occur either isolated or in the context of other autoimmune disorders, such as type 1 Diabetes mellitus (T1D), celiac disease, alopecia areata, vitiligo, etc. Especially at the pediatric age, a higher incidence of ATD is also observed in the context of specific genetic syndromes, such as trisomy 21 (Down syndrome), Klinefelter syndrome, Turner syndrome, or 22q11.2 deletion syndrome. Nevertheless, although thyroid dysfunction may also be observed in other genetic syndromes, such as Prader-Willi or Williams syndrome, the thyroid dysfunction in these syndromes is not the result of thyroid autoimmunity. Interestingly, there is emerging evidence supporting a possible link between autoimmunity and RASopathies. In this review article the incidence, as well as the clinical manifestation and accompanied pathologies of ATD in specific genetic syndromes will be presented and regular follow-up for the early identification of the disorder will be proposed.
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Lambert NC. Nonendocrine mechanisms of sex bias in rheumatic diseases. Nat Rev Rheumatol 2019; 15:673-686. [PMID: 31597952 DOI: 10.1038/s41584-019-0307-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2019] [Indexed: 12/22/2022]
Abstract
Rheumatic diseases affect a wide range of individuals of all ages, but the most common diseases occur more frequently in women than in men, at ratios of up to ten women to one man. Despite a growing number of studies on sex bias in rheumatic diseases, sex-specific health care is limited and sex specificity is not systematically integrated into treatment regimens. Women and men differ in three major biological points: the number of X chromosomes per cell, the type and quantities of sex hormones present and the ability to be pregnant, all of which have immunological consequences. Could a greater understanding of these differences lead to a new era of personalized sex-specific medicine? This Review focuses on the main genetic and epigenetic mechanisms that have been put forward to explain sex bias in rheumatic diseases, including X chromosome inactivation, sex chromosome aneuploidy and microchimerism. The influence of sex hormones is not discussed in detail in this Review, as it has been well described elsewhere. Understanding the sex-specific factors that contribute to the initiation and progression of rheumatic diseases will enable progress to be made in the diagnosis, treatment and management of all patients with these conditions.
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Affiliation(s)
- Nathalie C Lambert
- INSERM UMRs 1097 Arthrites Autoimmunes, Aix Marseille Université, Marseille, France.
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Shiraishi K, Matsuyama H. Klinefelter syndrome: From pediatrics to geriatrics. Reprod Med Biol 2019; 18:140-150. [PMID: 30996677 PMCID: PMC6452011 DOI: 10.1002/rmb2.12261] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Klinefelter syndrome (KS) is one of the major causes of nonobstructive azoospermia (NOA). Microdissection testicular sperm extraction (micro-TESE) is often performed to retrieve sperm. Infertility specialists have to care for KS patients on a lifelong basis. METHODS Based on a literature review and our own experience, male infertility treatment and KS pathophysiology were considered on a lifelong basis. MAIN FINDINGS Patients diagnosed early often have an increased number of aberrant X chromosomes. Cryptorchidism and hypospadias are often found, and surgical correction is required. Cryopreservation of testicular sperm during adolescence is an issue of debate because the sperm retrieval rate (SRR) in KS patients decreases with age. The SRR in adult KS patients is higher than that in other patients with NOA; however, low testosterone levels after micro-TESE will lower the general health and quality of life. KS men face a number of comorbidities, such as malignancies, metabolic syndrome, diabetes, cardiovascular disease, bone disease, and immune diseases, which ultimately results in increased mortality rates. CONCLUSION A deeper understanding of the pathophysiology of KS and the histories of KS patients before they seek infertility treatment, during which discussions with multidisciplinary teams are sometimes needed, will help to properly treat these patients.
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Affiliation(s)
- Koji Shiraishi
- Department of UrologyYamaguchi University School of MedicineUbeJapan
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Abstract
Male fertility can be impaired by a multitude of factors. In addition to environmental and life style factors, such as stress, noise, smoking and overweight, diverse diseases can also have a negative effect on the ability to father a child and the hormone balance, particularly the testosterone level. In many diseases the currently available data do not go beyond observations of limited fertility. In this article the focus is on diseases in the treatment field of dermatology. Special attention is paid to chronic inflammatory and autoimmune skin diseases. Data from recent years show that the excessive inflammatory reaction that these diseases have in common, most probably also has an influence on fertility and interacts with the testosterone concentration in serum. In addition, the impact of hereditary skin diseases on male fertility is discussed, which can have a direct influence on the ability to father a child due to disruption of the hypothalamus-pituitary-gonad axis.
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Affiliation(s)
- William Grobe
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland
| | - Jean-Pierre Allam
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland
| | - Gerhard Haidl
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland.
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Arnaud L, Nordin A, Lundholm H, Svenungsson E, Hellbacher E, Wikner J, Zickert A, Gunnarsson I. Effect of Corticosteroids and Cyclophosphamide on Sex Hormone Profiles in Male Patients With Systemic Lupus Erythematosus or Systemic Sclerosis. Arthritis Rheumatol 2017; 69:1272-1279. [DOI: 10.1002/art.40057] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 01/24/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Laurent Arnaud
- Centre National de Référence des Maladies Systémiques et Auto‐immunes rares, Université de Strasbourg, INSERM UMR‐S 1109, Strasbourg, France, and Karolinska University Hospital, Karolinska InstitutetStockholm Sweden
| | - Annica Nordin
- Karolinska University Hospital, Karolinska InstitutetStockholm Sweden
| | - Hannes Lundholm
- Karolinska University Hospital, Karolinska InstitutetStockholm Sweden
| | | | | | - Johan Wikner
- Karolinska Institutet and SödersjukhusetStockholm Sweden
| | - Agneta Zickert
- Karolinska University Hospital, Karolinska InstitutetStockholm Sweden
| | - Iva Gunnarsson
- Karolinska University Hospital, Karolinska InstitutetStockholm Sweden
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Iwamoto T, Fujimoto M, Ikeda K, Saku A, Makita S, Furuta S, Niewold TB, Nakajima H. Manifestations of systemic lupus erythematosus in female patients with polysomy X: Possible roles of chromosome X. Mod Rheumatol 2016; 29:192-194. [PMID: 27401488 DOI: 10.1080/14397595.2016.1205800] [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] [Indexed: 10/21/2022]
Abstract
Clinical manifestations of systemic lupus erythematosus (SLE) in female patients with polysomy X have been less characterized as compared to those in male patients. Here, we describe a 28-year-old woman with trisomy X (47,XXX) who developed SLE. She had polyarthritis, hemolytic anemia, and was positive for anti-nuclear and anti-dsDNA antibodies. We discuss the common SLE manifestations with female polysomy X and the possible link between the development of SLE and the presence of extra X-chromosomes.
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Affiliation(s)
- Taro Iwamoto
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan.,b Department of Immunology, Division of Rheumatology , Mayo Clinic , Rochester , MN , USA , and
| | - Masanori Fujimoto
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan.,c Department of Diabetes, Metabolism and Endocrinology , Chiba University Hospital , Chiba , Japan
| | - Kei Ikeda
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
| | - Aiko Saku
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
| | - Sohei Makita
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
| | - Shunsuke Furuta
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
| | - Timothy B Niewold
- b Department of Immunology, Division of Rheumatology , Mayo Clinic , Rochester , MN , USA , and
| | - Hiroshi Nakajima
- a Department of Allergy and Clinical Immunology , Chiba University Hospital , Chiba , Japan
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Peoples C, Medsger TA, Lucas M, Rosario BL, Feghali-Bostwick CA. Gender differences in systemic sclerosis: relationship to clinical features, serologic status and outcomes. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2016; 1:177-240. [PMID: 29242839 PMCID: PMC5726425 DOI: 10.5301/jsrd.5000209] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION There is a strong female preponderance reported in many connective tissue diseases and in almost all systemic sclerosis (SSc) case series. METHODS We compared gender differences in SSc patients in a large single-center cohort, including demographic features, disease subtype, environmental exposures, disease-specific serum autoantibodies, organ system involvement (frequency and severity) and survival. Adjustment for cutaneous subset (diffuse cutaneous [dc] and limited cutaneous [lc]) was performed. RESULTS We identified key characteristics which distinguished female from male SSc patients. Females were more frequently younger at disease onset with a longer disease duration at the time of their first visit. Females more often had lcSSc and, if an overlap syndrome was present, it was most often systemic lupus erythematosus. In contrast, males more frequently had dcSSc and overlap with myositis. Females more frequently had peripheral vascular involvement but in males it was more often severe. Males were more often cigarette smokers and more frequently had environmental exposures. Males more frequently had interstitial lung disease (ILD or pulmonary fibrosis) which was more severe. Females had a significantly increased frequency of anti-centromere antibody and males anti-topoisomerase I and anti-U3RNP antibody. Males had significantly reduced survival (73% at 5 years and 45% at 10 years after onset of SSc). The most frequent causes of death were ILD in males and pulmonary hypertension in females. CONCLUSIONS Gender differences may be important clues to understanding the natural history and pathogenesis of SSc.
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Affiliation(s)
- Christine Peoples
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania - USA
| | - Thomas A. Medsger
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania - USA
| | - Mary Lucas
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania - USA
| | - Bedda L. Rosario
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania - USA
| | - Carol A. Feghali-Bostwick
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania - USA
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine/Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina - USA
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Fujimoto M, Ikeda K, Nakamura T, Iwamoto T, Furuta S, Nakajima H. Development of mixed connective tissue disease and Sjögren's syndrome in a patient with trisomy X. Lupus 2015; 24:1217-20. [PMID: 25854827 DOI: 10.1177/0961203315580873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/17/2015] [Indexed: 01/18/2023]
Abstract
Increased risk of developing systemic lupus erythematosus (SLE) has been reported in patients with Klinefelter syndrome. Here, we describe a 16-year-old Japanese patient with trisomy X (47,XXX) who developed mixed connective tissue disease (MCTD) and Sjögren's syndrome. She had polyarthritis, edematous fingers with Raynaud's phenomenon, sicca syndrome, interstitial lung disease, possible myositis, and was positive for anti-nuclear antibody, anti-nRNP antibody and rheumatoid factor. This is the first report in the literature of a case of MCTD with female polysomy X, which further supports the link between the presence of extra X chromosome(s) and the development of autoimmune diseases.
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Affiliation(s)
- M Fujimoto
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan Department of Diabetes, Metabolism and Endocrinology, Chiba University Hospital, Chiba, Japan
| | - K Ikeda
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - T Nakamura
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - T Iwamoto
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - S Furuta
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - H Nakajima
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
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Petrikova J, Lazurova I, Dravecka I, Vrbikova J, Kozakova D, Figurova J, Vaczy Z, Rosocha J. The prevalence of non organ specific and thyroid autoimmunity in patients with polycystic ovary syndrome. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 159:302-6. [PMID: 25485530 DOI: 10.5507/bp.2014.062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/13/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is commonly associated with endocrine, metabolic, cardiovascular and other morbidities. However its association with autoimmune diseases is still controversial. AIM The aim of this study was to assess the prevalence of non organ-specific and antithyroid, antibodies in PCOS women compared to healthy controls. METHODS The study included 152 women with PCOS and 76 healthy controls for the evaluation of non organ-specific autoimmunity and 64 PCOS and 68 controls for the study of organ-specific autoimmunity. All sera were tested for autoantibodies.using the ELISA method. RESULTS There were no significant differences in the prevalence of ANA, SSA, SSB, anti-dsDNA, anti-RNP, ANCA/MPO or ANCA/PR3 between PCOS and controls. The prevalence of ACLA IgG was higher in controls than PCOS (5.4% v.s. 0%, P=0.011). Patients had a higher prevalence of anti-TPO antibodies (18.75% v.s. 7.35%, P=0.045) and slightly but not significantly higher prevalence of autoimmune thyroiditis (18.75% v.s. 10.29%) than controls. CONCLUSION The prevalence of non organ-specific autoantibodies in PCOS women is low and similar to controls. On the other hand, we found a slightly higher prevalence of thyroid autoimmunity in PCOS women.
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Affiliation(s)
- Jana Petrikova
- 1st Department of Internal Medicine, Medical Faculty, P. J. Safarik University Kosice, Slovak Republic
| | - Ivica Lazurova
- 1st Department of Internal Medicine, Medical Faculty, P. J. Safarik University Kosice, Slovak Republic
| | - Ingrid Dravecka
- 1st Department of Internal Medicine, Medical Faculty, P. J. Safarik University Kosice, Slovak Republic
| | | | - Darina Kozakova
- National Institute of Rheumatic Disesases, Piestany, Slovak Republic
| | - Jana Figurova
- 1st Department of Internal Medicine, Medical Faculty, P. J. Safarik University Kosice, Slovak Republic
| | - Zuzana Vaczy
- Associated Tissue Bank, Medical Faculty, P. J. Safarik University Kosice, Slovak Republic
| | - Jan Rosocha
- Associated Tissue Bank, Medical Faculty, P. J. Safarik University Kosice, Slovak Republic
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15
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Ngun TC, Ghahramani NM, Creek MM, Williams-Burris SM, Barseghyan H, Itoh Y, Sánchez FJ, McClusky R, Sinsheimer JS, Arnold AP, Vilain E. Feminized behavior and brain gene expression in a novel mouse model of Klinefelter Syndrome. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:1043-1057. [PMID: 24923877 PMCID: PMC4371776 DOI: 10.1007/s10508-014-0316-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Revised: 07/24/2013] [Accepted: 02/08/2014] [Indexed: 06/03/2023]
Abstract
Klinefelter Syndrome (KS) is the most common sex chromosome aneuploidy in men and is characterized by the presence of an additional X chromosome (XXY). In some Klinefelter males, certain traits may be feminized or shifted from the male-typical pattern towards a more female-typical one. Among them might be partner choice, one of the most sexually dimorphic traits in the animal kingdom. We investigated the extent of feminization in XXY male mice (XXYM) in partner preference and gene expression in the bed nucleus of the stria terminalis/preoptic area and the striatum in mice from the Sex Chromosome Trisomy model. We tested for partner preference using a three-chambered apparatus in which the test mouse was free to choose between stimulus animals of either sex. We found that partner preference in XXYM was feminized. These differences were likely due to interactions of the additional X chromosome with the Y. We also discovered genes that differed in expression in XXYM versus XYM. Some of these genes are feminized in their expression pattern. Lastly, we also identified genes that differed only between XXYM versus XYM and not XXM versus XYM. Genes that are both feminized and unique to XXYM versus XYM represent strong candidates for dissecting the molecular pathways responsible for phenotypes present in KS/XXYM but not XXM. In sum, our results demonstrated that investigating behavioral and molecular feminization in XXY males can provide crucial information about the pathophysiology of KS and may aid our understanding of sex differences in brain and behavior.
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Affiliation(s)
- Tuck C. Ngun
- Department of Human Genetics, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Negar M. Ghahramani
- Department of Human Genetics, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Michelle M. Creek
- Department of Counseling Psychology, University of Wisconsin–Madison, WI, USA
| | - Shayna M. Williams-Burris
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Hayk Barseghyan
- Department of Human Genetics, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Yuichiro Itoh
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Francisco J. Sánchez
- Department of Human Genetics, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
- Department of Counseling Psychology, University of Wisconsin–Madison, WI, USA
| | - Rebecca McClusky
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Janet S. Sinsheimer
- Department of Human Genetics, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Biomath, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Arthur P. Arnold
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Eric Vilain
- Department of Human Genetics, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, CA, USA
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16
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Chen X, Williams-Burris SM, McClusky R, Ngun TC, Ghahramani N, Barseghyan H, Reue K, Vilain E, Arnold AP. The Sex Chromosome Trisomy mouse model of XXY and XYY: metabolism and motor performance. Biol Sex Differ 2013; 4:15. [PMID: 23926958 PMCID: PMC3751353 DOI: 10.1186/2042-6410-4-15] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/27/2013] [Indexed: 11/29/2022] Open
Abstract
Background Klinefelter syndrome (KS), caused by XXY karyotype, is characterized by low testosterone, infertility, cognitive deficits, and increased prevalence of health problems including obesity and diabetes. It has been difficult to separate direct genetic effects from hormonal effects in human studies or in mouse models of KS because low testosterone levels are confounded with sex chromosome complement. Methods In this study, we present the Sex Chromosome Trisomy (SCT) mouse model that produces XXY, XYY, XY, and XX mice in the same litters, each genotype with either testes or ovaries. The independence of sex chromosome complement and gonadal type allows for improved recognition of sex chromosome effects that are not dependent on levels of gonadal hormones. All mice were gonadectomized and treated with testosterone for 3 weeks. Body weight, body composition, and motor function were measured. Results Before hormonal manipulation, XXY mice of both sexes had significantly greater body weight and relative fat mass compared to XY mice. After gonadectomy and testosterone replacement, XXY mice (both sexes) still had significantly greater body weight and relative fat mass, but less relative lean mass compared to XY mice. Liver, gonadal fat pad, and inguinal fat pad weights were also higher in XXY mice, independent of gonadal sex. In several of these measures, XX mice also differed from XY mice, and gonadal males and females differed significantly on almost every metabolic measure. The sex chromosome effects (except for testis size) were also seen in gonadally female mice before and after ovariectomy and testosterone treatment, indicating that they do not reflect group differences in levels of testicular secretions. XYY mice were similar to XY mice on body weight and metabolic variables but performed worse on motor tasks compared to other groups. Conclusions We find that the new SCT mouse model for XXY and XYY recapitulates features found in humans with these aneuploidies. We illustrate that this model has significant promise for unveiling the role of genetic effects compared to hormonal effects in these syndromes, because many phenotypes are different in XXY vs. XY gonadal female mice which have never been exposed to testicular secretions.
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Affiliation(s)
- Xuqi Chen
- Department of Integrative Biology & Physiology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Shayna M Williams-Burris
- Department of Integrative Biology & Physiology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Rebecca McClusky
- Department of Integrative Biology & Physiology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Tuck C Ngun
- Department of Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Negar Ghahramani
- Department of Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Hayk Barseghyan
- Department of Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Karen Reue
- Department of Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Eric Vilain
- Department of Human Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Departments of Pediatrics and Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
| | - Arthur P Arnold
- Department of Integrative Biology & Physiology, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA.,Laboratory of Neuroendocrinology of the Brain Research Institute, University of California, Los Angeles, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
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17
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Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome. Case Rep Rheumatol 2013; 2013:543953. [PMID: 23762731 PMCID: PMC3673322 DOI: 10.1155/2013/543953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 05/08/2013] [Indexed: 11/17/2022] Open
Abstract
Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints.
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19
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Lee MK, Kim BS, Jung SH, Lee GH, Kim JO, Rim DH, Lee YH, Kim WJ, Bang SY, Lee HS. A Case of Klinefelter's Syndrome Accompanying with Polymyositis. JOURNAL OF RHEUMATIC DISEASES 2012. [DOI: 10.4078/jrd.2012.19.3.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Min Kyu Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Byung Sik Kim
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Suk Hyun Jung
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Gun Hwa Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Jin Ok Kim
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Dong Hwi Rim
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Yu Hwa Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Woong Jun Kim
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - So-Young Bang
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
| | - Hye-Soon Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea
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20
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Kararizou E, Mentis AF, Gkiatas K, Davaki P. Rare association of sensorimotor polyneuropathy and Klinefelter syndrome (47,XXY): case report. Med Princ Pract 2011; 20:480-2. [PMID: 21757941 DOI: 10.1159/000328423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 01/10/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To describe a case with the rare association of Klinefelter syndrome (47,XXY) and peripheral sensorimotor polyneuropathy. CLINICAL PRESENTATION AND INTERVENTION A 50-year-old man with Klinefelter syndrome was referred to our neurology clinic complaining of pain, numbness and tingles in both legs, which began 10 years prior to admission. Two years before admission, the patient had difficulty in walking with progressive weakness. CONCLUSION This report shows a patient with diagnosed Klinefelter syndrome, in whom symmetrical sensorimotor polyneuropathy developed in late adulthood.
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Affiliation(s)
- E Kararizou
- Department of Neurology, Aeginition Hospital, University of Athens School of Medicine, Athens, Greece.
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21
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Mazen I, El-Ruby M, El-Bassyouni HT. Variable associations of Klinefelter syndrome in children. J Pediatr Endocrinol Metab 2010; 23:985-9. [PMID: 21158208 DOI: 10.1515/jpem.2010.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND KF is characterized by heterogeneity in the degree of expressed phenotypes. OBJECTIVE to ascertain the variable phenotypes of Klinefelter syndrome in children. SUBJECTS AND METHODS We present eight klinefelter patients, their age ranged from 2 to 11 years (mean 6.63). Subjects were meticulously examined for evidence of dysmorphology. Intelligence quotient was estimated. RESULTS Cytogenetic analysis revealed 47,XXY karyotype in all patients. The following was detected: Dysmorphism in 5/8, micropenis in 4/8, the left testis was nonpalpable in 4/8, short stature in 4/8, congenital cardiac malformations in 4/8, seizures in 4/8, mental retardation in 5/8, growth hormone deficiency in 2/8, hypothyroidism and delayed bone age in 1/8. CONCLUSION Our study demonstrated a variable association of mental retardation, dysmorphism, micropenis, undescended testis, seizures, congenital heart defects, and growth hormone deficiency among Egyptian patients with Klinefelter syndrome. This merits further study to facilitate earlier diagnosis and better management to improve their quality of life.
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Affiliation(s)
- Inas Mazen
- Clinical Genetics Department, National Research Center, Egypt
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22
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Petríková J, Lazúrová I, Yehuda S. Polycystic ovary syndrome and autoimmunity. Eur J Intern Med 2010; 21:369-71. [PMID: 20816585 DOI: 10.1016/j.ejim.2010.06.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 05/19/2010] [Accepted: 06/16/2010] [Indexed: 10/19/2022]
Abstract
Polycystic ovary syndrome (PCOS) is characterized by laboratory and/or clinical features consisting of hyperandrogenism with chronic anovulation and is currently one of the most common endocrinopathies in women of fertile age. PCOS is associated with a variety of endocrine and metabolic disturbances. It was demonstrated that the prevalence of autoimmune thyroiditis is high among these patients. Recent studies reveal a higher incidence of autoantibodies such as anti-histone, anti-dsDNA presented in systemic autoimmune disease, however their clinical significance is still unknown. According to results of current research the syndrome could be possibly associated with some autoimmune diseases. Further studies are required to determine the role of organ-specific and non-specific autoantibodies in patients with PCOS.
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Affiliation(s)
- Jana Petríková
- 1st Department of Internal Medicine, University Hospital, Safarikiensis University, Kosice, Slovakia
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