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Zhang R, Yu B, Wang X, Nie M, Ma W, Ji W, Huang Q, Zhu Y, Sun B, Zhang J, Zhang W, Liu H, Mao J, Wu X. Mixed hypogonadism: a neglected combined form of hypogonadism. Endocrine 2024; 83:488-493. [PMID: 37749390 DOI: 10.1007/s12020-023-03532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/10/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Kallmann syndrome is a rare disease characterized by delayed puberty, infertility and anosmia. We report the clinical and genetic characteristics of three patients with Kallmann syndrome who presented with Klinefelter syndrome and defined this neglected combined form of hypogonadism as mixed hypogonadism. METHODS Clinical data and examinations were obtained, including laboratory examination and magnetic resonance imagination (MRI) of the olfactory structures. Congenital hypogonadotropic hypogonadism (CHH) related genes were screened by next generation sequencing (NGS). RESULTS Three patients with Kallmann syndrome were included. They had co-existence with Klinefelter syndrome and showed hypogonadotropic hypogonadism. Patient 1 was complicated with germinoma. CONCLUSION Mixed hypogonadism was defined as hypogonadotropic hypogonadism in Klinefelter syndrome or primary testicular disease. Clinicians should be alert to mixed hypogonadism when spermatogenesis induction failed in patients with CHH or gonadotropin levels decrease in patients with Klinefelter syndrome.
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Affiliation(s)
- Rui Zhang
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Bingqing Yu
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
- Department of Ultrasonography, Peking University First Hospital, 100081, Beijing, China
| | - Xi Wang
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Min Nie
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Wanlu Ma
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Wen Ji
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
- Department of Endocrinology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qibin Huang
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Yiyi Zhu
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Bang Sun
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Junyi Zhang
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Wei Zhang
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Hongying Liu
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jiangfeng Mao
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China.
| | - Xueyan Wu
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 100730, Beijing, China.
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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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3
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Gal-Oz ST, Shay T. Genetics of Sex Differences in Immunity. Curr Top Microbiol Immunol 2023; 441:1-19. [PMID: 37695423 DOI: 10.1007/978-3-031-35139-6_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Women have a stronger immune response and a higher frequency of most autoimmune diseases than men. While much of the difference between men and women is due to the effect of gonadal hormones, genetic differences play a major role in the difference between the immune response and disease frequencies in women and men. Here, we focus on the immune differences between the sexes that are not downstream of the gonadal hormones. These differences include the gene content of the sex chromosomes, the inactivation of chromosome X in women, the consequences of non-random X inactivation and escape from inactivation, and the states that are uniquely met by the immune system of women-pregnancy, birth, and breast feeding. While these female-specific states are temporary and involve gonadal hormonal changes, they may leave a long-lasting footprint on the health of women, for example, by fetal cells that remain in the mother's body for decades. We also briefly discuss the immune phenotype of congenital sex chromosomal aberrations and experimental models that enable hormonal and the non-hormonal effects of the sex chromosomes to be disentangled. The increasing human life expectancy lengthens the period during which gonadal hormones levels are reduced in both sexes. A better understanding of the non-hormonal effects of sex chromosomes thus becomes more important for improving the life quality during that period.
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Affiliation(s)
- Shani T Gal-Oz
- Department of Life Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Tal Shay
- Department of Life Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
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Tarani L, Ceci FM, Carito V, Ferraguti G, Petrella C, Greco A, Ralli M, Minni A, Spaziani M, Isidori AM, Certo MGD, Barbato C, Putotto C, Fiore M. Neuroimmune Dysregulation in Prepubertal and Adolescent Individuals Affected by Klinefelter Syndrome. Endocr Metab Immune Disord Drug Targets 2023; 23:105-114. [PMID: 35794745 DOI: 10.2174/1871530322666220704101310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The syndrome Klinefelter syndrome (KS) is a genetic disorder due to an extra X chromosome in males. Many cases remain undiagnosed until the onset of major manifestations, which include hypergonadotropic hypogonadism and infertility. This condition is associated with many comorbidities that involve the cardiovascular, endocrine, and immune systems. Last but not the least, individuals with KS show a high risk of developing psychiatric and mood disorders in adult age. OBJECTIVE While many studies are accessible on KS in adult individuals, the neuroinflammatory condition in adolescent and prepubertal KS individuals is not fully known. METHODS Our study aims to evaluate in prepubertal and adolescent KS individuals, for the first time, the levels of the serum of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), cytokines having subtle roles in oxidative processes, and neuroinflammation with respect to the levels of TNF-α, TGF-β, MCP-1, IL-1α, IL-2, IL-6, IL-10, and IL-12 and oxidative stress by employing free oxygen radicals defense and free oxygen radicals test. RESULTS We found no changes in NGF and oxidative stress parameters, but BDNF decreased compared to healthy children. Quite interestingly, our data showed reduced levels of IL-2, IL-1α, IL- 12, IL-10, and IL-6 in prepubertal KS children. CONCLUSION The present study discloses disrupted immune system and neurotrophin pathways in KS children.
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Affiliation(s)
- Luigi Tarani
- Department of Pediatrics, Sapienza University Hospital of Rome, Rome, Italy
| | - Flavio Maria Ceci
- Department of Experimental Medicine, Sapienza University Hospital of Rome, Rome, Italy
| | - Valentina Carito
- Institute of Biochemistry and Cell Biology, Section of Neurobiology, National Research Council (IBBC-CNR), Rome, Italy
| | - Giampiero Ferraguti
- Department of Experimental Medicine, Sapienza University Hospital of Rome, Rome, Italy
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology, Section of Neurobiology, National Research Council (IBBC-CNR), Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University Hospital of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University Hospital of Rome, Rome, Italy
| | - Antonio Minni
- Department of Sense Organs, Sapienza University Hospital of Rome, Rome, Italy
| | - Matteo Spaziani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Di Certo
- Institute of Biochemistry and Cell Biology, Section of Neurobiology, National Research Council (IBBC-CNR), Rome, Italy
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology, Section of Neurobiology, National Research Council (IBBC-CNR), Rome, Italy
| | - Carolina Putotto
- Department of Pediatrics, Sapienza University Hospital of Rome, Rome, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology, Section of Neurobiology, National Research Council (IBBC-CNR), Rome, Italy
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Hovnik T, Zitnik E, Avbelj Stefanija M, Bertok S, Sedej K, Bancic Silva V, Battelino T, Groselj U. An Adolescent Boy with Klinefelter Syndrome and 47,XXY/46,XX Mosaicism: Case Report and Review of Literature. Genes (Basel) 2022; 13:genes13050744. [PMID: 35627128 PMCID: PMC9141365 DOI: 10.3390/genes13050744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023] Open
Abstract
Klinefelter syndrome is the most commonly reported sex chromosome abnormality. It is heavily underdiagnosed due to the substantial variability of clinical presentations but is generally characterized by small, firm testes, hypergonadotropic hypogonadism, and the absence of spermatogenesis. Most patients with Klinefelter syndrome have a 47,XXY genotype. If they present with mosaicism, two different cell lines are usually identified, an aneuploid 47,XXY cell line and a normal male 46,XY cell line. There are very few cases of 47,XXY mosaicism with the additional female cell line 46,XX described in the literature. We report a case of an adolescent with the male phenotype and a rare variant mosaic 47,XXY/46,XX karyotype who presented with painless bilateral gynaecomastia. 47,XXY and 46,XX mosaic cell lines were identified with GTG-banding and further characterized using fluorescent in situ hybridization. We summarized the available clinical presentations of reported male patients with 47,XXY/46,XX mosaicism. To improve the clinical management and quality of life in individuals with rare and cryptic genomic imbalances, the genetic diagnosis would need to be extended to atypical cases.
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Affiliation(s)
- Tinka Hovnik
- Clinical Institute for Special Laboratory Diagnostics, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia;
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Eva Zitnik
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
| | - Magdalena Avbelj Stefanija
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Sara Bertok
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Katarina Sedej
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
| | - Vesna Bancic Silva
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
| | - Tadej Battelino
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Urh Groselj
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children’s Hospital, UMC, 1000 Ljubljana, Slovenia; (E.Z.); (M.A.S.); (S.B.); (K.S.); (V.B.S.); (T.B.)
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-522-9235
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6
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GREEN TAMAR, FLASH SHIRA, SHANKAR GEETA, SHRESTHA SHARONBADE, JO BOOIL, KLABUNDE MEGAN, HONG DAVIDS, REISS ALLANL. Effect of sex chromosome number variation on attention-deficit/hyperactivity disorder symptoms, executive function, and processing speed. Dev Med Child Neurol 2022; 64:331-339. [PMID: 34431088 PMCID: PMC8816867 DOI: 10.1111/dmcn.15020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 01/15/2023]
Abstract
AIM To study sex differences in attention-deficit/hyperactivity disorder (ADHD) symptoms, we explored whether X chromosome absence or excess is independently associated with deficits in attention and hyperactivity, executive function, and processing speed. METHOD We assessed 116 children (ages 3y 10mo-11y 11mo, mean 8y 5mo, SD 1y 11mo) with a variable number of sex chromosomes: 36 females with Turner syndrome (45, X0), 20 males with Klinefelter syndrome (47, XXY), 37 typically developing females (XX), and 23 typically developing males (XY). RESULTS X chromosome absence was associated with increased attention problems, hyperactivity, and deficits in inhibitory control, compared with female children with XX (all p<0.003). Conversely, X chromosome excess was associated with weakness in working memory (p=0.018) and approached significance for attention problems (p=0.071) but not with hyperactivity, or weakness in inhibitory control relative to male children with XY. Using non-parametric effect size to quantify the clinical effect revealed that X chromosome absence affected attention, hyperactivity, executive function, and processing speed (all r>0.4), while X excess affected in-laboratory as well as parent-reported working memory (all r>0.4). INTERPRETATION Our observations provide compelling evidence that the absence or excess of an X chromosome distinctly affects cognition and behaviors associated with ADHD.
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Affiliation(s)
- TAMAR GREEN
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - SHIRA FLASH
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - GEETA SHANKAR
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - SHARON BADE SHRESTHA
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - BOOIL JO
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - MEGAN KLABUNDE
- Department of Psychology, University of Essex, Colchester, UK
| | - DAVID S HONG
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - ALLAN L REISS
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Department of Radiology, Stanford University School of Medicine, Stanford, CA,Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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7
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Kuiper K, Swaab H, Tartaglia N, van Rijn S. Early developmental impact of sex chromosome trisomies on attention deficit-hyperactivity disorder symptomology in young children. Am J Med Genet A 2021; 185:3664-3674. [PMID: 34240550 PMCID: PMC9292447 DOI: 10.1002/ajmg.a.62418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/14/2021] [Accepted: 06/18/2021] [Indexed: 01/16/2023]
Abstract
Individuals with sex chromosome trisomies ([SCT], XXX, XXY, and XYY)) are at increased risk for neurodevelopmental problems, given that a significant portion of the sex chromosome genes impact brain functioning. An elevated risk for psychopathology has also been described, including attention deficit-hyperactivity disorder (ADHD). The present study aimed at identifying early markers of ADHD, providing the first investigation of ADHD symptomology in very young children with SCT. The variety, type, and severity of ADHD symptomology in 1-6-year-old children with SCT (n = 104) were compared with population-based controls (n = 101) using the strengths and weaknesses of ADHD symptoms and normal-behavior (SWAN) parent-report questionnaire. ADHD symptomology was significantly more prevalent in SCT and already present from toddlerhood on, compared to controls. ADHD inattention symptoms were significantly increased in all karyotypes (XXX, XXY, and XYY), boys with XYY also showed significantly more hyperactivity/impulsivity symptoms than controls. Inattentiveness was more pronounced with increasing age for SCT, in contrast to controls. Within the SCT group, 24% of the children had significantly elevated ADHD symptoms at a clinical level. Already from an early age on, SCT is associated with a risk for ADHD, suggesting that its neurodevelopmental risk lies anchored in early brain maturation. Studying this genetically vulnerable population allows for the prospective study of risk markers to facilitate early and preventive interventions.
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Affiliation(s)
- Kimberly Kuiper
- Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeidenThe Netherlands
| | - Hanna Swaab
- Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeidenThe Netherlands
| | - Nicole Tartaglia
- eXtraordinarY Kids Clinic, Developmental PediatricsChildren's Hospital ColoradoAuroraColoradoUSA
- Department of PediatricsUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Sophie van Rijn
- Clinical Neurodevelopmental SciencesLeiden UniversityLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeidenThe Netherlands
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8
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Urbanus E, van Rijn S, Swaab H. A review of neurocognitive functioning of children with sex chromosome trisomies: Identifying targets for early intervention. Clin Genet 2019; 97:156-167. [PMID: 31267526 PMCID: PMC6973121 DOI: 10.1111/cge.13586] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/22/2019] [Accepted: 06/04/2019] [Indexed: 02/03/2023]
Abstract
Sex chromosome trisomies (SCT) are among the most common chromosomal duplications in humans. Due to recent technological advances in non‐invasive screening, SCT can already be detected during pregnancy. This calls for more knowledge about the development of (young) children with SCT. This review focused on neurocognitive functioning of children with SCT between 0 and 18 years, on domains of global intellectual functioning, language, executive functioning, and social cognition, in order to identify targets that could benefit from early treatment. Online databases were used to identify peer‐reviewed scientific articles using specific search terms. In total 18 studies were included. When applicable, effect sizes were calculated to indicate clinical significance. Results of the reviewed studies show that although traditionally, the focus has been on language and intelligence (IQ) in this population, recent studies suggest that executive functioning and social cognition may also be significantly affected already in childhood. These findings suggest that neuropsychological screening of children diagnosed with SCT should be extended, to also include executive functioning and social cognition. Knowledge about these neurocognitive risks is important to improve clinical care and help identify targets for early support and intervention programs to accommodate for the needs of individuals with SCT.
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Affiliation(s)
- Evelien Urbanus
- Clinical Child and Adolescent Studies, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Sophie van Rijn
- Clinical Child and Adolescent Studies, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Hanna Swaab
- Clinical Child and Adolescent Studies, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden, the Netherlands
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9
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Frederick R, Vuillermin P, Tang MLK, Ponsonby A, Webster E, Saffery R, Collier F. A child with Klinefelter syndrome and both IgE-mediated food allergy and low proportion of naive Treg. Clin Case Rep 2019; 7:302-303. [PMID: 30847194 PMCID: PMC6389460 DOI: 10.1002/ccr3.1928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 10/11/2018] [Accepted: 10/24/2018] [Indexed: 11/18/2022] Open
Abstract
This case suggests a possible association between Klinefelter Syndrome and decreased regulatory T cells (Treg) cells, relating to an increased risk of allergic and autoimmune disorders in these patients. The immune phenotyping of the circulating FOXP3+ naive Treg populations in KS patients may help to indicate this predisposition.
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Affiliation(s)
| | - Peter Vuillermin
- Child Health Research UnitBarwon HealthGeelongVictoriaAustralia
- Murdoch Children’s Research Institute, Royal Children’s HospitalUniversity of MelbourneParkvilleVictoriaAustralia
- School of MedicineDeakin UniversityGeelongVictoriaAustralia
| | | | | | - Elise Webster
- Child Health Research UnitBarwon HealthGeelongVictoriaAustralia
| | | | - Fiona Collier
- Child Health Research UnitBarwon HealthGeelongVictoriaAustralia
- Murdoch Children’s Research Institute, Royal Children’s HospitalUniversity of MelbourneParkvilleVictoriaAustralia
- School of MedicineDeakin UniversityGeelongVictoriaAustralia
- Geelong Centre for Emerging Infectious Diseases (GCEID)Barwon HealthGeelongVictoriaAustralia
| | - the Barwon Infant Study Investigator Group
- Child Health Research UnitBarwon HealthGeelongVictoriaAustralia
- Murdoch Children’s Research Institute, Royal Children’s HospitalUniversity of MelbourneParkvilleVictoriaAustralia
- School of MedicineDeakin UniversityGeelongVictoriaAustralia
- Geelong Centre for Emerging Infectious Diseases (GCEID)Barwon HealthGeelongVictoriaAustralia
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10
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Management of nonobstructive azoospermia: a committee opinion. Fertil Steril 2018; 110:1239-1245. [DOI: 10.1016/j.fertnstert.2018.09.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 09/21/2018] [Indexed: 12/27/2022]
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11
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Goddard MN, van Rijn S, Rombouts SARB, Swaab H. White matter microstructure in a genetically defined group at increased risk of autism symptoms, and a comparison with idiopathic autism: an exploratory study. Brain Imaging Behav 2017; 10:1280-1288. [PMID: 26699143 PMCID: PMC5660893 DOI: 10.1007/s11682-015-9496-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Klinefelter syndrome (47,XXY) is associated with physical, behavioral, and cognitive consequences. Deviations in brain structure and function have been reported, but structural characteristics of white matter have barely been assessed. This exploratory diffusion tensor imaging study assessed white matter microstructure in boys with 47,XXY compared with non-clinical, male controls. Additionally, both similarities and differences between 47,XXY and autism spectrum disorders (ASD) have been reported in cognition, behavior and neural architecture. To further investigate these brain-behavior pathways, white matter microstructure in boys with 47,XXY was compared to that of boys with ASD. Fractional anisotropy (FA), radial diffusivity (Dr), axial diffusivity (Da), and mean diffusivity (MD) were assessed in 47,XXY (n = 9), ASD (n = 18), and controls (n = 14), using tract-based spatial statistics. Compared with controls, boys with 47,XXY have reduced FA, coupled with reduced Da, in the corpus callosum. Boys with 47,XXY also have reduced Dr. in the left anterior corona radiata and sagittal striatum compared with controls. Compared with boys with ASD, boys with 47,XXY show reduced Da in the right inferior fronto-occipital fasciculus. Although this study is preliminary considering the small sample size, reduced white matter integrity in the corpus callosum may be a contributing factor in the cognitive and behavioral problems associated with 47,XXY. In addition, the differences in white matter microstructure between 47,XXY and ASD may be important for our understanding of the mechanisms that are fundamental to behavioral outcome in social dysfunction, and may be targeted through intervention.
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Affiliation(s)
- Marcia N Goddard
- Faculty of Social and Behavioural Sciences, Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Sophie van Rijn
- Faculty of Social and Behavioural Sciences, Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Serge A R B Rombouts
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanna Swaab
- Faculty of Social and Behavioural Sciences, Department of Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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van Rijn S, Barneveld P, Descheemaeker MJ, Giltay J, Swaab H. The effect of early life stress on the cognitive phenotype of children with an extra X chromosome (47,XXY/47,XXX). Child Neuropsychol 2016; 24:277-286. [DOI: 10.1080/09297049.2016.1252320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sophie van Rijn
- Clinical Child and Adolescent Studies, Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
| | - Petra Barneveld
- Clinical Child and Adolescent Studies, Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
| | | | - Jacques Giltay
- Department of Medical Genetics, University Medical Centre Utrecht, The Netherlands
| | - Hanna Swaab
- Clinical Child and Adolescent Studies, Leiden University, The Netherlands
- Leiden Institute for Brain and Cognition, The Netherlands
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Nistal M, Paniagua R, González-Peramato P, Reyes-Múgica M. Perspectives in Pediatric Pathology, Chapter 16. Klinefelter Syndrome and Other Anomalies in X and Y Chromosomes. Clinical and Pathological Entities. Pediatr Dev Pathol 2016; 19:259-77. [PMID: 25105890 DOI: 10.2350/14-06-1512-pb.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Manuel Nistal
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo No. 2, Madrid 28029, Spain
| | - Ricardo Paniagua
- 2 Department of Cell Biology, Universidad de Alcala, Madrid, Spain
| | - Pilar González-Peramato
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo No. 2, Madrid 28029, Spain
| | - Miguel Reyes-Múgica
- 3 Department of Pathology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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Goddard MN, Swaab H, Rombouts SARB, van Rijn S. Neural systems for social cognition: gray matter volume abnormalities in boys at high genetic risk of autism symptoms, and a comparison with idiopathic autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci 2016; 266:523-31. [PMID: 26233431 PMCID: PMC4990618 DOI: 10.1007/s00406-015-0623-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 07/20/2015] [Indexed: 12/16/2022]
Abstract
Klinefelter syndrome (47, XXY) is associated with several physical, cognitive, and behavioral consequences. In terms of social development, there is an increased risk of autism symptomatology. However, it remains unclear how social deficits are related to abnormal brain development and to what degree underlying mechanisms of social dysfunction in 47, XXY are similar to, or different from, those in idiopathic autism (ASD). This study was aimed at investigating the neural architecture of brain structures related to social information processing in boys with 47, XXY, also in comparison with boys with idiopathic ASD. MRI scans of 16 boys with 47, XXY, 16 with ASD, and 16 nonclinical, male controls were analyzed using voxel-based morphometry (VBM). A region of interest mask containing the superior temporal cortex, amygdala, orbitofrontal cortex (OFC), insular cortex, and medial frontal cortex was used. The Social Responsiveness Scale (SRS) was used to assess degree of autism spectrum symptoms. The 47, XXY group could not be distinguished from the ASD group on mean SRS scores, and their scores were significantly higher than in controls. VBM showed that boys with 47, XXY have significant gray matter volume reductions in the left and right insula, and the left OFC, compared with controls and boys with ASD. Additionally, boys with 47, XXY had significantly less gray matter in the right superior temporal gyrus than controls. These results imply social challenges associated with 47, XXY may be rooted in neural anatomy, and autism symptoms in boys with 47, XXY and boys with ASD might have, at least partially, different underlying etiologies.
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Affiliation(s)
- Marcia N. Goddard
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands ,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands ,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Serge A. R. B. Rombouts
- Institute of Psychology, Leiden University, Leiden, The Netherlands ,Leiden Institute for Brain and Cognition, Leiden, The Netherlands ,Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sophie van Rijn
- Department of Clinical Child and Adolescent Studies, Faculty of Social and Behavioural Sciences, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands ,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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Lee HJ, Jung HW, Lee GM, Kim HY, Kim JH, Lee SH, Kim JH, Lee YA, Shin CH, Yang SW. No influence of parental origin of intact X chromosome and/or Y chromosome sequences on three-year height response to growth hormone therapy in Turner syndrome. Ann Pediatr Endocrinol Metab 2014; 19:127-34. [PMID: 25346916 PMCID: PMC4208262 DOI: 10.6065/apem.2014.19.3.127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 07/17/2014] [Accepted: 09/03/2014] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Whether parental origin of the intact X chromosome and/or the presence of Y chromosome sequences (Yseq) play a role in three-year height response to growth hormone (GH) were investigated. METHODS Paternal (Xp) or maternal (Xm) origin of X chromosome was assessed by microsatellite marker analysis and the presence of hidden Yseq was analyzed. The first-, second-, and third-year GH response was measured as a change in height z-score (Z_Ht) in Turner syndrome (TS) patients with 45,Xp (n=10), 45,Xm (n=15), and 45,X/46,X,+mar(Y) (Xm_Yseq) (n=8). RESULTS The mean baseline Z_Ht did not differ according to Xp or Xm origin, however the mean baseline Z_Ht was higher in the Xm_Yseq group than in Xm group, after adjusting for bone age delay and midparental Z_Ht (P=0.04). There was no difference in the height response to GH between the 3 groups. The height response to GH decreased progressively each year (P<0.001), such that the third-year increase in Z_Ht was not significant. This third-year decrease in treatment response was unaffected by Xp, Xm, and Xm_Yseq groups. Increasing GH dosage from the second to third-year of treatment positively correlated with the increase in Z_Ht (P=0.017). CONCLUSION There was no evidence of X-linked imprinted genes and/or Yseq affecting height response to 3 years of GH therapy. Increasing GH dosages may help attenuate the decrease in third-year GH response in TS patients with 45,X and/or 46,X/+mar(Y).
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Affiliation(s)
- Hye Jin Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Woon Jung
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Gyung Min Lee
- Department of Pediatrics, Konyang University Hospital, Daejeon, Korea
| | - Hwa Young Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sun Hee Lee
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Ji Hyun Kim
- Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sei Won Yang
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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Can Attention Deficits Predict a Genotype? Isolate Attention Difficulties in a Boy with Klinefelter Syndrome Effectively Treated with Methylphenidate. Case Rep Pediatr 2014; 2014:980401. [PMID: 25215256 PMCID: PMC4157007 DOI: 10.1155/2014/980401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/15/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022] Open
Abstract
This paper describes a 17-year-old boy who was diagnosed with Klinefelter syndrome (KS) (XXY) at the age of 16 years. Although cognitive level was absolutely normal, he showed attentional difficulties that negatively affected school adjustment. He was successfully treated with methylphenidate. A significant improvement was observed in the ADHD Rating Scale IV and in the inattention subscale score of the Conners Scales. The CGI-S score improved from 3 to 1, and the CGI-I score at the end point was 1 (very much improved). Also attention measures, particularly forward and backward digit span, improved with MPH treatment. Given the widely variable and often aspecific features, KS may run undiagnosed in a large majority of affected patients. A close attention to the cognitive phenotype may favour a correct diagnosis, and a timely treatment.
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Abstract
OBJECTIVE We report a case of a patient with Klinefelter syndrome and glaucoma. CASE PRESENTATION A 30-year-old patient with karyotype 47, XXY, presented with a known medical history of glaucoma. Besides reduced fertility, no characteristic physical or behavioral symptoms for Klinefelter syndrome were found on clinical examination. While both eyes were treated with topical intraocular pressure-lowering medications, an increased intraocular pressure, visual field losses, and advanced optic disc damage with a cup-disc ratio of 0.9 were assessed only in the right eye. However, gonioscopy revealed goniodysgenesis in both eyes. DISCUSSION Klinefelter syndrome is the most common cause of male hypogonadism with a variety of clinical signs and symptoms. The principal effect is the hypogonadism predisposing to infertility and requiring testosterone replacement therapy. Several other classical features of the syndrome including mental retardation, gynecomastia, and breast cancer are described. However, the association between Klinefelter syndrome and ocular manifestations is rare. CONCLUSIONS : Glaucoma or in fact any other ocular manifestations associated with Klinefelter syndrome are rarely described. Here, we report a case of glaucoma and its treatment combining trabeculotomy and trabeculectomy in a patient with Klinefelter syndrome.
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Abstract
This article summarizes the current literature regarding azoospermia caused by spermatogenic failure. The causes and genetic contributions to spermatogenic failure are reviewed. Medical therapies including use of hormonal manipulation, whether guided by a specific abnormality or empiric, to induce spermatogenesis are discussed. The role of surgical therapy, including a discussion of varicocelectomy in men with spermatogenic failure, as well as an in-depth review of surgical sperm retrieval with testicular sperm extraction and microdissection testicular sperm extraction, is provided. Finally, future directions of treatment for men with spermatogenic failure are discussed, namely, stem cell and gene therapy.
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Affiliation(s)
- Boback M Berookhim
- Department of Urology, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA; Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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19
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Spontaneous pelvic rupture as a result of renal colic in a patient with klinefelter syndrome. Case Rep Urol 2013; 2013:374973. [PMID: 23585981 PMCID: PMC3622382 DOI: 10.1155/2013/374973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/28/2013] [Indexed: 11/17/2022] Open
Abstract
We present the case of a young man with Klinefelter syndrome, who was admitted to our clinic with renal colic. Shortly after admittance, spontaneous decrease in pain has occurred. Ultrasound and intravenous contrast computed tomography were performed, which showed the evidence of urine extravasation at the level of left renal pelvis and a 4 mm stone in the lower third of the left ureter. The management with a double-J ureteric stent for three weeks was successful. Then, the stent was removed and computed tomography confirmed the absence of urine extravasation. We also analyze the literature related to this case and discuss the main mechanisms of collecting system rupture.
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Ning L, Meng J, Goossens E, Lahoutte T, Marichal M, Tournaye H. In search of an efficient injection technique for future clinical application of spermatogonial stem cell transplantation: infusion of contrast dyes in isolated cadaveric human testes. Fertil Steril 2012; 98:1443-8.e1. [DOI: 10.1016/j.fertnstert.2012.08.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 08/13/2012] [Accepted: 08/13/2012] [Indexed: 11/17/2022]
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Genetic evaluation of the azoospermic or severely oligozoospermic male. Curr Opin Obstet Gynecol 2012; 24:221-8. [PMID: 22729088 DOI: 10.1097/gco.0b013e3283558560] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide a contemporary overview of the genetic evaluation of azoospermic or severely oligozoospermic men. RECENT FINDINGS Genetic tests should be selected based upon the initial clinical evaluation. Patients with vasal agenesis or unexplained obstructive azoospermia and low semen volume should be tested for abnormalities of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Cytogenetic testing (karyotype) and Y chromosome microdeletion (YCMD) screening are indicated in all cases when severely impaired sperm production due to testicular failure is suspected. Mutational screening of commonly implicated genes should be considered when congenital hypogonadotropic hypogonadism is clinically apparent. SUMMARY A clinically directed genetic evaluation is indicated in all azoospermic and severely oligozoospermic men. Such genetic testing is informative about the cause of infertility, the prognosis for biological paternity using assisted reproduction, and the risks of genetic abnormalities and disease in offspring. Future genetic testing may reveal a predisposition for medical conditions beyond infertility that warrant clinical management.
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22
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Manning JT, Kilduff LP, Trivers R. Digit ratio (2D:4D) in Klinefelter's syndrome. Andrology 2012; 1:94-9. [DOI: 10.1111/j.2047-2927.2012.00013.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 08/08/2012] [Indexed: 11/26/2022]
Affiliation(s)
- J. T. Manning
- Department of Psychology; Swansea University; Swansea; UK
| | - L. P. Kilduff
- Sport & Exercise Science Research Centre; Swansea University; Swansea; UK
| | - R. Trivers
- Department of Anthropology; Rutgers University; New Brunswick; USA
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23
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Ma Y, Li C, Gu J, Tang F, Li C, Li P, Ping P, Yang S, Li Z, Jin Y. Aberrant gene expression profiles in pluripotent stem cells induced from fibroblasts of a Klinefelter syndrome patient. J Biol Chem 2012; 287:38970-9. [PMID: 23019320 DOI: 10.1074/jbc.m112.380204] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Klinefelter syndrome (KS) is the most common male chromosome aneuploidy. Its pathophysiology is largely unexplained due to the lack of adequate models. Here, we report the derivation of induced pluripotent stem cell (iPSCs) lines from a KS patient with a karyotype of 47, XXY. Derived KS-iPSCs meet all criteria of normal iPSCs with the potential for germ cell differentiation. Although X chromosome inactivation occurs in all KS-iPSCs, genome-wide transcriptome analysis identifies aberrantly expressed genes associated with the clinical features of KS. Our KS-iPSCs can serve as a cellular model for KS research. Identified genes may become biomarkers for early diagnosis or potential therapeutic targets for KS and significantly accelerate the understanding, diagnosis, and treatment of Klinefelter syndrome.
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Affiliation(s)
- Yu Ma
- Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Jiao Tong University School of Medicine and Shanghai Institutes of Biological Sciences, Chinese Academy of Sciences, Shanghai, 200025, China
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Maiburg M, Repping S, Giltay J. The genetic origin of Klinefelter syndrome and its effect on spermatogenesis. Fertil Steril 2012; 98:253-60. [PMID: 22749222 DOI: 10.1016/j.fertnstert.2012.06.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 06/10/2012] [Accepted: 06/12/2012] [Indexed: 01/18/2023]
Abstract
Klinefelter syndrome is the most prevalent chromosome abnormality and genetic cause of azoospermia in males. The availability of assisted reproductive technology (ART) has allowed men with Klinefelter syndrome to father their own genetic offspring. When providing ART to men with Klinefelter syndrome, it is important to be able to counsel them properly on both the chance of finding sperm and the potential effects on their offspring. The aim of this review is twofold: [1] to describe the genetic etiology of Klinefelter syndrome and [2] to describe how spermatogenesis occurs in men with Klinefelter syndrome and the consequences this has for children born from men with Klinefelter syndrome.
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Affiliation(s)
- Merel Maiburg
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands.
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25
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Ning L, Goossens E, Geens M, Saen DV, Tournaye H. Spermatogonial stem cells as a source for regenerative medicine. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2012. [DOI: 10.1016/j.mefs.2011.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Sheppard O, Wiseman FK, Ruparelia A, Tybulewicz VLJ, Fisher EMC. Mouse models of aneuploidy. ScientificWorldJournal 2012; 2012:214078. [PMID: 22262951 PMCID: PMC3259538 DOI: 10.1100/2012/214078] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 11/16/2011] [Indexed: 02/07/2023] Open
Abstract
Abnormalities of chromosome copy number are called aneuploidies and make up a large health load on the human population. Many aneuploidies are lethal because the resulting abnormal gene dosage is highly deleterious. Nevertheless, some whole chromosome aneuploidies can lead to live births. Alterations in the copy number of sections of chromosomes, which are also known as segmental aneuploidies, are also associated with deleterious effects. Here we examine how aneuploidy of whole chromosomes and segmental aneuploidy of chromosomal regions are modeled in the mouse. These models provide a whole animal system in which we aim to investigate the complex phenotype-genotype interactions that arise from alteration in the copy number of genes. Although our understanding of this subject is still in its infancy, already research in mouse models is highlighting possible therapies that might help alleviate the cognitive effects associated with changes in gene number. Thus, creating and studying mouse models of aneuploidy and copy number variation is important for understanding what it is to be human, in both the normal and genomically altered states.
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Affiliation(s)
- Olivia Sheppard
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Frances K. Wiseman
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Aarti Ruparelia
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Victor L. J. Tybulewicz
- Division of Immune Cell Biology, MRC National Institute for Medical Research, The Ridgeway, Mill Hill, London NW7 1AA, UK
| | - Elizabeth M. C. Fisher
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
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Matsunaga Y, Goto A, Wakasugi H, Itoh A, Yonezawa K, Itoh M, Fujii K, Suzuki K, Abe T, Ushijima K, Shinomura Y. Extensive portal and mesenteric vein thrombosis in a young man with Klinefelter's syndrome. Hepatol Res 2012; 42:103-9. [PMID: 22175800 DOI: 10.1111/j.1872-034x.2011.00903.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Klinefelter's syndrome (KS) is a unique physical condition characterized by tall stature, eunuchoid body proportions, gynecomastia, and azoospermia, in addition to an extra X chromosome. In contrast to the original description, symptoms or physical findings can be extremely varied. KS is the most common chromosomal disorder, with an incidence of 1 in 500 males and is also the most commonly undiagnosed chromosomal disorder. Here, we present the case of a 26-year-old man with KS, who visited our hospital with complaints of abdominal pain and fever. On a routine physical examination, he did not differ from a normal karyotype male. Computed tomography showed extensive portal and mesenteric vein thrombosis (PMVT). It is well known that KS is frequently associated with venous thrombosis, but KS with PMVT has rarely been reported. Approximately one-third of PMVT is idiopathic, but this case suggests the possibility that undiagnosed KS is one of the causes of PMVT, as some individuals with KS are not easily distinguishable from those with the normal karyotype.
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Affiliation(s)
- Yasutaka Matsunaga
- Department of Gastroenterology, Kushiro City General Hospital, Kushiro First Department of Internal Medicine, Sapporo Medical University, Sapporo, Japan
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Attitudes of Klinefelter men and their relatives towards TESE-ICSI. J Assist Reprod Genet 2011; 28:809-14. [PMID: 21717174 PMCID: PMC3169690 DOI: 10.1007/s10815-011-9603-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 06/14/2011] [Indexed: 11/29/2022] Open
Abstract
Purpose At the start of the implementation of TESE-ICSI for Klinefelter men in the Netherlands, we aimed to evaluate their wish to father children and their attitudes towards this artificial reproduction technique. Methods Questionnaires were distributed to members of the Dutch Klinefelter Association (n = 365) and to Klinefelter cases known at our Department (n = 58). Questions addressed several aspects: socio-demographic characteristics, ascertainment of diagnosis, children and child wish, and TESE-ICSI. Data were characterized using descriptive statistics. Results A total of 260 questionnaires (corresponding to 194 cases, 46%) were returned. A possible wish to father children was reported by 90% of Klinefelter men. 70% of Klinefelter men and 74% of their partners would (probably) opt for TESE-ICSI. Conclusion The majority of Dutch Klinefelter men and their partners desire to have children and have a positive attitude towards TESE-ICSI. Concerns include the risk of congenital malformations/developmental delay of the child and the limited success rate of TESE-ICSI. Electronic supplementary material The online version of this article (doi:10.1007/s10815-011-9603-z) contains supplementary material, which is available to authorized users.
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Postow M, Shah MA, Lowery M, Shamseddine A, El-Kutoubi A, Al Olayan A, Naghy M, Ang C, Tamraz S, Jazieh AR, O’Reilly EM, Kelsen DP, Abou-Alfa GK. A Man with Klinefelter’s Syndrome and New Abdominal Distension: A Discussion of Evaluation and Management. J Gastrointest Cancer 2011; 43:314-8. [DOI: 10.1007/s12029-011-9294-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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30
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An unusual case of identification by DNA analysis of siblings. Forensic Sci Int Genet 2011; 6:121-3. [PMID: 21444260 DOI: 10.1016/j.fsigen.2011.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 02/14/2011] [Accepted: 02/21/2011] [Indexed: 11/23/2022]
Abstract
A badly decomposed body required identification by means of DNA analysis. A brother and sister of the deceased were available as reference subjects. Although investigation of Y-chromosomal markers established an exclusion condition, autosomal markers suggested a positive identification. In order to increase the reliability of the tests, X-chromosomal markers were also investigated. This analysis showed the body to have an XXY genotype (Klinefelter's syndrome). A number of hypotheses were assessed using biostatistical methods, ultimately resulting in a definite identification. The special aspect of Klinefelter's syndrome proved highly useful for biostatistical analysis.
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Wilkins JF, Úbeda F. Diseases associated with genomic imprinting. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2011; 101:401-45. [PMID: 21507360 DOI: 10.1016/b978-0-12-387685-0.00013-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Genomic imprinting is the phenomenon where the expression of a locus differs between the maternally and paternally inherited alleles. Typically, this manifests as transcriptional silencing of one of the alleles, although many genes are imprinted in a tissue- or isoform-specific manner. Diseases associated with imprinted genes include various cancers, disorders of growth and metabolism, and disorders in neurodevelopment, cognition, and behavior, including certain major psychiatric disorders. In many cases, the disease phenotypes associated with dysfunction at particular imprinted loci can be understood in terms of the evolutionary processes responsible for the origin of imprinting. Imprinted gene expression represents the outcome of an intragenomic evolutionary conflict, where natural selection favors different expression strategies for maternally and paternally inherited alleles. This conflict is reasonably well understood in the context of the early growth effects of imprinted genes, where paternally inherited alleles are selected to place a greater demand on maternal resources than are maternally inherited alleles. Less well understood are the origins of imprinted gene expression in the brain, and their effects on cognition and behavior. This chapter reviews the genetic diseases that are associated with imprinted genes, framed in terms of the evolutionary pressures acting on gene expression at those loci. We begin by reviewing the phenomenon and evolutionary origins of genomic imprinting. We then discuss diseases that are associated with genetic or epigenetic defects at particular imprinted loci, many of which are associated with abnormalities in growth and/or feeding behaviors that can be understood in terms of the asymmetric pressures of natural selection on maternally and paternally inherited alleles. We next described the evidence for imprinted gene effects on adult cognition and behavior, and the possible role of imprinted genes in the etiology of certain major psychiatric disorders. Finally, we conclude with a discussion of how imprinting, and the evolutionary-genetic conflicts that underlie it, may enhance both the frequency and morbidity of certain types of diseases.
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