An infant born to a mother with gestational diabetes presenting with 49,XXXXY syndrome and renal agenesis-a case report

Sexual and developmental aspects of 49, XXXXY Syndrome: A case report

49, XXXXY syndrome is one of the rarest sexual chromosome disorders, with an incidence of 1:85000-100000 males. It is caused by nondisjunction of the X chromosomes in both meiosis I and II. Early intervention is vital to improve behavioural, neural and sexual well-being. Information about sexual and developmental aspects is extremely limited in previous literature. We present a case of a 26-month-old male child presenting with hypotonia, micropenis and bilateral cryptorchidism. Karyotype study was done in Jordan at the age of 16 months and revealed 49, XXXXY syndrome. Global developmental delay, hypotonia and weak truncal muscles were noted on examination. Growth parameters were within normal limits. Kidney ultrasound revealed findings suggestive of Vesicoureteral reflux. Laboratory investigations revealed hypoandrogenism with normal 17-OHP levels. This study reviews current knowledge about sexual and developmental characteristics of 49, XXXXY syndrome.

Lifestyle, pregnancy and epigenetic effects

Rapidly growing evidences link maternal lifestyle and prenatal factors with serious health consequences and diseases later in life. Extensive epidemiological studies have identified a number of factors such as diet, stress, gestational diabetes, exposure to tobacco and alcohol during gestation as influencing normal fetal development. In light of recent discoveries, epigenetic mechanisms such as alteration of DNA methylation, chromatin modifications and modulation of gene expression during gestation are believed to possibly account for various types of plasticity such as neural tube defects, autism spectrum disorder, congenital heart defects, oral clefts, allergies and cancer. The purpose of this article is to review a number of published studies to fill the gap in our understanding of how maternal lifestyle and intrauterine environment influence molecular modifications in the offspring, with an emphasis on epigenetic alterations. To support these associations, we highlighted laboratory studies of rodents and epidemiological studies of human based on sampling population cohorts.