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Alla A, Ongoth FEM, Tahiri A, Karrou M, Rouf S, Benhaddou H, Kamaoui I, Mcelreavey K, Latrech H. Novel homozygous inactivating mutation in the luteinizing hormone receptor gene ( LHCGR) associated with 46, XY DSD in a Moroccan family. J Pediatr Endocrinol Metab 2022; 35:1215-1221. [PMID: 35670320 DOI: 10.1515/jpem-2021-0717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We present the first cases of two male brothers with Leydig cell hypoplasia secondary to a novel mutation in the LHCGR gene that has never been described before. CASE PRESENTATION We report the case of two brothers with Leydig cell hypoplasia (LCH) type II caused by novel homozygous inactivating mutation of the LHCGR gene, located in exon 10 in c 947 position. The two patients presented at 11 years 7 months and 1 year 6 months, respectively, with abnormal sexual development, micropenis and cryptorchidism. Genetic analysis revealed a homozygous deletion of approximately 4 bp encompassing exon 10 of the LHR gene in the two brothers indicating autosomal recessive inheritance. An hCG stimulation test induced testosterone secretion within the normal range. Subsequently, a treatment with enanthate of testosterone was started, with an increase in the length of the penis. CONCLUSIONS Leydig cell hypoplasia is a rare form of disorder of sex development. We report the occurrence of a new mutation of the LHCGR gene in two Moroccan brothers in whom the clinical features and the molecular diagnosis were correlated.
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Affiliation(s)
- Achwak Alla
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Farel Elilie Mawa Ongoth
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Abir Tahiri
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Marouan Karrou
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Siham Rouf
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Houssain Benhaddou
- Department of Pediatric Surgery, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | | | - Hanane Latrech
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco.,Laboratory of Epidemiology, clinical Research and Public health, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
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Sigha OB, Mbono Betoko R, Nkoro GA, Fossi Happi M, Ekoube CE, Kelbaba BB, Mandeng Ma Linwa E, Kouotou EA. Bart's syndrome associated with a disorder of sexual differentiation: An atypical presentation in a Cameroonian newborn. Clin Case Rep 2022; 10:e05234. [PMID: 35028143 PMCID: PMC8741868 DOI: 10.1002/ccr3.5234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/25/2021] [Accepted: 12/09/2021] [Indexed: 12/01/2022] Open
Abstract
Bart's syndrome consists of congenital aplasia of the skin affecting only the lower limbs, associated with bullae over the skin and/or mucous membranes, as well as a nail anomaly. It is an extremely rare genetic disorder, which can be associated with other birth defects. We report the case of a newborn baby admitted at day 0 of life in the neonatal department, for multifocal skin detachment predominantly at the lower limbs. In addition, examination of the external genitalia revealed a clitoridomegaly genital bud measuring 14 mm, scrotalized and unfused genital bulges with the presence of 2 orifices. No gonad was palpated. The clinical diagnosis of Bart's syndrome associated with a disorder of sexual differentiation was retained. We hereby report the first case of Bart's syndrome described in Cameroon in association with a disorder of sexual differentiation.
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Affiliation(s)
- Odette Berline Sigha
- Faculty of Health SciencesUniversity of BamendaBambiliCameroon
- Service de dermatologieHôpital Laquintinie de DoualaDoualaCameroun
| | - Ritha Mbono Betoko
- Département de pédiatrieHôpital Laquintinie de DoualaDoualaCameroun
- Faculté de Médecine et des Sciences PharmaceutiquesUniversité de DoualaDoualaCameroun
| | - Grace Anita Nkoro
- Service de dermatologieHôpital Gynéco‐obstétrique et Pédiatrique de YaoundéYaoundéCameroun
- Faculté de Médecine et des Sciences BiomédicalesUniversité de Yaoundé 1YaoundéCameroun
| | | | - Charlotte Eposse Ekoube
- Département de pédiatrieHôpital Laquintinie de DoualaDoualaCameroun
- Faculté de Médecine et des Sciences PharmaceutiquesUniversité de DoualaDoualaCameroun
| | | | | | - Emmanuel Armand Kouotou
- Faculté de Médecine et des Sciences BiomédicalesUniversité de Yaoundé 1YaoundéCameroun
- Service de dermatologieCentre Hospitalier Universitaire de YaoundéYaoundéCameroun
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Gupta RK, Tiwari P, Parelkar SV, Sanghvi BV, Mudkhedkar KP, Mhaskar SS, Shah RS. An Unusual Case of Type A Posterior Cloaca Associated with 46XX Disorder of Sexual Differentiation with Y Duplication of Urethra. J Indian Assoc Pediatr Surg 2022; 27:251-254. [PMID: 35937130 PMCID: PMC9350634 DOI: 10.4103/jiaps.jiaps_352_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/24/2021] [Accepted: 05/17/2021] [Indexed: 11/19/2022] Open
Abstract
We report an infant reared as a girl who presented with ambiguous genitalia and urine coming per rectum. On examination, she had minimal clitoromegaly with labial fusion and Y urethral duplication. On investigations, genetic, metabolic, and endocrine causes for disorder of sexual differentiation were ruled out. This girl was operated via a posterior sagittal approach. This case was unique in that the urogenital sinus was deviated posteriorly and opened in the anterior rectal wall and the accessory urethra opened in clitoris, along with ambiguity of external genitalia, thus making it a rare variant of the posterior cloaca. The diagnosis requires a high index of suspicion in clinician and a meticulous examination of the external genitalia. Very little literature is available for this rare anomaly. Few reports have classified them as female pseudohermaphroditism with cloacal and urogenital sinus defects. Hence, we hereby discuss and review the literature for previously reported cases.
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Affiliation(s)
- Rahul K. Gupta
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Pooja Tiwari
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India,Address for correspondence: Dr. Pooja Tiwari, Department of Pediatric Surgery, Seth G. S. Medical College and K.E.M. Hospital, Parel, Mumbai - 400 012, Maharashtra, India. E-mail:
| | - Sandesh V. Parelkar
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Beejal V. Sanghvi
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Kedar P. Mudkhedkar
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Satej S. Mhaskar
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Rujuta S. Shah
- Department of Pediatric Surgery, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
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Lugli L, Bariola MC, Ferri L, Lucaccioni L, Bertucci E, Cattini U, Torcetta F, Morrone A, Iughetti L, Berardi A. Disorder of sex development associated with a novel homozygous nonsense mutation in COG6 expands the phenotypic spectrum of COG6-CDG. Am J Med Genet A 2021; 185:1187-1194. [PMID: 33394555 DOI: 10.1002/ajmg.a.62061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 12/15/2022]
Abstract
Congenital disorders of glycosylation (CDG) are an expanding group of metabolic disorders that result from abnormal protein glycosylation. A special subgroup of CDG type II comprises defects in the Conserved Oligomeric Golgi Complex (COG). In order to further delineate the genotypic and phenotypic spectrum of COG complex defect, we describe a novel variant of COG6 gene found in homozygosity in a Moroccan patient with severe presentation of COG6-CDG (OMIM #614576). We compared the phenotype of our patient with other previously reported COG6-CDG cases. Common features in COG6-CDG are facial dysmorphism, growth retardation, microcephaly, developmental disability, liver or gastrointestinal disease, recurrent infections, hypohidrosis/hyperthermia. In addition to these phenotypic features, our patient exhibited a disorder of sexual differentiation, which has rarely been reported in COG6-CDG. We hypothesize that the severe COG6 gene mutation interferes with glycosylation of a disintegrin and metalloprotease family members, inhibiting the correct gonadal distal tip cells migration, fundamental for the genitalia morphogenesis. This report broadens the genetic and phenotypic spectrum of COG6-CDG and provides further supportive evidence that COG6-CDG can present as a disorder of sexual differentiation.
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Affiliation(s)
- Licia Lugli
- Neonatology Unit, Mother-Child Department, University Hospital of Modena, Modena, Italy
| | - Maria Carolina Bariola
- Post-graduated School of Pediatrics, Department of Medical and Surgical Sciences for Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Ferri
- Molecular and Cell Biology Laboratory of Neurometabolic Diseases, Neuroscience Department, Meyer Children's Hospital, Florence, Italy
| | - Laura Lucaccioni
- Pediatric Unit, Mother-Child Department, University Hospital of Modena, Modena, Italy
| | - Emma Bertucci
- Obstetric-Gynecology Unit, Mother-Child Department, University Hospital of Modena, Modena, Italy
| | - Umberto Cattini
- Post-graduated School of Pediatrics, Department of Medical and Surgical Sciences for Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Torcetta
- Neonatology Unit, Mother-Child Department, University Hospital of Modena, Modena, Italy
| | - Amelia Morrone
- Molecular and Cell Biology Laboratory of Neurometabolic Diseases, Neuroscience Department, Meyer Children's Hospital, Florence, Italy.,Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Florence, Italy
| | - Lorenzo Iughetti
- Post-graduated School of Pediatrics, Department of Medical and Surgical Sciences for Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatology Unit, Mother-Child Department, University Hospital of Modena, Modena, Italy
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Slater B, Glinton K, Dai H, Lay E, Karaviti L, Mizerik E, Murali CN, Lalani SR, Bacino CA, Rossetti LZ. Sudden infant death with dysgenesis of the testes syndrome in a non-Amish infant: A case report. Am J Med Genet A 2020; 182:2751-2754. [PMID: 32885560 DOI: 10.1002/ajmg.a.61842] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/09/2020] [Accepted: 08/13/2020] [Indexed: 11/11/2022]
Abstract
Sudden Infant Death with Dysgenesis of the Testes syndrome (SIDDT) is a very rare condition associated with biallelic pathogenic variants in the TSPYL1 gene first reported in 2004. It is characterized by sudden cardiac or respiratory arrest, disordered testicular development, neurologic dysfunction, and is uniformly fatal before the age of 12 months. There were previously 21 reported cases of SIDDT in the literature, all from nine Old Order Amish families published in a single paper. In this report, we describe a non-Amish, phenotypically female infant with poor feeding and abnormal motor movements noted at birth. Initial testing showed that she had a 46,XY chromosome complement, and chromosomal microarray showed a significant absence of heterozygosity (AOH) totalling roughly 600 Mb across multiple different chromosomes, indicating consanguinity. Further workup with exome sequencing revealed homozygosity for a frameshift variant in TSPYL1 (c.725_726delTG, p.Val242GlufsTer52) consistent with a diagnosis of SIDDT, explaining many of her clinical features. However, she was also noted to have a mild T-cell lymphopenia and developed intractable epilepsy after hospital discharge. These features have not previously been reported in SIDDT and may represent phenotypic expansion. To our knowledge, this patient is the 22nd case of SIDDT to be reported in the literature, and the first to be of non-Amish heritage.
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Affiliation(s)
| | - Kevin Glinton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Hongzheng Dai
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA
| | - Erica Lay
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Lefkothea Karaviti
- Division of Pediatric Endocrinology, Baylor College of Medicine, Houston, Texas, USA
| | - Elizabeth Mizerik
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Chaya N Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Carlos A Bacino
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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Abstract
BACKGROUND AND OBJECTIVES 46 XY disorders of sexual development (DSD) cover a wide spectrum of phenotypes ranging from unambiguous female genitalia to ambiguous male genitalia with hypospadias or dysgenetic gonads. Management of these patients depends on the cause of DSD, degree of feminization, age at presentation, and gender orientation. The aim of this study was to evaluate the presentation and management of patients with 46XY DSD at our center. PATIENTS AND METHODS All new and old patients of 46XY DSD attending the endocrine OPD in a period of 16 months were included in this study. Clinical, cytogenetic, hormonal, and radiological evaluation were done to identify the cause of DSD. RESULTS Among 19 patients, eight were diagnosed with disorders of gonadal development (one with complete gonadal dysgenesis, four with partial gonadal dysgenesis, two with congenital bilateral anorchia, and one with ovotesticular DSD) and eight with disorders of androgen synthesis and action (one with complete androgen insensitivity syndrome [AIS], three with partial AIS and four with 5α reductase deficiency). In three patients, a definitive diagnosis could not be made. CONCLUSIONS Management of patients with DSD depends on etiology, gender assignment, gender orientation, hormonal treatment, genital surgery, and consequent psychosocial implications. Due to the overlapping clinical and biochemical parameters in different subsets of DSD, only a preliminary etiological diagnosis can be made in some cases. Genetic studies with long-term follow-up are required for an accurate diagnosis.
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Affiliation(s)
- Chauhan Vasundhera
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Viveka P. Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | | | - Nandita Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Seshadri KG. The curious case of Sudyumna: A tale of sex reversal from the Bhagavata Purana. Indian J Endocrinol Metab 2013; 17:451-453. [PMID: 23869301 PMCID: PMC3712375 DOI: 10.4103/2230-8210.111640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Tracking endocrine disease in mythology especially one as old and diverse as Indian mythology is a challenge. A curious case of sex reversal in the bhagavata purana is described and hunches about the disorder of sexual differentiation that manifested itself in the hapless Sudyumna the son of Manu is attempted. 5 alpha reductase deficiency appears to be the closest candidate but some twists in the tale are required to fill in the gaps.
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Affiliation(s)
- Krishna G. Seshadri
- Professor and Head Department of Endocrinology Diabetes and Metabolism, Sri Ramachandra University, Chennai, Tamil Nadu, India
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