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[Charles II: From spell to genitourinary pathology].

Angel García-Escudero López¹, A Arruza Echevarría, J Padilla Nieva

¹Servicio de Urología, Hospital Txagorritxu, Vitoria, Alava, España. agareslo@telefonica.net

Archivos Espanoles De Urologia

|June 23, 2009

Summary

The Hapsburg dynasty ended with Charles II due to his complex genetic and genitourinary disorders, likely including hypospadias and a XX male syndrome, leading to infertility and death. Further genetic studies of his remains could clarify his condition.

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Area of Science:

Medical history
Genetics
Endocrinology

Background:

Charles II of Spain, the last Hapsburg monarch, suffered from a debilitating genitourinary disorder that prevented him from producing an heir.
His condition was exacerbated by a history of consanguineous marriages within the Hapsburg dynasty, leading to widespread speculation and the belief he was 'bewitched'.

Discussion:

Analysis suggests Charles II may have had posterior hypospadias, monorchism, and an atrophic testicle, contributing to an intersex state with ambiguous genitalia.
His phenotype aligns more with true hermaphroditism or XX male syndrome, possibly with Fragile X syndrome, rather than Klinefelter's syndrome.
Congenital monorenal condition and chronic kidney failure due to nephropathy and recurrent urinary tract infections likely caused his death.

Key Insights:

The Hapsburg dynasty's end in Spain was precipitated by Charles II's complex pluripathological condition.
Endogamic matrimonial policies significantly contributed to the Habsburg dynasty's extinction.
Genetic and chromosomal analysis of Charles II's remains is crucial for definitive diagnosis.

Outlook:

Further research into Charles II's genetic makeup could provide definitive answers regarding his intersex condition.
Understanding the genetic impact of royal inbreeding offers insights into historical health outcomes.
The case of Charles II highlights the long-term consequences of consanguinity on dynastic survival.