在NR5A1中呈现为46,XY性别发展差异的新型变体
Yunting Yu1, Peter A Lee1,2, Lina Huerta-Saenz1,2
1Penn State College of Medicine, Hershey, PA 17033, USA.
JCEM case reports
|September 18, 2023
概括
这项案例研究突出了在患有46,XY性别发育差异 (DSD) 的患者中发现的一种新型NR5A1基因变异. 分子遗传测试对于诊断DSD和确定潜在的遗传原因至关重要.
科学领域:
- 遗传学 是一个遗传学.
- 内分泌学 在内分泌学.
- 儿科手术 儿科手术
背景情况:
- 性发育差异 (DSDs) 涵盖了影响性腺,染色体和解剖性发育的先天性疾病.
- DSD的临床表现可能含糊不清,这使得准确的诊断具有挑战性.
- 先天性上腺增生 (CAH) 是DDS患者常见的误诊.
研究的目的:
- 报告一个患有46,XY DSD的病人的病例,最初被误诊为CAH.
- 为了确定患者严重的低 virilized 男性表型的潜在遗传病因.
- 强调分子遗传测试在诊断DSD中的重要性.
主要方法:
- 临床检查和详细的病史.
- 高剂量上腺皮质激素刺激研究,以排除CAH.
- 外科干预包括双边骨架和缺修复.
- 对46,XY DSD进行分子遗传测试,包括对NR5A1基因的测序.
主要成果:
- 这位患者最初被诊断患有CAH,但并没有这种情况.
- 身体检查显示,这些特征与严重的低病毒化相一致.
- 基因测试在NR5A1基因中发现了一种新的,主导的,异构的,可能致病的变体 (c.102 + 1G > C).
- 这种NR5A1变异与46,XY DSD个体的严重表型有关.
结论:
- 准确诊断DSD需要全面的评估超出最初的临床表现.
- 分子遗传测试,特别是对NR5A1等基因的测试,对于识别DSDs的特定病因至关重要.
- 这一案例强调了NR5A1基因变异在严重的低病毒化和DSD中所扮演的角色.
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