Asunto(s)
Hiperplasia Suprarrenal Congénita/cirugía , Trastornos del Desarrollo Sexual/genética , Trastornos del Desarrollo Sexual/cirugía , Procedimientos de Cirugía Plástica/legislación & jurisprudencia , Trastornos del Desarrollo Sexual 46, XX/diagnóstico , Trastornos del Desarrollo Sexual 46, XX/cirugía , Trastornos Testiculares del Desarrollo Sexual 46, XX/diagnóstico , Trastornos Testiculares del Desarrollo Sexual 46, XX/genética , Trastornos Testiculares del Desarrollo Sexual 46, XX/cirugía , Hiperplasia Suprarrenal Congénita/diagnóstico , California , Trastornos del Desarrollo Sexual/diagnóstico , Femenino , Política de Salud/legislación & jurisprudencia , Humanos , Lactante , Recién Nacido , Masculino , Formulación de Políticas , Medición de Riesgo , Factores de TiempoRESUMEN
OBJECTIVE: We present a case of X-Y translocation with male phenotype (46,XX testicular disorder of sex development) and review the literature. METHODS: Disorders of sex development with mismatch of genetic, gonadal and phenotypic sex are quite rare, and some are due to genetic or chromosomal abnormalities. The karyotype was investigated by a cytogenetic study of peripheral blood (phytohemagglutinin-timulated lymphocyte culture over 72 hours). G-banding analysis of 25 metaphases showed a 46,XX chromosome constitution (46 chromosomes with XX sexual composition). Fluorescence in situ hybridization (FISH) analysis with probes for X centromeres and the sex-determining region of the Y chromosome (SRY) (testis-determining factor gene) showed two X chromosomes. The analysis also showed the SRY signal in the telomeric region of the short arm of one of the chromosomes. RESULTS: In recent years, a number of other genes involved in disorders of sex development in animals and humans have also been identified. Genetic defects in the peptide hormone receptors, members of the steroid receptor superfamily, and other transcription factors, as well as any of a series of enzymes and cofactors involved in steroid biosynthesis can cause abnormal determination and differentiation. CONCLUSIONS: Although chromosomal abnormalities are rarely present in patients with apparently normal external genitalia, they should be considered in urology consultations by adolescents and adults, particularly in the investigation of gynecomastia or infertility.