RESUMO
Se presenta un caso clínico de Síndrome de Klinefelter y se revisan que los aspectos en relación al sueño en estos pacientes, siendo relevante a ser abordado y estudiado debido a la relación causal entre el metabolismo de esteroides sexuales afectados. En especial la testosterona y cómo esto influye en la microarquitectura del sueño y la probabilidad de presentar síndrome de apnea obstructiva del sueño, con las repercusiones cognitivas que pueden sumarse a las ya descritas por el síndrome en si. De allí la importancia de un seguimiento y abordaje dirigido en este aspecto, al momento del diagnóstico y en el seguimiento a largo plazo.
A clinical case of Klinefelter's Syndrome is presented and the aspects related to sleep in these patients are reviewed, being relevant to be addressed and studied due to the causal relationship between the metabolism of affected sex steroids, especially testosterone and how this influences the microarchitecture of sleep and the probability of presenting obstructive sleep apnea syndrome with the cognitive repercussions that can be added to those already described by the syndrome itself. Hence the importance of a targeted follow-up and approach in this aspect, at the time of diagnosis and in long-term follow-up.
Assuntos
Humanos , Masculino , Criança , Sono , Síndrome de Klinefelter/diagnóstico , Testosterona , Vitamina DRESUMO
To investigate the factors affecting the sperm retrieval rate of microdissection testicular sperm extraction (micro-TESE) in patients with nonmosaic Klinefelter syndrome (KS), 64 patients with nonmosaic KS who underwent micro-TESE in the Center for Reproductive Medicine of Peking University Third Hospital (Beijing, China) between January 2016 and December 2017 were included in the study. Data on medical history, physical examination and laboratory examination results, and micro-TESE outcomes were collected. Patients were divided into two groups according to micro-TESE outcomes. The following factors were compared between the two groups by the Mann‒Whitney U test or Student's t-test based on the distribution (nonnormal or normal) of the factors: age, testicular size, follicle-stimulating hormone level, luteinizing hormone level, testosterone level, and anti-Müllerian hormone level. The overall success rate of sperm retrieval was 50.0%. Correlation analysis showed that testicular volume was positively correlated with testosterone level. Using a logistic regression model, age and anti-Müllerian hormone levels were found to be better predictors for the sperm retrieval rate than the other parameters.
Assuntos
Humanos , Masculino , Recuperação Espermática , Síndrome de Klinefelter , Microdissecção , Hormônio Antimülleriano , Sêmen , Testículo , Espermatozoides , Testosterona , Azoospermia , Estudos RetrospectivosRESUMO
Klinefelter syndrome (KS) is the most common genetic cause of human male infertility. However, the effect of the extra X chromosome on different testicular cell types remains poorly understood. Here, we profiled testicular single-cell transcriptomes from three KS patients and normal karyotype control individuals. Among the different somatic cells, Sertoli cells showed the greatest transcriptome changes in KS patients. Further analysis showed that X-inactive-specific transcript ( XIST ), a key factor that inactivates one X chromosome in female mammals, was widely expressed in each testicular somatic cell type but not in Sertoli cells. The loss of XIST in Sertoli cells leads to an increased level of X chromosome genes, and further disrupts their transcription pattern and cellular function. This phenomenon was not detected in other somatic cells such as Leydig cells and vascular endothelial cells. These results proposed a new mechanism to explain why testicular atrophy in KS patients is heterogeneous with loss of seminiferous tubules but interstitial hyperplasia. Our study provides a theoretical basis for subsequent research and related treatment of KS by identifying Sertoli cell-specific X chromosome inactivation failure.
Assuntos
Animais , Humanos , Masculino , Feminino , Células de Sertoli/metabolismo , Síndrome de Klinefelter/genética , Células Endoteliais , Testículo/metabolismo , Cromossomo X/metabolismo , Mamíferos/genéticaRESUMO
Objective: To investigate the clinicopathological characteristics of testicular biopsies from Klinefelter syndrome (KS) patients. Methods: The testicular biopsy specimens of 87 patients with KS (a total of 107 biopsy specimens) were collected from the Department of Pathology, Peking University Third Hospital, Beijing, China from January 2017 to July 2022. All patients were diagnosed as KS by peripheral blood karyotyping analysis. The testicular histopathologic features, testicular volume and hormone levels were evaluated retrospectively. The histopathologic analysis was used to assess the quantity and morphology of Leydig cells, the spermatogenic state of seminiferous tubules, the thickening of the basement membrane of seminiferous tubules and the changes of stroma. Results: Leydig cell proliferative nodules were seen in 95.3% (102/107) of KS testicular biopsy tissues. The eosinophilic inclusion bodies and lipofuscin in Leydig cells were found in 52.3% (56/107) and 57.9% (62/107) of specimens, respectively. The Sertoli cell only seminiferous tubules and the hyalinized tubules were found in 66.4% (71/107) and 76.6% (82/107) of the examined tissues, respectively. The tubules with complete spermatogenic arrest were found in 15.9% (17/107) of specimens, and 5.6% (6/107) of the specimens showed low spermatogenesis or incomplete spermatogenic arrest. In 85.0% (91/107) of the specimens, increased thick-walled small vessels with hyaline degeneration were identified. Conclusions: The most common features of KS testicular specimens are Leydig cell proliferative nodules, hyaline degeneration of seminiferous tubules and proliferation of thick-walled blood vessels. Testicular biopsy specimens of KS are rare. The pathologists can make a tentative diagnosis of KS based on the histological findings, combined with the ultrasound and laboratory results, which is helpful for further diagnosis and treatment of KS.
Assuntos
Masculino , Humanos , Testículo/patologia , Síndrome de Klinefelter/patologia , Estudos Retrospectivos , Túbulos Seminíferos/patologia , BiópsiaRESUMO
O cariótipo 49,XXXXY, uma variante rara da Síndrome de Klinefelter, acomete 1:85.000100.000 nascidos vivos do sexo masculino e surge a partir de uma dupla não disjunção durante as duas rodadas da meiose (I e II) materna. No entanto, as pesquisas envolvendo indivíduos com essa constituição cromossômica são limitadas. Deste modo, este estudo tem como objetivo geral caracterizar a idade no diagnóstico, a apresentação clínica e o tratamento de indivíduos 49,XXXXY. Foi realizada uma revisão da literatura na base de dados PubMed utilizando os descritores 49,XXXXY and diagnosis e 49,XXXXY. Os critérios de inclusão foram: artigos originais e relato de caso, idioma inglês, versão completa disponível online gratuitamente e que contenham as informações que respondam integralmente ao objetivo geral. Os resultados dos 20 estudos incluídos nessa revisão mostraram que a identificação de indivíduos com cariótipo 49,XXXXY ocorre geralmente após o nascimento, sendo que o diagnóstico no pré-natal é extremamente raro. A presença de diversas anomalias congênitas pode contribuir significativamente para o diagnóstico precoce, ao contrário de pacientes com cariótipo 47,XXY, que geralmente são assintomáticos até a puberdade. Nossos achados podem contribuir para despertar a atenção dos profissionais de saúde no reconhecimento desse distúrbio genético, visto que o diagnóstico precoce dessa síndrome permite o tratamento adequado mais rapidamente, a fim de se obter menor impacto no desenvolvimento global desse indivíduo, com consequente melhora na sua qualidade de vida.
Assuntos
Sinais e Sintomas , Cromossomo X , Diagnóstico , Cariótipo , Síndrome de KlinefelterRESUMO
Klinefelter syndrome (KS) is one of the most frequent genetic abnormalities and the leading genetic cause of nonobstructive azoospermia. The breeding and study of KS mouse models are essential to advancing our knowledge of the underlying pathological mechanism. Karyotyping and fluorescence in situ hybridization are reliable methods for identifying chromosomal contents. However, technical issues associated with these methods can decrease the efficiency of breeding KS mouse models and limit studies that require rapid identification of target mice. To overcome these limitations, we developed three polymerase chain reaction-based assays to measure specific genetic information, including presence or absence of the sex determining region of chromosome Y (Sry), copy number of amelogenin, X-linked (Amelx), and inactive X specific transcripts (Xist) levels. Through a combined analysis of the assay results, we can infer the karyotype of target mice. We confirmed the utility of our assays with the successful generation of KS mouse models. Our assays are rapid, inexpensive, high capacity, easy to perform, and only require small sample amounts. Therefore, they facilitate the breeding and study of KS mouse models and help advance our knowledge of the pathological mechanism underlying KS.
Assuntos
Animais , Camundongos , Azoospermia , Hibridização in Situ Fluorescente , Cariotipagem , Síndrome de Klinefelter/genética , Reação em Cadeia da PolimeraseRESUMO
This study assessed the relative risk of using male and partner contraceptive methods relative to non-use, identified the types of methods preferred by participants, and assessed the associated determinants of the use of male and partner methods. It used secondary data from the Demographic and Health Surveys conducted in Lesotho, Namibia, South Africa, and Zimbabwe. Participants were sexually active men aged 1554. The study found that 32% of respondents did not utilize any method, while 36% and 32% used partner and male methods, respectively. The male method was more prevalent among men who had two or more sexual partners and among urban dwellers, while the partner method was predominant among those with less than two children and those who were indifferent about whether contraception is a woman's business. The study recommends that family planning programs should pay attention to male contraceptive needs and concerns. (Afr J Reprod Health 2022; 26[6]:27-35).
Assuntos
Humanos , Masculino , Agentes Comunitários de Saúde , Anticoncepcionais Masculinos , Certificação , Anticoncepcionais , Síndrome de KlinefelterRESUMO
Os sinais clínicos da síndrome de Klinefelter foram observados pela primeira vez em 1942, mas sua etiologia só foi definida em 1959. Trata-se de uma condição genética na qual pelo menos um cromossomo X extra é adicionado ao cariótipo masculino normal (46,XY) e acomete cerca de 1 em cada 500 homens. É caracterizada por variabilidade fenotípica que leva a atraso ou ausência de diagnóstico, com uma estimativa de 50% a 75% de homens com Síndrome de Klinefelter nunca obterem o diagnóstico correto. Apesar de o cariótipo clássico (47,XXY) ser encontrado em 80%-90% dos pacientes e o mosaicismo (46,XY/47,XXY) nos 10% restantes, outros cariótipos podem ser encontrados menos frequentemente. Nesse sentido, este estudo tem por finalidade descrever os possíveis cariótipos identificados nos pacientes com Síndrome de Klinefelter. Os resultados mostram que a Síndrome de Klinefelter é usualmente diagnosticada na vida adulta e caracterizada por uma heterogeneidade citogenética quanto aos cariótipos possíveis apresentados pelos pacientes afetados. A condição foi diagnosticada precocemente quando associada à anomalia dos cromossomos autossomos, excesso de cromossomos X extra ou quando foi realizado diagnóstico pré-natal por idade materna avançada. É imprescindível que os profissionais de saúde, em especial os médicos, se familiarizem mais com essa condição, pois o diagnóstico correto e precoce permite a intervenção e tratamento adequados visando melhorar a qualidade de vida desses indivíduos.
Assuntos
Trissomia , Análise Citogenética , Cariótipo , Infertilidade , Síndrome de KlinefelterRESUMO
This retrospective study demonstrates the clinical outcomes of patients with nonmosaic Klinefelter's syndrome (KS) who underwent preimplantation genetic testing (PGT) with frozen-thawed testicular spermatozoa. Microdissection testicular sperm extraction (micro-TESE) was performed for sperm retrieval. Next-generation sequencing (NGS) was conducted for embryo analysis. A total of 18 couples aged ≤35 years were included, and 22 oocyte retrieval cycles were completed. Euploidy was detected in 29 of 45 (64.4%) embryos. Additionally, the numbers of aneuploid and mosaic embryos detected were 8 (17.8%) and 8 (17.8%), respectively, regardless of a lack of sex chromosome abnormalities. Finally, 13 couples with euploid embryos completed 14 frozen embryo transfer (FET) cycles. Ten couples had clinical pregnancies, and 6 of them had already delivered 5 healthy babies and 1 monozygotic twin. There were also 4 ongoing pregnancies and 2 biochemical pregnancies, but no early pregnancy loss was reported. Based on our results, we speculate that for KS patients, when sperm can be obtained by micro-TESE, the cryopreservation strategy makes the ovarian stimulation procedure more favorable for female partners. The paternal genetic risk of sex chromosome abnormalities in their offspring is extremely low in men with KS. In addition to PGT, the intracytoplasmic sperm injection (ICSI) procedure is comparably effective but more economical for young nonmosaic KS couples. ICSI should be offered as an option for such couples, but monitoring by prenatal genetic diagnosis is recommended.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Síndrome de Klinefelter/terapia , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Indução da Ovulação/estatística & dados numéricos , Estudos Retrospectivos , Injeções de Esperma Intracitoplásmicas/métodosRESUMO
Resumen: Introducción: El síndrome de Klinefelter y sus variantes, como alteración en el número de cromosomas sexuales, se encuentra entre los trastornos del desarrollo sexual. Sus portadores manifiestan hipogonadismo hipergonadotrófico en la pubertad; las variantes severas presentan además problemas neurocognitivos y del lenguaje desde edades tempranas. Objetivo: Describir dos pacientes portadores de mal formación genital con diagnóstico genético de variantes severas de síndrome de Klinefelter; y revisar aspectos clínicos y terapéuticos. Casos Clínicos: Caso 1: Diagnóstico de genitales atípicos al nacer: Falo pequeño y corvo con meato uretral a nivel escrotal y escroto bífido. Sin otra anomalía somática, excepto sutil clinodactilia del 5 dedo. Cariotipo: 49,XXXXY. Al año de vida se reconstruyeron los genitales. Evolucionó con retraso global del desarrollo, principalmente del lenguaje, manejado con estimulación temprana kinésica y fonoaudiológica desde los 2 meses, logró integrarse en un jardín de infantes. Caso 2: Al mes de vida se constató falo pequeño y corvo severo (más de 70°), testículos en bolsa. Cariotipo: 48,XXYY. Al año de vida se corrigió malformación del pene. Evolucionó con retraso global del desarrollo, fundamentalmente en el lenguaje expresivo, y fue manejado con el equipo de estimulación temprana desde los 4 meses, logrando adaptación en un jardín de infantes. Conclusión: Las malformaciones genitales condujeron al diagnóstico de variantes severas de síndrome de Klin efelter, y fueron corregidas alrededor del año de vida. La identificación temprana de estas variantes permitió la intervención del equipo de neuroestimulación, favoreciendo el desarrollo neurocognitivo y la integración social de estos niños.
Abstract: Introduction: Among the disorders of sexual development, Klinefelter syndrome and its variants are classified as an alteration in the number of sex chromosomes. These patients show signs of hypergonadotropic hypogonadism at puberty, however cases of severe variants also present neurocognitive and language problems from an early age. Objective: To describe two patients with genital malformation with genetic diagnosis of severe variants of Klinefelter syndrome, and to review clinical and therapeutic aspects. Clinical Cases: Case 1: Diagnosis of atypical genitalia at birth: Small and curved phallus with the urethral meatus at scrotal level, and bifid scrotum. No other somatic abnormality was observed, except for subtle clinodactyly of the fifth finger. Karyotype: 49, XXXXY. At one year of life, genitalia were reconstructed. The patient presented a global developmental delay, mainly in language, which was managed with early stimulation and speech and language therapy since he was two months old. Finally, he was able to attend kindergarten. Case 2: At one month of life, a small and severe curved phallus (more than 70°) was observed, and testicles were in the scrotum. Karyotype: 48, XXYY. At one year of life, the penile malformation was corrected. The patient presented global developmental delay, mainly in expressive language which was managed with early stimulation since the age of four months, achieving kindergarten attendance. Conclusion: Genital malformations led to the diagno sis of severe variants of Klinefelter syndrome, and were corrected around the year of life. The early identification of these variants allowed the intervention of the neurostimulation team, favoring the neurocognitive development and social integration of these children.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Genitália/anormalidades , Síndrome de Klinefelter/diagnóstico , Índice de Gravidade de Doença , Síndrome de Klinefelter/patologiaRESUMO
Klinefelter syndrome (47, XXY in most cases) is a frequently underdiagnosed chromosomal anomaly associated with multiple comorbidities in adult life. Patients with Klinefelter syndrome have a higher risk of cancer. Specifically, these patients have a higher risk for mediastinal germ cell tumors. It is estimated that 8% of male patients with mediastinal tumors have Klinefelter. We report a 42-years-old male who suffered recurrent respiratory infections. During the study, a mediastinal mass was found, whose pathological study disclosed a type B thymoma. The patient had a history of infertility, high stature, gynecomastia, obesity with gynecoid distribution of body fat and testicular atrophy. A karyotype was requested (47, XXY), confirming the diagnosis of Klinefelter syndrome.
Assuntos
Humanos , Masculino , Adulto , Timoma/patologia , Neoplasias do Timo/patologia , Síndrome de Klinefelter/patologia , Timoma/diagnóstico por imagem , Neoplasias do Timo/diagnóstico , Radiografia Torácica , Tomografia Computadorizada por Raios X , Síndrome de Klinefelter/diagnóstico , Síndrome de Klinefelter/genética , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/patologiaRESUMO
Hidradenitis suppurativa (HS) is a chronic, inflammatory and painful skin disease with recurrent nodules and tracts involving the intertriginous regions. It is known that the patient with HS shows an increased risk of metabolic disorders such as diabetes, metabolic syndrome and autoimmune diseases. Klinefelter syndrome (KS) is a sex chromosomal disorder occurring in males due to an abnormality of sexual differentiation, characterized by 47, XXY karyotype. Also, KS is related with somatic comorbidities such as metabolic syndrome, autoimmune and rheumatologic disorders as HS is. We report a HS patient with KS who shows a big improvement while on tumor necrosis factor-alpha inhibitor treatment.
Assuntos
Humanos , Masculino , Adalimumab , Doenças Autoimunes , Transtornos Cromossômicos , Comorbidade , Hidradenite Supurativa , Hidradenite , Cariótipo , Síndrome de Klinefelter , Diferenciação Sexual , Dermatopatias , Fator de Necrose Tumoral alfaRESUMO
Klinefelter syndrome (KS) is characterized by small testes, gynecomastia, tall stature, and hypergonadotropic hypogonadism. This condition is associated with extra X chromosomes. It is well known that these aneuploidies predispose individuals to the development of several cancers. Moreover, there are many case reports that show KS patients to have a higher relative risk for the development of malignancy. However, incracranial germ cell tumor (ICGCT) associated with KS is very uncommon. Herein, we report delayed diagnosis of KS in a 15-year-old boy with ICGCT, embryonal carcinoma of the pineal gland, after multimodality treatment in Korea.
Assuntos
Adolescente , Humanos , Masculino , Aneuploidia , Carcinoma Embrionário , Diagnóstico Tardio , Ginecomastia , Hipogonadismo , Síndrome de Klinefelter , Coreia (Geográfico) , Neoplasias Embrionárias de Células Germinativas , Glândula Pineal , Testículo , Cromossomo XRESUMO
@#Male breast cancer (MBC), which constitutes only 1% of all breast cancer cases worldwide, is associated with mutations in the BRCA1 and BRCA2 genes, Klinefelter’s syndrome and a positive family history of breast or ovarian malignancy. Patients with MBC typically present with a palpable subareolar mass, with or without nipple involvement. MBC can be identified by mammography and/or ultrasonography. The definitive diagnosis is made through core needle biopsy and cytology. Breast cancer in men are typically low-grade, and usually estrogen- and progesterone-receptor positive. The surgical treatment of choice is usually a modified radical mastectomy. Hormone therapy, can be used as first-line treatment for hormone-receptor positive MBC, and as adjuvant or palliative therapy for advanced cases. The use of adjuvant cytotoxic chemotherapy has been shown to reduce cancer recurrence and improve overall survival. We present the case of a 51-year-old male who came in due to an enlarging right breast mass that had been removed twice in the past eight years. We were able to establish that the patient had MBC, for which he subsequently underwent a modified radical mastectomy
Assuntos
Síndrome de Klinefelter , Mastectomia Radical ModificadaRESUMO
Klinefelter syndrome a genetic disorder with various clinical manifestations. Neurological symptoms, such as seizures, are rarely reported with Klinefelter syndrome, and it response well to anti-epileptic drugs. A 5-month-old boy visited the Inha university hospital due to jerking movements and hiccups. The patient had been diagnosed with Klinefelter syndrome at birth and had a medical history of admission to the neonatal intensive care unit due to opisthotonus and ocular deviation at 26 days of age. The patient's serum testosterone level was decreased and his anti-Müllerian hormone level was increased. The brain image examination was normal and the electoencephalography and other blood test results showed no specific findings. However, after admission, the patient recurred generalized tonic-clonic-seizures recurred intermittently even after the administration of antiepileptic drugs. This paper reports a case of non-febrile seizures in a child with Klinefelter syndrome who presented with a refractory course.
Assuntos
Criança , Humanos , Lactente , Recém-Nascido , Masculino , Anticonvulsivantes , Encéfalo , Epilepsia , Testes Hematológicos , Soluço , Terapia Intensiva Neonatal , Síndrome de Klinefelter , Parto , Convulsões , TestosteronaRESUMO
In men, obesity and metabolic complications are associated with lower serum testosterone (T) and dihydrotestosterone (DHT) and an increased risk of, and mortality from, multiple chronic diseases in addition to cardiovascular disease (CVD). The causal interrelationships between these factors remain a matter of debate. In men with untreated congenital and lifelong forms of hypogonadotropic hypogonadism, there appears to be no increased risk. Men with Klinefelter's syndrome have an increased risk of various types of cancers, as well as CVD, which persist despite T therapy. In the absence of pathology of the hypothalamic-pituitary-gonadal axis, the effect of modest reductions in serum T in aging men is unclear. The prevalence of low serum T concentrations is high in men with cancer, renal disease, and respiratory disease and is likely to be an indicator of severity of systemic disease, not hypogonadism. Some population-based studies have found low serum T to be associated with a higher risk of deaths attributed to cancer, renal disease, and respiratory disease, while others have not. Although a meta-analysis of longitudinal studies has shown an association between low serum T and all-cause mortality, marked heterogeneity between studies limited a firm conclusion. Therefore, while a decrease in T particularly occurring later in life may be associated with an increase in all-cause and specific types of mortality in men, the differential effects, if any, of T and other sex steroids as compared to health and lifestyle factors are unknown at the current time.
Assuntos
Humanos , Masculino , Fatores Etários , Doenças Cardiovasculares/metabolismo , Causas de Morte , Di-Hidrotestosterona/metabolismo , Hipogonadismo/metabolismo , Síndrome de Klinefelter/metabolismo , Mortalidade , Obesidade/metabolismo , Testosterona/metabolismoRESUMO
Klinefelter syndrome (KS) is the set of symptoms that result from the presence of an extra X chromosome in males. Postnatal population-based KS screening will enable timely diagnosis of this common chromosomal disease, providing the opportunity for early intervention and therapy at the time point when they are most effective and may prevent later symptoms or complications. Therefore, through this study, we introduced a simple high-resolution melting (HRM) assay for KS screening and evaluated its clinical sensitivity and specificity in three medical centers using 1373 clinical blood samples. The HRM assay utilized a single primer pair to simultaneously amplify specific regions in zinc finger protein, X-linked (ZFX) and zinc finger protein, Y-linked (ZFY). In cases of KS, the ratios of ZFX/ZFY are altered compared to those in normal males. As a result, the specific melting profiles differ and can be differentiated during data analysis. This HRM assay displayed high analytical specificity over a wide range of template DNA amounts (5 ng-50 ng) and reproducibility, high resolution for detecting KS mosaicism, and high clinical sensitivity (100%) and specificity (98.1%). Moreover, the HRM assay was rapid (2 h per run), inexpensive (0.2 USD per sample), easy to perform and automatic, and compatible with both whole blood samples and dried blood spots. Therefore, this HRM assay is an ideal postnatal population-based KS screening tool that can be used for different age groups.
Assuntos
Humanos , Lactente , Recém-Nascido , Masculino , DNA/genética , Teste em Amostras de Sangue Seco , Cariotipagem , Síndrome de Klinefelter/diagnóstico , Fatores de Transcrição Kruppel-Like/genética , Programas de Rastreamento/métodos , Reação em Cadeia da Polimerase , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Chromosomal abnormalities are confirmed as one of the frequent causes of male infertility. The microdeletion of the azoospermia factor (AZF) region in the Y chromosome was discovered as another frequent genetic cause associated with male infertility. The aim of this study was to evaluate the frequency and type of chromosomal abnormalities and Y chromosome microdeletions in Korean infertile men. METHODS: A total of 846 infertile men with azoospermia and severe oligozoospermia were included for genetic screening. Cytogenetic analyses using G-banding and screening for Y chromosome microdeletions by multiplex PCR for AZF genes were performed. RESULTS: Chromosomal abnormalities were detected in 112 infertile men (13.2%). Of these, Klinefelter's syndrome was the most common (55.4%, 62/112), followed by balanced translocation including translocation between sex chromosome and autosome (14.3%), Yq deletion (13.4%), X/XY mosaicism with Yq deletion (12.5%), and XX male (4.5%). The overall prevalence of Y chromosome microdeletions was 9.2% (78/846). Most microdeletions were in the AZFc region (51.3%) with a low incidence in AZFa (7.7 %) and AZFb (6.4 %). Combined deletions involving the AZFbc and AZFabc regions were detected in 26.9 % and 7.7 % of men, respectively. Among the infertile men with Y chromosome microdeletions, the incidence of chromosomal abnormality was 25.6% (20/78). CONCLUSIONS: There was a high incidence (20.1%) of chromosomal abnormalities and Y chromosome microdeletions in Korean infertile men. These findings strongly suggest that genetic screening for chromosomal abnormalities and Y chromosome microdeletions should be performed, and genetic counseling should be provided before starting assisted reproductive techniques.
Assuntos
Humanos , Masculino , Azoospermia , Aberrações Cromossômicas , Análise Citogenética , Aconselhamento Genético , Testes Genéticos , Incidência , Infertilidade Masculina , Síndrome de Klinefelter , Programas de Rastreamento , Mosaicismo , Reação em Cadeia da Polimerase Multiplex , Oligospermia , Prevalência , Técnicas de Reprodução Assistida , Cromossomos Sexuais , Cromossomo YRESUMO
Les dysgonosomies sont des anomalies des chromosomes sexuels diagnostiquées sur la base du caryotype. Ce groupe de maladies chromosomiques est peu connu en Afrique sub saharienne à cause du manque d'outils diagnostiques. Dans le but de faire connaitre ce groupe d'affections et d'en faciliter le diagnostic et la prise en charge, une étude rétrospective des cas de dysgonosomies diagnostiqués au Laboratoire de Cytogénétique et de Biologie Moléculaire de la Faculté des Sciences de la Santé de Cotonou a été réalisée. Elle a couvert la période allant de janvier 1999 à septembre 2016 par exploitation des registres du Laboratoire. Les données collectées étaient épidémiologiques, cliniques et cytogénétiques. L'incidence annuelle des dysgonosomies sur la période d'étude (17 ans) était de trois cas par an avec une prévalence de 2,6 % dans ledit laboratoire. L'âge moyen des patients était de 15,16 ans avec un minimum de 02 jours et un maximum de 40 ans. La sex-ratio était de 1,08. Les motifs de demandes de caryotype les plus fréquents étaient les anomalies de développement sexuel (59,61%) et l'infertilité (15,38%). Les principales anomalies chromosomiques retrouvées étaient le syndrome de Klinefelter (n=12), le syndrome de Turner (n=6), un isochromosome du X et un syndrome XXYY. Les dysgonosomies ne sont pas rares dans la population fréquentant le Laboratoire de Cytogénétique et de Biologie Moléculaire de Cotonou et possèdent une variabilité phénotypique
Assuntos
Cariótipo Anormal , Benin , Transtornos Cromossômicos , Síndrome de Klinefelter , Síndrome de TurnerRESUMO
La existencia de una doble aneuploidía en un mismo individuo es una anomalía cromosómica poco frecuente que involucra, mayoritariamente, al par sexual y al cromosoma 21. En el presente artículo, se expone el caso clínico de un niño con la doble aneuploidía 48,XXY,+18. El fenotipo del paciente era coincidente con el síndrome de Edwards. El diagnóstico se efectuó mediante la realización del estudio citogenético de linfocitos de sangre periférica. En la bibliografía revisada, solo se han encontrado 15 casos reportados de pacientes con síndromes de Klinefelter y Edwards.
The co-existence of a double chromosomal abnormality in one individual is a rare event, even more the simultaneous presence of Klinefelter (XXY) and Edwards (trisomy 18) syndrome. The aim of this article is to report the case of a newborn with a double aneuploidy, which consists in the coexistence of Edwards and Klinefelter syndrome. The patient's phenotype correlates mainly with Edwards syndrome. The diagnosis is made by performing the cytogenetics (karyotype) of peripheral blood lymphocytes. Only 15 cases of patients with Klinefelter and Edwards syndromes had been reported in literature so far.