medigraphic.com
SPANISH

Revista Mexicana de Urología

Organo Oficial de la Sociedad Mexicana de Urología
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2021, Number 3

Next >>

Rev Mex Urol 2021; 81 (3)

Chromosomal and SRY gene findings by FISH in patients with disorders of sexual development

Herrera LA, Zarante I, Clavijo A, Suárez F, Rojas A, Pérez J, Céspedes C, Forero C, Fernández N, Bolívar J, Moreno-Niño O
Full text How to cite this article

Language: English
References: 23
Page: 1-12
PDF size: 321.06 Kb.


Key words:

Disorders of sexual development, Karyotype, FISH, SRY gene, chromosomal mosaicism, Isodicentric Y chromosome.

ABSTRACT

Objective: Disorders of sexual development are a group of congenital diseases that affect the normal formation of genital structures. Within the pathophysiologic mechanisms described, there are genetic factors caused by chromosomal or sex-determining gene alterations. Therefore, chromosomal analysis is an essential priority in the diagnostic approach. Alterations in the chromosomes and the SRY gene as a cause of disorder of sexual development was analyzed herein.
Material and methods: G or R-banding karyotype and FISH analyses for the SRY gene were performed in lymphocytes, gonadal tissue, and scrotal tissue in twelve cases, three cases, and one case, respectively. The clinical information was obtained from the patients’ medical reports.
Results: In 9 (73%) cases, the assigned sex was male, and in 3 (27%) cases, it was female. Karyotype 46,XY was found in 8 (66%) cases, 46,XX in 2 (17%) cases, and mosaic karyotype in 2 (17%) cases with idic(Y). A single case of gonadal tissue showed mosaicism due to the presence of a tetraploid cell line. The most common clinical diagnosis was abnormal genital differentiation in 8 (67%) cases, followed by hypospadias in 5 (41.7%) cases.
Conclusions: The results show the importance of applying different cytogenetic tests in making the diagnosis, and the need for a multidisciplinary team to address the disorder.


REFERENCES

  1. García-Acero M, Moreno O, Suárez F, Rojas A. Disorders of Sexual Development: Current Status and Progress in the Diagnostic Approach. CUR. 2019;13(4):169–78. doi: 10.1159/000499274

  2. Hughes IA. Disorders of sex development: a new definition and classification. Best Pract Res Clin Endocrinol Metab. 2008;22(1):119–34. doi: 10.1016/j.beem.2007.11.001

  3. Achermann J, Hughes IA. Sexual Dysfunction in Men and Women. In: Williams Texbook of Endocrinology. 13th ed. 2016. p. 785–830.

  4. Eid W, Biason-Lauber A. Why boys will be boys and girls will be girls: Human sex development and its defects. Birth Defects Research Part C: Embryo Today: Reviews. 2016;108(4):365–79. doi: https://doi.org/10.1002/bdrc.21143

  5. Zarante I, Franco L, López C, Fernández N. Frequencies of congenital malformations: assessment and prognosis of 52,744 births in three cities of Colombia. Biomédica. 2010;30(1):65– 71. doi: 10.7705/biomedica.v30i1.154

  6. Brain CE, Creighton SM, Mushtaq I, Carmichael PA, Barnicoat A, Honour JW, et al. Holistic management of DSD. Best Pract Res Clin Endocrinol Metab. 2010;24(2):335–54. doi: 10.1016/j.beem.2010.01.006

  7. Mouriquand PDE, Gorduza DB, Gay C-L, Meyer-Bahlburg HFL, Baker L, Baskin LS, et al. Surgery in disorders of sex development (DSD) with a gender issue: If (why), when, and how? J Pediatr Urol. 2016;12(3):139–49. doi: 10.1016/j.jpurol.2016.04.001

  8. Fernandez N, Moreno O, Rojas A, Céspedes C, Forero C, Mora L, et al. Manejo transdisciplinario de pacientes con desórdenes del desarrollo sexual en Colombia. Limitantes para un manejo oportuno e integral. Urología Colombiana. 2017;26(3):164– 8. doi: 10.1016/j.uroco.2016.06.004

  9. Achermann JC, Domenice S, Bachega TASS, Nishi MY, Mendonca BB. Disorders of sex development: effect of molecular diagnostics. Nat Rev Endocrinol. 2015;11(8):478–88. doi: 10.1038/nrendo.2015.69

  10. Witchel SF. Disorders of sex development. Best Pract Res Clin Obstet Gynaecol. 2018;48:90– 102. doi: 10.1016/j.bpobgyn.2017.11.005

  11. Clouston H. Lymphocyte culture. In: Human Cytogenetics constitutional analyses. 3rd ed. London: Rooney DE Editor; 2001.

  12. McGowan-Jordan J, Simons A, Schmid M, Karger S. ISCN 2016 | Karger Book. 2016. [accessed 3 Jun 2021] Available from: https:// www.karger.com/Book/Home/271658

  13. Olshan J, Eimicke T, Belfort E. Gender Incongruity in Children With and Without Disorders of Sexual Differentiation. Endocrinol Metab Clin North Am. 2016;45(2):463–82. doi: 10.1016/j.ecl.2016.02.001

  14. Rodriguez-Buritica D. Overview of genetics of disorders of sexual development. Curr Opin Pediatr. 2015;27(6):675–84. doi: 10.1097/ MOP.0000000000000275

  15. García-Acero M, Molina M, Moreno O, Ramirez A, Forero C, Céspedes C, et al. Gene dosage of DAX-1, determining in sexual differentiation: duplication of DAX-1 in two sisters with gonadal dysgenesis. Mol Biol Rep. 2019;46(3):2971–8. doi: 10.1007/s11033-019-04758-y

  16. Kashimada K, Koopman P. Sry: the master switch in mammalian sex determination. Development. 2010;137(23):3921–30. doi: 10.1242/dev.048983

  17. McClelland K, Bowles J, Koopman P. Male sex determination: insights into molecular mechanisms. Asian J Androl. 2012;14(1):164– 71. doi: 10.1038/aja.2011.169

  18. Farrugia MK, Sebire NJ, Achermann JC, Eisawi A, Duffy PG, Mushtaq I. Clinical and gonadal features and early surgical management of 45,X/46,XY and 45,X/47,XYY chromosomal mosaicism presenting with genital anomalies. J Pediatr Urol. 2013;9(2):139–44. doi: 10.1016/j. jpurol.2011.12.012

  19. Chang HJ, Clark RD, Bachman H. The phenotype of 45,X/46,XY mosaicism: an analysis of 92 prenatally diagnosed cases. Am J Hum Genet. 1990;46(1):156–67.

  20. Abacı A, Çatlı G, Berberoğlu M. Gonadal malignancy risk and prophylactic gonadectomy in disorders of sexual development. J Pediatr Endocrinol Metab. 2015;28(9–10):1019–27. doi: 10.1515/jpem-2014-0522

  21. Huang H, Wang C, Tian Q. Gonadal tumour risk in 292 phenotypic female patients with disorders of sex development containing Y chromosome or Y-derived sequence. Clin Endocrinol (Oxf). 2017;86(4):621–7. doi: 10.1111/cen.13255

  22. Guedes AD, Bianco B, Lipay MVN, Brunoni D, Chauffaille M de L, Verreschi ITN. Determination of the sexual phenotype in a child with 45,X/46,X,Idic(Yp) mosaicism: Importance of the relative proportion of the 45,X line in gonadal tissue. American Journal of Medical Genetics Part A. 2006;140A(17):1871– 5. doi: https://doi.org/10.1002/ajmg.a.31363

  23. Acero MG, Moreno O, Gutiérrez A, Sánchez C, Cataño JG, Suárez-Obando F, et al. Novel homozygous mutation in a colombian patient with persistent müllerian duct syndrome: expanded phenotype. Int Braz J Urol. 2019;45(5):1064–70. doi: 10.1590/S1677-5538. IBJU.2018.0808




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Mex Urol. 2021;81