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A Novel Mutation of the Steroid 5-Alpha Reductase Type 2 (SRD5A2) Gene in a Korean Newborn with Ambiguous Genitalia

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키워드

주제분류소아과학

초록

The term “disorders of sex development” (DSD) includes congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. Steroid 5-alpha reductase type 2 deficiency (5α-RD2) is an uncommon autosomal recessive disorder of sexual differentiation. It results from impaired conversion of testosterone (T) to dihydrotestosterone (DHT) due to mutations in the steroid 5-alpha reductase type 2 (SRD5A2) gene. It is characterized by a lack of masculinization in XY individuals due to failure to convert testosterone to dihydrotestosterone. More than 40 mutations have been reported in all five exons of the SRD5A2 gene. Here, we report on a 17-day-old Korean newborn who was confirmed to have 5α-RD2 by SRD5A2 gene analysis. He manifested micropenis, hypospadia and bilateral cryptorchidism without skin hyperpigmentation. T/DHT ratio after human chorionic gonadotropin (hCG) stimulation was slightly increased and genetic analysis of SRD5A2 revealed compound heterozygous mutations, c.657C˃G (p.Phe219Leu) and c.656del (p.Phe219SerfsX60), the former of which is a novel mutation. We report a novel SRD5A2 gene mutation in a Korean newborn with 5α-RD2.

Abstract

The term “disorders of sex development” (DSD) includes congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. Steroid 5-alpha reductase type 2 deficiency (5α-RD2) is an uncommon autosomal recessive disorder of sexual differentiation. It results from impaired conversion of testosterone (T) to dihydrotestosterone (DHT) due to mutations in the steroid 5-alpha reductase type 2 (SRD5A2) gene. It is characterized by a lack of masculinization in XY individuals due to failure to convert testosterone to dihydrotestosterone. More than 40 mutations have been reported in all five exons of the SRD5A2 gene. Here, we report on a 17-day-old Korean newborn who was confirmed to have 5α-RD2 by SRD5A2 gene analysis. He manifested micropenis, hypospadia and bilateral cryptorchidism without skin hyperpigmentation. T/DHT ratio after human chorionic gonadotropin (hCG) stimulation was slightly increased and genetic analysis of SRD5A2 revealed compound heterozygous mutations, c.657C˃G (p.Phe219Leu) and c.656del (p.Phe219SerfsX60), the former of which is a novel mutation. We report a novel SRD5A2 gene mutation in a Korean newborn with 5α-RD2.

참고문헌 (12)

  1. Choi JH, "Molecular analysis of the AR and SRD5A2 genes in patients with 46,XY disorders of sex development", J Pediatr Endocrinol Metab, 21, pp.545~553 (2008)
  2. Chan AO, "Diagnosis of 5alpha-reductase 2 deficiency: a local experience", Hong Kong Med J, 15, pp.130~135 (2009)
  3. Mendonca BB, "46,XY disorders of sex development (DSD)", Clin Endocrinol (Oxf), 70, pp.173~187 (2009)
  4. Kim SH, "A novel frameshift mutation in the 5alpha-reductase type 2 gene in Korean sisters with male pseudohermaphroditism", Fertil Steril, 85, pp.750~ (2006)
  5. Allen L, "Disorders of sexual development", Obstet Gynecol Clin North Am, 36, pp.25~45 (2009)
  6. Bentz EK, "A common polymorphism of the SRD5A2 gene and transsexualism", Reprod Sci, 14, pp.705~709 (2007)
  7. Sahu R, "Genetic analysis of the SRD5A2 gene in Indian patients with 5alpha-reductase deficiency", J Pediatr Endocrinol Metab, 22, pp.247~254 (2009)
  8. Mieszczak J, "Assignment of the sex of rearing in the neonate with a disorder of sex development", Curr Opin Pediatr, 21, pp.541~547 (2009)
  9. Kojima Y, "Long-term physical, hormonal, and sexual outcome of males with disorders of sex development", J Pediatr Surg, 44, pp.1491~1496 (2009)
  10. Chavhan GB, "Imaging of ambiguous genitalia: classification and diagnostic approach", Radiographics, 28, pp.1891~1904 (2008)
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  12. Vilain E, "Disorders of sex development. In:Pediatric endocrinology and inborn errors of metabolism", pp.545~546 (2009), McGraw-Hill

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