Complete androgen insensitivity syndrome and discordant Mullerian remnants: two cases with novel mutation in the androgen receptor


GUVEN A., DURSUN F., Ozkanli S. Ş. , GUCLUER B., KURU L. I.

JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM, cilt.26, ss.909-914, 2013 (SCI İndekslerine Giren Dergi)

  • Cilt numarası: 26
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1515/jpem-2013-0047
  • Dergi Adı: JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM
  • Sayfa Sayısı: ss.909-914

Özet

Complete androgen insensitivity syndrome (CAIS) associated with Mullerian remnant is rare during childhood. The Mullerian system usually regresses because of the presence of the anti-Mullerian hormone (AMH) originating from the Sertoli cells of the gonads. Rarely, residual Mullerian structures may exist. We present two cases from the same family, raised as females. They were 12 and 18 years old, respectively, and they had Tanner V breast development but Tanner I-II pubic hair. The older patient had primary amenorrhea. Both have a 46, XY genotype. Pelvic ultrasonography revealed no uterus and ovaries. The patients underwent bilateral laporoscopic gonadectomy. Both had residual Mullerian structures. Mutation analyses were performed, and both patients were found to be carrying a point mutation in exon 4 of the AR gene consisting of a G nucleotide deletion at position c. 1890delG, followed by a frame-shift mutation and a stop codon. This mutation has not been described yet in the literature. Although the association with CAIS and Mullerian remnant is rare, no genetic defect specific to androgen insensitivity with Mullerian remnants has been identified so far.