A case of 45,X male: genetic reevaluation and hormonal and metabolic follow-up in adult age

Fertil Steril. 2008 Nov;90(5):2011.e17-21. doi: 10.1016/j.fertnstert.2008.07.1723. Epub 2008 Sep 7.

Abstract

Objective: To report a case of a 45,X man, a rare condition with a clinical course that has not been dealt with by any previous article in the literature.

Design: Case report.

Setting: University Genetic Center and Endocrine Clinic.

Patient(s): A 41-year-old man, already known by our genetics center for a 45,X chromosome constitution and a normal male differentiation, came back with requests on his sexual and fertility potential. Twenty-one years ago, high-resolution analysis of prometaphase chromosomes revealed additional euchromatic material on a 15-p chromosome, and in situ hybridization with Y-specific probe pDP105 gave positive signal on 15p11.2, suggesting a t(Yp;15p) translocation.

Intervention(s): Fluorescence in situ hybridization analyses on metaphase chromosomes, standard oral glucose tolerance test, dynamic hormone assays, semen analysis, and dual-energy x-ray absorptiometry.

Main outcome measure(s): Reexamination at clinical, genetic, hormonal, and metabolic level.

Result(s): The derivative chromosome 15 was characterized as der(15)(Ypter-->q11.21::15p11.2-->qter). The patient's findings satisfied the criteria of the metabolic syndrome. Hypergonadotropinemic hypotestosteronemia was diagnosed.

Conclusion(s): Our study offers new insights into the natural history of this condition and suggests that hypogonadism could play a role in the development of metabolic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Blood Glucose / metabolism
  • Bone Density / genetics
  • Chromosomes, Human, Pair 15*
  • Chromosomes, Human, X*
  • Chromosomes, Human, Y*
  • Fertility / genetics*
  • Glucose Tolerance Test
  • Hormones / blood
  • Humans
  • Hypogonadism / complications
  • Hypogonadism / genetics*
  • Hypogonadism / metabolism
  • Hypogonadism / pathology
  • In Situ Hybridization, Fluorescence
  • Male
  • Metabolic Syndrome / genetics*
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / pathology
  • Semen Analysis
  • Testis / pathology
  • Translocation, Genetic*

Substances

  • Blood Glucose
  • Hormones