Lara Orejas E, Golmayo Gaztelu L, Núñez Estevez M, San Román Cos-Gayón M A, Alonso Blanco M, Barrio Castellanos R
Servicios de Pediatría, Hospital Universitario Ramón y Cajal, Madrid, Spain.
An Pediatr (Barc). 2008 Feb;68(2):140-2. doi: 10.1157/13116229.
There is wide variation in the clinical expression of 45,X/46,XY mosaicism. Ninety percent of prenatally diagnosed boys have normal male phenotype at birth, while those diagnosed postnatally show a wide spectrum of phenotypes, ranging from Turner syndrome, mixed gonadal dysgenesis, and male pseudohermaphroditism to apparent normality. We report the clinical, cytogenetic, endocrinologic and histologic findings in three boys with an apparently normal male phenotype and 45,X/46,XY mosaicism who were diagnosed postnatally because of their short stature. With the exception of one patient with Turner stigmata, no other abnormal features were found. No correlation between the proportion of 45,X/46,XY cell lines in blood, gonads and phenotype was found. Both prenatally and postnatally diagnosed boys with normal male phenotype must be followed-up because they can develop late-onset abnormalities, such as dysgenetic testes leading to infertility or neoplastic transformation, and short stature, which could be improved with growth hormone therapy.
45,X/46,XY嵌合体的临床表型存在很大差异。产前诊断的男孩中有90%出生时具有正常男性表型,而产后诊断的男孩则表现出广泛的表型谱,从特纳综合征、混合型性腺发育不全、男性假两性畸形到外观正常。我们报告了三名具有明显正常男性表型且因身材矮小而产后诊断为45,X/46,XY嵌合体的男孩的临床、细胞遗传学、内分泌学和组织学检查结果。除一名有特纳体征的患者外,未发现其他异常特征。未发现血液、性腺中45,X/46,XY细胞系比例与表型之间存在相关性。产前和产后诊断的具有正常男性表型的男孩均必须进行随访,因为他们可能会出现迟发性异常,如导致不育或肿瘤转化的发育不全睾丸,以及身材矮小,生长激素治疗可能会改善身材矮小的情况。