Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2013 Mar 1;54(2):538-40. doi: 10.3349/ymj.2013.54.2.538.
Klinefelter syndrome is the most common type of genetic cause of hypogonadism. This syndrome is characterized by the presence of 1 or more extra X chromosomes. Phenotype manifestations of this syndrome are small testes, fibrosis of the seminiferous tubules, inability to produce sperm, gynecomastia, tall stature, decrease of serum testosterone and increases of luteinizing hormone and follicle stimulating hormone. Most patients with Klinefelter syndrome are tall, with slender body compositions, and reports of obesity are rare. We report the case of a 35-yr-old man with hypogonadism and morbid obesity and diabetes mellitus. He had gynecomastia, small testes and penis, very sparse body hair and his body mass index was 44.85. He did not report experiencing broken voice and was able to have erections. We conducted a chromosome study. His genotype was 47,X,+t(X;X)(p22.3;p22.3)del(X)(p11.23q11.2). In this case, the patient was diagnosed as Klinefelter syndrome. He showed rare phenotypes like morbid obesity and average height and the phenotype may be caused by the karyotype and the excess number of X chromosome. Further studies of the relationship between chromosomes and phenotype are warranted.
克氏综合征是引起性腺功能减退症的最常见遗传病因。该综合征的特征是存在 1 个或多个额外的 X 染色体。该综合征的表型表现为睾丸小、曲细精管纤维化、无法产生精子、男性乳房发育、身材高大、血清睾酮降低和黄体生成素和卵泡刺激素升高。大多数克氏综合征患者身材高大,身体成分细长,肥胖的报道很少见。我们报告了 1 例 35 岁性腺功能减退、肥胖症和糖尿病患者的病例。他有男性乳房发育、睾丸小和阴茎小、体毛非常稀疏,他的体重指数为 44.85。他没有报告过声音变粗的情况,并且能够勃起。我们进行了染色体研究。他的基因型为 47,X,+t(X;X)(p22.3;p22.3)del(X)(p11.23q11.2)。在这种情况下,患者被诊断为克氏综合征。他表现出罕见的表型,如病态肥胖和平均身高,表型可能是由染色体核型和额外的 X 染色体数量引起的。需要进一步研究染色体和表型之间的关系。