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原发性闭经女性的临床特征与细胞遗传学相关性

Clinical profile and cytogenetic correlations in females with primary amenorrhea.

作者信息

Chandel Divya, Sanghavi Priyanka, Verma Ramtej

机构信息

Department of Zoology, BioMedical Technology and Human Genetics, Gujarat University, Ahmedabad, India.

出版信息

Clin Exp Reprod Med. 2023 Sep;50(3):192-199. doi: 10.5653/cerm.2023.05848. Epub 2023 Jun 13.

Abstract

OBJECTIVE

This study was conducted to investigate chromosomal abnormalities and their correlations with clinical and radiological findings in females with primary amenorrhea (PA).

METHODS

Detailed forms were recorded for 470 females, including the construction of three-generation pedigrees. Peripheral venous blood was drawn, with informed consent, for cytogenetic analysis.

RESULTS

An abnormal karyotype was found in 16.38% of participants. The incidence of structural abnormalities (6.8%) exceeded that of numerical abnormalities (6.15%). Turner syndrome represented 45% of all numerical abnormalities. Furthermore, the Y chromosome was detected in 5% of females with PA. Among the structural chromosomal abnormalities detected (n=32) were mosaicism (25%), deletions (12.5%), isochromosomes (18.75%), fragile sites (3.12%), derivatives (3.12%), marker chromosomes (3.12%), and normal variants (29.125%). An examination of secondary sexual characteristics revealed that 29.6% of females had a complete absence of breast development, 29.78% lacked pubic hair, and 36.88% exhibited no axillary hair development. Radiological findings revealed that 51.22% of females had a hypoplastic uterus and 26.66% had a completely absent uterus. Abnormal ovarian development, such as the complete absence of both ovaries, absence of one ovary, one absent and other streak, or both streak ovaries, was observed in 69.47% of females with PA. Additionally 43.1%, 36.1%, 67.4%, and 8% of females had elevated levels of serum follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and prolactin, respectively.

CONCLUSION

This study underscores the importance of karyotyping as a fundamental diagnostic tool for assessing PA. The cytogenetic correlation with these profiles will aid in genetic counseling and further management of the condition.

摘要

目的

本研究旨在调查原发性闭经(PA)女性的染色体异常情况及其与临床和影像学表现的相关性。

方法

为470名女性记录详细表格,包括构建三代家系。在获得知情同意后采集外周静脉血进行细胞遗传学分析。

结果

16.38%的参与者发现核型异常。结构异常的发生率(6.8%)超过数目异常(6.15%)。特纳综合征占所有数目异常的45%。此外,在PA女性中5%检测到Y染色体。在检测到的结构染色体异常中(n = 32),有嵌合体(25%)、缺失(12.5%)、等臂染色体(18.75%)、脆性位点(3.12%)、衍生染色体(3.12%)、标记染色体(3.12%)和正常变异(29.125%)。对第二性征的检查显示,29.6%的女性完全没有乳房发育,29.78%没有阴毛,36.88%没有腋毛发育。影像学检查结果显示,51.22%的女性子宫发育不全,26.66%的女性子宫完全缺失。在69.47%的PA女性中观察到卵巢发育异常,如双侧卵巢完全缺失、一侧卵巢缺失、一侧缺失另一侧条索状或双侧条索状卵巢。此外,43.1%、36.1%、67.4%和8%的女性血清促卵泡生成素、促黄体生成素、促甲状腺激素和催乳素水平升高。

结论

本研究强调了核型分析作为评估PA的基本诊断工具的重要性。这些特征的细胞遗传学相关性将有助于遗传咨询和该疾病的进一步管理。

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