Opitz J M, Pallister P D
Am J Med Genet. 1979;4(4):333-43. doi: 10.1002/ajmg.1320040404.
The history of gonadal by dysgenesis cautions against overinterpretation of data: The streak gonads are neither the result of dysgenesis nor of embryonic origin but represent late fetal/neonatal degeneration; the X-chromatin-negative character of the buccal smear and the frequency of color vision defects did not indicate male sex in the Ullrich-Turner syndrome but rather an XO constitution; severity of dysgenesis did not correlate with risk of gonadal neoplasia but with genotype; the gonadal lesion in the Ullrich-Turner syndrome was not due to a pituitary defect but a primary ovarian lesion; patients with the Noonan syndrome do not have the Turner phenotype. The concept of gonadal dysgenesis, introduced to Kermauner in 1912, has outlived its usefulness. Improved methods of phenotype analysis, family studies, and endocrine and cytogenetic methods have showen it to be causally and pathogenetically heterogeneous and have contributed to a better identification and delineation of the several different genetic entities which it formerly comprised.
条索状性腺既不是发育不全的结果,也不是胚胎起源,而是代表胎儿晚期/新生儿期的退化;口腔涂片的X染色质阴性特征和色觉缺陷的频率在乌尔里希-特纳综合征中并不表明为男性,而是XO核型;发育不全的严重程度与性腺肿瘤的风险无关,而与基因型有关;乌尔里希-特纳综合征中的性腺病变不是由于垂体缺陷,而是原发性卵巢病变;努南综合征患者没有特纳表型。1912年引入克尔马纳的性腺发育不全概念已经过时。表型分析、家系研究以及内分泌和细胞遗传学方法的改进表明,它在病因和发病机制上是异质性的,并且有助于更好地识别和描述它以前所包含的几种不同的遗传实体。