Familial complete androgen insensitivity syndrome (CAIS): a case series of three siblings with emphasis on diagnosis, management, and psychosocial outcomes.

OBJECTIVE

To highlight the clinical presentation, diagnostic challenges, and management of Complete Androgen Insensitivity Syndrome (CAIS) through a case series of three sisters, emphasizing the importance of early recognition and multidisciplinary care.

METHODS

Three phenotypically female siblings with primary amenorrhea underwent hormonal evaluation, imaging, and genetic testing. Hormonal studies revealed elevated serum testosterone levels, while imaging confirmed the absence of a uterus and ovaries. Karyotyping identified a 46, XY genotype with the presence of the SRY gene, confirming CAIS.

RESULTS

All three sisters exhibited normal female secondary sexual characteristics despite a 46, XY karyotype. The absence of Müllerian structures on imaging and elevated testosterone levels guided the diagnosis. Multidisciplinary management, including hormonal therapy, psychological support, and surgical planning, was discussed.

CONCLUSION

CAIS should be considered in individuals with primary amenorrhea and normal female phenotype. Early diagnosis is crucial for appropriate management, including psychological counseling, gonadectomy when indicated, and hormonal therapy to optimize long-term health and quality of life.