Kamijo H, Narita O
Department of OB/GYN, Narita Hospital.
Nihon Rinsho. 1997 Nov;55(11):2925-9.
Patients with female pseudohermaphroditism have female internal genitalia and karyotype (XX) and various degree of external genitalia virilization. External genitalia is musculinized congenitally when female fetus is exposed to excess androgenic environment. Congenital adrenal hyperplasia (CAH), mostly 21-hydroxylase deficiency, is the most common cause. Maternal androgen excess due to maternal ovarian tumor or drug intake also causes female pseudohermaphroditism. Combination of hormonal therapy and surgical correction is required for CAH. When appropriate treatments were given, normal puberty, fertility and child bearing are possible. HLA typing in patient's family is useful for identifying heterozygote and homozygote, because of close linkage of 21-hydroxylase gene and HLA gene. Prenatal diagnosis and genetic diagnosis for female pseudohermaphroditism due to 21-hydroxylase deficiency can be performed, however prenatal treatment is not completely established.
女性假两性畸形患者具有女性内生殖器和核型(XX),外生殖器有不同程度的男性化。当女性胎儿暴露于过量雄激素环境时,外生殖器会先天性男性化。先天性肾上腺皮质增生症(CAH),主要是21-羟化酶缺乏,是最常见的原因。母体卵巢肿瘤或药物摄入导致的母体雄激素过多也会引起女性假两性畸形。CAH需要激素治疗和手术矫正相结合。给予适当治疗后,有可能实现正常的青春期、生育能力和妊娠。由于21-羟化酶基因与HLA基因紧密连锁,对患者家族进行HLA分型有助于识别杂合子和纯合子。对于21-羟化酶缺乏导致的女性假两性畸形,可以进行产前诊断和基因诊断,然而产前治疗尚未完全确立。