Alvarez-Nava F, González-Ferrer S, Soto M
Unidad de Genética Medica, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
Invest Clin. 1998 Dec;39(4):273-92.
Abnormalities of sexual differentiation (ASD) represent a group of entities, heterogeneous in their etiopathogenesis and clinical manifestations. In order to characterize and analyze the epidemiologic, clinical, endocrine and genetic aspects of patients with ASD consulting UGM-LUZ between 1971-1996, the families that had at least one of its members affected were evaluated. Strict diagnostic criteria to each entity were applied. Cytogenetic, hormonal, radiological, echographic and anatomopathological evaluations were done in each patient. From 391 families, 429 patient consulted with ASD. They represent 5.4% of the patient who consulted to UGM-LUZ in the same period. 214 (50%) patients with definitive diagnosis of ASD were identified to fill the established inclusion criteria. The distribution was the following: 139 with anomalies of the sexual chromosomes; 36 with congenital adrenal hyperplasia; 21 with complete androgen insensitivity syndrome; 14 with mixed gonadal dysgenesis; and 4 with true hermaphroditism. 183 (42.7%) patients with male pseudohermaphroditism and 17 (3.9%) with female pseudohermaphroditism were diagnosed as they did not fulfill the established diagnostic criteria. 15 (3.4%) patients presented ASD associated to a polymalformative syndrome. The ASD are very complex entities, they need the participation of an interdisciplinary team for their diagnosis and management process.
性分化异常(ASD)是一组在病因发病机制和临床表现上具有异质性的疾病。为了描述和分析1971年至1996年间在UGM-LUZ就诊的ASD患者的流行病学、临床、内分泌和遗传学特征,对至少有一名成员患病的家庭进行了评估。对每个疾病实体都应用了严格的诊断标准。对每位患者进行了细胞遗传学、激素、放射学、超声和解剖病理学评估。在391个家庭中,有429名患者因ASD前来就诊。他们占同期在UGM-LUZ就诊患者的5.4%。确定有214名(50%)患者确诊为ASD,符合既定的纳入标准。分布情况如下:139例性染色体异常;36例先天性肾上腺皮质增生;21例完全性雄激素不敏感综合征;14例混合性性腺发育不全;4例真两性畸形。183例(42.7%)男性假两性畸形和17例(3.9%)女性假两性畸形患者因不符合既定诊断标准而被诊断。15例(3.4%)患者的ASD与多畸形综合征相关。ASD是非常复杂的疾病实体,在其诊断和管理过程中需要多学科团队的参与。