Ruken YILDIRIM, Edip ÜNAL, YUSUF KENAN HASPOLAT

Jinekomasti İle Tanı Alan 46,Xx Testiküler Cinsel Gelişim Bozukluğu Olgusu

46, XX Testiküler bozukluk, fenotipi erkek olan bir bireyde karyotip analizinin 46,XX olmasıyla karakterize oldukça nadir görülen bir bozukluktur. Puberte sonrası jinekomasti, küçük testisler ve azospermiye bağlı sterilite görülebilir, ancak penis boyu ve pubik kıllanma genellikle normaldir. Olgularda nadiren dış genital yapının yetersiz virilizasyonu; hipospadias, inmemiş testis, ya da ambigius genitaleye kadar değişen bulgular görülür. Kısa boy ve normal zihinsel gelişim 46, XX testiküler bozukluğun diğer klinik özellikleridir. On üç buçuk yaşında erkek hasta memede büyüme şikayeti ile polikliniğimize başvurdu. Fizik muayenesinde, boy kısalığı (10. Persantil), jinekomasti ve küçük testisler mevcuttu. Laboratuvar incelemesinde LH:24.32 mIU/ml, FSH:34.26 mIU/ml, Estradiol:34.53 pg/ml, Total Testosteron:1.62 ng/ml saptanması üzerine hastadan karyotip analizi istendi ve 46 XX olarak rapor edildi. SRY gen analizinin pozitif olması ile hastaya 46, XX testiküler cinsel gelişim bozukluğu tanısı kondu. Puberte döneminde jinekomasti ile başvuran olgularda hipergonadotropik hipogonadizm saptandığında kromozom analizinin yapılmasının önemini vurgulamak için bu olgu sunuldu.

Diagnosed with Gynecomastia Field of 46, Xx Testicular Sexual Developmental Disorder Cases

46, XX testicular disorder is a rare disorder characterized by karyotype analysis being 46,XX in an individual whose phenotype is male. Gynecomastia after puberty, small testes and sterility due to azoospermia may occur, but penile length and pubic hair are usually normal. In rare cases, inadequate virilization of the external genitalia; hypospadias, undescended testis, or ambigius genitalia could be seen. Short stature and normal mental development are other clinical features of 46, XX testicular disorder. A 13 1/2 old male patient presented to our outpatient clinic with the complaint of gynaecomastia. İn the physical examination revealed that short stature (10th percentile), gynecomastia and small testes. On laboratory examination, LH: 24.32 mIU / ml, FSH: 34.26 mIU / ml, Estradiol: 34.53 pg / ml, Total Testosterone: 1.62 ng / ml, after this results karyotype analysis was performed and reported as 46 XX. With positive SRY gene analysis, the patient was diagnosed with 46, XX testicular sexual development disorder. This case is presented to emphasize the importance of chromosome analysis when hypergonadotropic hipogonadism is detected in patients presenting with gynecomastia during puberty.

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