A Novel p.Arg179Ser (c.537 G>T) Heterozygotes Mutation on Exon 3 of SRD5A2 Gene Accompany with Biotinidase Deficiency in Case with Ambiguous External Genitalia
SRD5A2 enzimini kodlayan SRD5A2geni kromozomun 2p23 bölgesinde yerleşir. Genin kodlayan bölgesi 254 amino asitlik bir proteine çevrilen 5 ekzon bölgesi içerir. Çalışmanın amacı, belirsiz dış genitalli vakada biyotinidaz eksikliğinin eşlik ettiği kromozom 2p23 bölgesinde yerleşen SRD5A2 enzimini kodlayan SRD5A2genini değerlendirmektir. Biz belirsiz dış genitalli bir vakayı sitogenetik ve gen mutasyonu analizi için inceledik. Gen mutasyon analizi ve sitogenetik analizler sırasıyla, PCR temelli bir standart DNA sekans metodu ve uluslararası standart terminolojiye (ISCN) göre yapıldı. Biyotinidaz eksikliğinin eşlik ettiği, SRD5A2 geninin ekzon 3'ünde yeni bir heterozigot mutasyonu pArg179Ser (c.537 G>T) tespit edildi. Kromozomal analiz sonucu 46, XY'idi. Bu biyotinidaz eksikliği olan ve 5 alfa redüktaz eksikliğine neden olan SRD5A2 geninde yeni bir mutasyon R179S p.Arg179Ser (c.537 G>T) olan ilk olgudur.
Belirsiz Dış Genitalli Bir Hastada, Biotinidaz Eksikliği Eşlik Eden SRD5A2 Geninin Ekzon 3'ünde Yeni Bir p.Arg179Ser (c.537 G> T) Heterozigot Mutasyonu
The SRD5A2 gene that encodes SRD5A2 enzyme is placed on chromosome 2p23. The gene includes 5 exons that are translated into a 254-amino acid protein. To evaluate SRD5A2 gene that encodes SRD5A2 enzyme is placed on chromosome 2p23 accompany with biotinidase deficiency in case with ambiguous external genitalia. We investigated a case with ambiguous external genitalia for cytogenetic and gene mutation analysis. Gene mutation analysis and cytogenetic analysis were performed according to a standard DNA sequencing method and the present international standard nomenclature (ISCN), respectively. A Novel p.Arg179Ser (c.537 G>T) heterozygotes mutation on exon 3 of SRD5A2 gene accompany with biotinidase deficiency was detected. The chromosomal analysis result is 46, XY. This is the first case with biotinidase deficiency and novel R179S p.Arg179Ser (c.537 G>T) mutation of the SRD5A2 gene, which cause 5-alpha reductase deficiency.
___
- 1.Parisi MA, Ramsdell LA, Burns MW, et al. A Gender Assessment Team: experience with 250 patients over a period of 25 years. Genet Medicine2007;9:348-357.
- 2. Maimoun L, Philibert P, Cammas B, et al. Undervirilization in XY newborns may hide a 5?-reductase deficiency: report of three new SRD5A2 gene mutations. International Journal of Andrology 2010;33:841-847.
- 3. Berra M, Williams EL, Muroni B, et al. Recognition of 5?-reductase-2 deficiency in an adult female 46XY DSD clinic. European Journal of Endocrinology 2011;164:1019-1025.
- 4. Imperato-McGinley J, Zhu YS. Androgens and male physiology: the syndrome of 5?-reductase-2 deficiency. Mol Cell Endocrinol 2002;198:51-59
- 5. Wilson JD, Griffin JE, Russel DW. Steroid 5-?-reductase 2 deficiency. Endocrine Reviews 1993;14:577-593.
- 6. Hochberg Z, Chayen R, Reiss N, et al. Clinical, biochemical, and genetic findings in a large pedigree of male and female patients with 5 alpha-reductase 2 deficiency. Journal of Clinical Endocrinology and Metabolism 1996;81:2821-2827.
- 7. Hiort O, Willenbring H, Albers N, et al. Molecular genetic analysis and human chorionic gonadotropin stimulation tests in the diagnosis of prepubertal patients with partial 5a-reductase 2 deficiency. European Journal of Pediatrics 1996;155:445-451.
- 8. Sinnecker GH, Hiort O, Dibbelt L, et al. Phenotypic classification of male pseudohermaphroditism due to steroid 5 alpha-reductase 2 deficiency. American Journal of Medical Genetics 1996;63:223-30.
- 9. Chávez B, Ramos L, Gómez R, et al. 46,XY disorder of sexual development resulting from a novel monoallelic mutation (p.Ser31Phe) in the steroid 5?-reductase type-2 (SRD5A2) gene. Molecular Genetics & Genomic Medicine 2014;2:292-6.
- 10. Di Marco C, Bulotta AL, Varetti C, et al. Ambiguous external genitalia due to defect of 5-?-reductase in seven Iraqi patients: prevalence of a novel mutation. Gene2013;10:490-493.
- 11. Costa E, Domenice S, Sircili M, et al. Inacio M, Mendonca BB. DSD due to 5 alpha reductase 2 deficiency: from diagnosis to long term outcome. Seminars in Reproductive Medicine 2012;30:427-431.
- 12. Boudon C, Lobaccaro JM, Lumbroso S, et al. A new deletion of the 5 alpha-reductase type 2 gene in a Turkish family with 5 alpha-reductase deficiency. Clin Endocrinol 1995 Aug;43: 183-8.
- 13. Adiyaman PB, Öcal G, Çetinkaya E, et al. 5? steroid reductase deficiency in Turkey. Pediatric Endocrinology Reviews. 2006;3:462-469.
- 14. Cohen-Kettenis PT. Gender change in 46,XY persons with 5alpha-reductase-2 deficiency and 17-betahydroxysteroid dehydrogenase-3 deficiency. Archives of Sexual Behavior 2005;34:399-410.
- 15. Imperato-McGinley J, Guerrero L, Gautier T, et al. Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science1974;27:1213-1215.
- 16. Labrie F, Sugimoto Y, Luu-The V, et al. Structure of human type II 5 alphareductase gene. Endocrinology 1992;131:1571-1573.
- 17. Bertha C, Luis R, Rita G, et al. 46,XY disorder of sexual development resulting from a novel monoallelic mutation (p.Ser31Phe) in the steroid 5?-reductase type-2 (SRD5A2) gene. Molecular Genetics & Genomic Medicine2014;2:292-296.
- 18. Wilson JD. Androgens, androgen receptors, and male gender role behavior. Hormones and Behavior2001;40:358-366.
- 19. Carla C, Cíntia CC, Alda MC, et al. The dilemma of the gender assignment in a Portuguese adolescent with disorder of sex development due to 17?-hydroxysteroid-dehydrogenase type 3 enzyme deficiency. Endocrinol Diabetes Metab Case Reports 2014; 2014:140064.
- 20. Imperato-McGinley J, Peterson RE, Gautier T, et al. Androgens and the evolution of male-gender identity among male pseudohermaphrodites with 5?-reductase deficiency. The New England Journal of Medicine 1979;31:1233-1237.
- 21. Soheir S, Abou E, Maha A, et al. Genetic evaluation of children with ambiguous genitalia. Menoufia Medical Journal 2016;29:79-88.