46,XX DSD and Antley-Bixler syndrome due to novel mutations in the cytochrome P450 oxidoreductase gene

• Main Author: Guaragna-Filho,Guilherme
• Publication Date: 2012
• Other Authors: Castro,Carla Cristina Telles de Sousa, De Carvalho,Rodrigo Ribeiro, Coeli,Fernanda Borchers, Ferraz,Lúcio Fábio Caldas, Petroli,Reginaldo José, De Mello,Maricilda Palandi, Sewaybricker,Letícia Esposito, Lemos-Marini,Sofia Helena Valente, D'Souza-Li,Lilia Freire Rodrigues, Miranda,Márcio Lopes, Maciel-Guerra,Andréa Trevas, Guerra-Junior,Gil
• Format: Article
• Language: eng
• Source: Arquivos Brasileiros de Endocrinologia & Metabologia (Online)
• Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302012000800020

Deficiency of the enzyme P450 oxidoreductase is a rare form of congenital adrenal hyperplasia with characteristics of combined and partial impairments in steroidogenic enzyme activities, as P450 oxidoreductase transfers electrons to CYP21A2, CYP17A1, and CYP19A1. It results in disorders of sex development and skeletal malformations similar to Antley-Bixley syndrome. We report the case of a 9-year-old girl who was born with virilized genitalia (Prader stage V), absence of palpable gonads, 46,XX karyotype, and hypergonadotropic hypogonadism. During the first year of life, ovarian cyst, partial adrenal insufficiency, and osteoarticular changes, such as mild craniosynostosis, carpal and tarsal synostosis, and limited forearm pronosupination were observed. Her mother presented severe virilization during pregnancy. The molecular analysis of P450 oxidoreductase gene revealed compound heterozygosis for the nonsense p.Arg223*, and the novel missense p.Met408Lys, inherited from the father and the mother, respectively. Arq Bras Endocrinol Metab. 2012;56(8):578-85