Aromatase deficiency caused by mutation of CYP19A1 gene: A case report

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Jun 28;47(6):794-800. doi: 10.11817/j.issn.1672-7347.2022.210401.
[Article in English, Chinese]

Abstract

Aromatase deficiency (AD) is a rare autosomal recessive genetic disease caused by loss-of-function mutations in aromatase gene (CYP19A1), leading to congenital estrogen deficiency syndrome. Both mothers of AD patients during pregnancy and female AD fetus show virilization, while male patients are usually diagnosed in adulthood due to continued height increase and metabolic abnormalities. In 2019, a patient with AD was admitted in the Second Xiangya Hospital. The patient was a 37-year-old adult male who continued to grow linearly after adulthood. His estradiol was below the measurable line, the follicle-stimulating hormone (FSH) increased, bone age delayed, epiphysis unfused, and the bone mass reduced. CYP19A1 gene detection showed that c.1093C>T, p.R365W was homozygous mutation. This disease is rare in clinic. Clinicians need to raise awareness of the disease for early diagnosis and treatment to improve the long-term prognosis of patients.

芳香化酶缺乏症(aromatase deficiency,AD)是一种罕见的芳香化酶基因(CYP19A1)失活突变引起的常染色体隐性遗传病,导致先天性雌激素缺乏综合征。AD患者的母亲在妊娠期以及女性胎儿出生时均可出现男性化表现,而男性患者通常在成年后因身高持续增长和代谢异常才得以诊断。2019年中南大学湘雅二医院收治了1例AD患者,该患者为37岁成年男性,成年后仍持续生长,其雌二醇低于可测线、促卵泡激素(follicle-stimulating hormone,FSH)升高、骨龄落后、骨骺未闭合、骨量减少,CYP19A1基因检测示c.1093C>T,p.R365W纯合子突变。该病临床较罕见,临床医生需提高对该病的认识,早期诊断和治疗,以改善患者的长期预后。.

芳香化酶缺乏症(aromatase deficiency,AD)是一种罕见的芳香化酶基因(CYP19A1)失活突变引起的常染色体隐性遗传病,导致先天性雌激素缺乏综合征。AD患者的母亲在妊娠期以及女性胎儿出生时均可出现男性化表现,而男性患者通常在成年后因身高持续增长和代谢异常才得以诊断。2019年中南大学湘雅二医院收治了1例AD患者,该患者为37岁成年男性,成年后仍持续生长,其雌二醇低于可测线、促卵泡激素(follicle-stimulating hormone,FSH)升高、骨龄落后、骨骺未闭合、骨量减少,CYP19A1基因检测示c.1093C>T,p.R365W纯合子突变。该病临床较罕见,临床医生需提高对该病的认识,早期诊断和治疗,以改善患者的长期预后。

Keywords: CYP19A1 gene; aromatase deficiency; estrogen deficiency.

Publication types

  • Case Reports

MeSH terms

  • 46, XX Disorders of Sex Development* / genetics
  • Adult
  • Aromatase / deficiency
  • Aromatase / genetics
  • Aromatase / metabolism
  • Female
  • Gynecomastia* / genetics
  • Humans
  • Infertility, Male
  • Male
  • Metabolism, Inborn Errors
  • Mutation
  • Pregnancy

Substances

  • Aromatase
  • CYP19A1 protein, human

Supplementary concepts

  • Aromatase deficiency