Severe Undervirilisation in a 46,XY Case Due to a Novel Mutation in HSD17B3 Gene

J Clin Res Pediatr Endocrinol. 2015 Sep;7(3):249-52. doi: 10.4274/jcrpe.2069.

Abstract

17-β-hydroxysteroid dehydrogenase type 3 (17β-HSD3) is an important enzyme involved in the final steps of androgen synthesis and is required for the development of normal male external genitalia. 46,XY individuals with deficiency of this enzyme present a wide clinical spectrum from a female appearance of the external genitalia through ambiguous genitalia to a predominantly male genitalia with micropenis or hypospadias. This paper reports a one-year-old 46,XY patient with 17β-HSD3 deficiency who presented with female external genitalia and bilaterally palpable gonads in the inguinal region. The low T/Δ4 ratio after human chorionic gonadotropin (hCG) stimulation suggested 17β-HSD3 deficiency. A homozygous mutation, c.761_762delAG, was determined at the intron 9/exon 10 splice site of the HSD17B3 gene. To the best of our knowledge, this mutation has not been reported thus far, but its localization and type would imply a complete disruption of the 17β-HSD3 which may explain the phenotype of our patient.

Publication types

  • Case Reports

MeSH terms

  • 17-Hydroxysteroid Dehydrogenases / deficiency*
  • 17-Hydroxysteroid Dehydrogenases / genetics
  • Disorder of Sex Development, 46,XY / diagnosis
  • Disorder of Sex Development, 46,XY / genetics*
  • Disorders of Sex Development / genetics*
  • Female
  • Genitalia, Female
  • Gynecomastia / diagnosis
  • Gynecomastia / genetics*
  • Homozygote
  • Humans
  • Infant
  • Karyotype
  • Male
  • Mutation*
  • Steroid Metabolism, Inborn Errors / diagnosis
  • Steroid Metabolism, Inborn Errors / genetics*

Substances

  • 17-Hydroxysteroid Dehydrogenases
  • 17beta-hydroxysteroid dehydrogenase type 3

Supplementary concepts

  • 17-Hydroxysteroid Dehydrogenase Deficiency