Testicular adrenal rest tumors in congenital adrenal hyperplasia-cross-sectional study of 51 Croatian male patients
| Autor: | Veselin Škrabić, Saša Kralik Oguić, Miroslav Dumić, Vesna Kušec, Zorana Grubic, Vlatko Duspara |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Infertility
Adult Male medicine.medical_specialty endocrine system diseases Adolescent Genotype Cross-sectional study 030209 endocrinology & metabolism Disease urologic and male genital diseases Gastroenterology 03 medical and health sciences Young Adult 0302 clinical medicine Testicular Neoplasms Risk Factors Internal medicine medicine Adrenal Rest Tumor Humans Congenital adrenal hyperplasia Child Infertility Male Gynecology Azoospermia 030219 obstetrics & reproductive medicine Adrenal Hyperplasia Congenital business.industry Age Factors Infant medicine.disease Testicular adrenal rest tumor Cross-Sectional Studies Child Preschool Pediatrics Perinatology and Child Health Disease Progression Testicular ultrasound Fertility business Hormone |
| Zdroj: | European journal of pediatrics. 176(10) |
| ISSN: | 1432-1076 |
| Popis: | Testicular adrenal rest tumors (TARTs) are common cause of infertility in males with congenital adrenal hyperplasia (CAH). We studied the role of genotype and disease regulation on TART development, their impact on gonadal function, and frequency in 47 21-hydroxylase deficiency (21-OHD) and four 11-hydroxylase deficiency (11-OHD) male patients. Testicular ultrasound (TU), genotype, hormonal measurement in 51, and spermiogram in five patients were performed. TARTs were detected in 14 SW21-OHD and one 11-OHD patient: 1/8 patients aged7 years (1.8 years old is the youngest), 1/8 patients aged12 years, 5/17 patients aged18 years, and in 8/18 adults. All 21-OHD TART patients had exclusively severe mutations of CYP21A2 gene. Poor hormonal control in 8/15 patients with and 12/36 patients without TART indicates correlation of tumor development with poor disease control. None of the TART patients fathered a child. Low inhibin-B was found in 7/15 TART patients. Azoospermia was found in four and oligoasthenozoospermia in one patient.TART was detected exclusively in patients with severe CYP21A2 mutations. Disease regulation plays a role in development of TART that impairs testicular function and increases the risk of infertility. Screening for TART by TU is indicated from early childhood. What is Known: • Due to improved diagnostic and therapeutic possibilities, majority of the male patients with congenital adrenal hyperplasia nowadays reach adulthood and screening for long-term complications is becoming more important. • Testicular adrenal rest tumors (TARTs) are common cause of infertility and impaired gonadal function in males with CAH. What is New: • A 1.8-year-old boy described in this paper is the youngest reported patient with TART. • Screening for TART by testicular ultrasound from early childhood, especially in patients with severe CYP21A mutations, is recommended. |
| Databáze: | OpenAIRE |
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