DAX1 and X-linked adrenal hypoplasia congenita: Clinical and molecular analysis in five patients

Giovanna Mantovani, Ernesto De Menis, Giorgio Borretta, Giorgio Radetti, Sara Bondioni, Anna Spada, Luca Persani, Paolo Beck-Peccoz

Research output: Contribution to journalArticle

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Abstract

Objective: Mutations in the gene coding for the orphan nuclear receptor DAX1 cause X-linked adrenal hypoplasia congenita (AHC). Affected boys usually present with primary adrenal failure in early infancy or childhood. Impaired sexual development due to hypogonadotropic hypogonadism becomes manifest at the time of puberty. Moreover, evidence from Dax1 knockout mice and a limited number of patients with AHC, suggests that mutations in DAX1 may directly cause abnormalities in spermatogenesis. The aim of this study was to characterize clinically and genetically five patients with AHC. Design: DNA sequencing analysis, endocrine testing, testicular ultrasound and semen analysis with 1-year follow-up after gonadotropin treatment. Methods: We report on five men with classic AHC manifestations. Genomic DNA was extracted from patients' peripheral blood leukocytes and the coding region, splice sites, and promoter (-240 bp) region of DAX1 were directly sequenced. Results: Three known and two novel mutations were detected in the DAX1 coding sequence in these patients. Semen analysis was performed in four of the five patients and showed azoospermia. Twelve-month treatment with gonadotropins did not restore fertility in these patients. All patients showed a normal testicular Doppler ultrasound, in contrast with that observed in Dax1-deficient mice, which display abnormalities in the rete testis. Conclusions: These cases further expand the number of DAX1 mutations reported in the literature, as well as our clinical knowledge of this rare disease.

Original languageEnglish
Pages (from-to)685-689
Number of pages5
JournalEuropean Journal of Endocrinology
Volume154
Issue number5
DOIs
Publication statusPublished - May 2006

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Mutation
Semen Analysis
Gonadotropins
Rete Testis
Orphan Nuclear Receptors
Doppler Ultrasonography
Azoospermia
Sexual Development
Hypogonadism
Spermatogenesis
Puberty
Rare Diseases
X-linked adrenal hypoplasia congenita
DNA Sequence Analysis
Knockout Mice
Fertility
Leukocytes
DNA
Therapeutics
Genes

ASJC Scopus subject areas

  • Endocrinology

Cite this

DAX1 and X-linked adrenal hypoplasia congenita : Clinical and molecular analysis in five patients. / Mantovani, Giovanna; De Menis, Ernesto; Borretta, Giorgio; Radetti, Giorgio; Bondioni, Sara; Spada, Anna; Persani, Luca; Beck-Peccoz, Paolo.

In: European Journal of Endocrinology, Vol. 154, No. 5, 05.2006, p. 685-689.

Research output: Contribution to journalArticle

Mantovani, Giovanna ; De Menis, Ernesto ; Borretta, Giorgio ; Radetti, Giorgio ; Bondioni, Sara ; Spada, Anna ; Persani, Luca ; Beck-Peccoz, Paolo. / DAX1 and X-linked adrenal hypoplasia congenita : Clinical and molecular analysis in five patients. In: European Journal of Endocrinology. 2006 ; Vol. 154, No. 5. pp. 685-689.
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