Gonadotropin-dependent precocious puberty in a patient with X-linked adrenal hypoplasia congenita caused by a novel DAX-1 mutation

Horm Res Paediatr. 2011 Feb;75(2):153-6. doi: 10.1159/000320701. Epub 2010 Oct 22.

Abstract

Background/aims: X-linked adrenal hypoplasia congenita (AHC) is typically characterized by a DAX-1 gene mutation and hypogonadotropic hypogonadism. However, rare cases with precocious puberty or normal puberty have been reported. Currently, the mechanism of action of the DAX-1 gene on puberty is not clearly known.

Case report: We report a male who was diagnosed as having AHC in the newborn period and detected as having stop codon Q155 X mutation in the DAX-1 gene. This subject developed central precocious puberty when he was 9 months old.

Results: This paper is the first case report of AHC, central precocious puberty and a mutation in the DAX-1 gene. DAX-1 gene mutations can result in various phenotypes.

Conclusion: In cases with AHC, central precocious puberty can develop rather than hypogonadotropic hypogonadism, which is the most frequently observed puberty disorder related to DAX-1 gene mutations.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Hyperplasia, Congenital / drug therapy
  • Adrenal Hyperplasia, Congenital / genetics
  • Adrenal Insufficiency
  • DAX-1 Orphan Nuclear Receptor / genetics*
  • Genetic Diseases, X-Linked / drug therapy
  • Genetic Diseases, X-Linked / genetics
  • Gonadotropin-Releasing Hormone
  • Humans
  • Hypoadrenocorticism, Familial
  • Infant
  • Leuprolide / therapeutic use
  • Male
  • Puberty, Precocious / genetics*

Substances

  • DAX-1 Orphan Nuclear Receptor
  • Gonadotropin-Releasing Hormone
  • Leuprolide