Abstract
46,XY gonadal dysgenesis (GD) constitutes a rare group of disorders characterized
by the presence of dysfunctional testes in genotypic males. The molecular etiology
is not known in about 2 thirds of instances. The aim of this study was to identify
the genetic cause in patients with 46,XY gonadal dysgenesis. Based on clinical, cytogenetic,
and biochemical screening, 10 patients with 46,XY GD were recruited. Direct sequencing
of SRY, NR5A1, SOX9, DAX1, DHH, DMRT1 genes was carried out for molecular analysis. Among 10 patients, 5 were diagnosed
with complete gonadal dysgenesis (CGD), 3 with partial gonadal dysgenesis (PGD), and
3 with testicular agenesis. Molecular analysis revealed 12 heterozygous genetic changes,
4 of which were novel. One (c.416T>A) was observed in evolutionary conserved region
of DMRT1 gene in a patient with CGD and was found to be probably damaging on in silico analysis.
Other 3 were identified in NR5A1 gene (c.990+22 C>A, c.1387+1403T>A and p.131P), but their association with gonadal
dysgenesis is not evident from our study. These genetic changes were absent in parents
and 50 healthy control samples, which were also studied. With targeted sequencing
approach, a molecular diagnosis was made in only one patient with 46,XY GD. The application
of new genomic technologies is required for the precise evaluation of these rare genetic
defects.
Key words
46,XY gonadal dysgenesis - genes - mutation - molecular diagnosis