Secondary treatment failure without anti-human chorionic gonadotropin antibody in a patient with Kallmann syndrome.
A 29-year-old man with Kallmann syndrome suddenly developed decreased semen volume, azoospermia, and facial hair loss after 11 years of successful human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) treatment. Anti-hCG antibody was not detected in the patient's serum. A high serum level of luteinizing hormone (LH) with nasal LH-releasing hormone analogue administration failed to increase serum testosterone to a sufficient level. Testosterone injection after cessation of hCG and hMG therapy was able to improve semen volume, but not azoospermia. Resumption of hCG and hMG therapy after 6 months cessation partially restored spermatogenesis. The secondary failure of hCG and hMG therapy suggests a decrease of testicular sensitivity to LH as well as hCG.
Department of Urology, Tokyo Medical and Dental University School of Medicine, Japan.
S
S
Kitahara
K
K
Yoshida
K
K
Ishizaka
Y
Y
Higashi
K
K
Takagi
H
H
Oshima
D000328:Adult; D000906:Antibodies / Q000097:blood; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D002064:Buserelin / Q000008:administration & dosage; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000276:immunology*; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D017436:Kallmann Syndrome / Q000188:drug therapy* / Q000276:immunology; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009845:Oligospermia / Q000188:drug therapy / Q000276:immunology; D013739:Testosterone / Q000008:administration & dosage / Q000097:blood; D017211:Treatment Failure
D000906:Antibodies; D018931:Antineoplastic Agents, Hormonal; D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002064:Buserelin