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


METHODS
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.


CONCLUSIONS
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.
Department of Pediatric Endocrinology and Metabolism, Ege University, Izmir, Turkey.
Sukran
S
Darcan
Damla
D
Goksen
Samim
S
Ozen
Ferda
F
Ozkinay
Burak
B
Durmaz
Enzo
E
Lalli
D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy / Q000235:genetics; D000309:Adrenal Insufficiency; D057137:DAX-1 Orphan Nuclear Receptor / Q000235:genetics*; D040181:Genetic Diseases, X-Linked / Q000188:drug therapy / Q000235:genetics; D007987:Gonadotropin-Releasing Hormone; D006801:Humans; D000075262:Hypoadrenocorticism, Familial; D007223:Infant; D016729:Leuprolide / Q000627:therapeutic use; D008297:Male; D011629:Puberty, Precocious / Q000235:genetics*
D057137:DAX-1 Orphan Nuclear Receptor; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide