title: [The diagnosis, treatment and following up of 7 patients with 45, X/46, XY mixed gonadal dysgenesis].
abstract: OBJECTIVE
  To investigate the clinical features, therapeutic regimens and follow-up information of patients with 45, X/46, XY mixed gonadal dysgenesis in order to improve the diagnosis and treatment of the disease.
  
  
  METHODS
  We performed a retrospective review of patients with 45, X/46, XY mosaicism hospitalized in Chinese PLA General Hospital between 2000 and 2014. The clinical features,sex hormones,treatment and follow-up information were summarized.
  
  
  RESULTS
  (1) Seven patients ranging 12-17 years old were diagnosed as having 45, X/46, XY mixed gonadal dysgenesis. Six of them had female sex of rearing and one had male. (2) All of them presented with short stature and growth retardation, and had similar specific somatic signs to Turner syndrome. (3) The external genitalia presented with a wide variety of phenotypes. One patient presented with male phenotype with hypospadia, one presented with clitoridauxe, and five presented with female phenotype. The masculinization scores for the external genitalia showed that five patients presented with female phenotype, one patient with mild undervirilization and one patient with ambiguous genitalia. (4) By surgical exploration and ultrasound, two patients were found with testes and one was with ovary-like gonads. No gonad could be detected in the other four patients. (5) Five patients were treated with recombinant human growth hormone (rhGH). Two patients received sex hormone replacement therapy with one patient taking testosterone, whose penis became enlarged and erect after treatment, and one taking artificial cycle.
  
  
  CONCLUSIONS
  The patients with 45, X/46, XY mosaicism share similar specific somatic signs to Turner syndrome. The 45, X/46, XY mosaicism presents with a wide spectrum of phenotypes with the highest proportion of being genital ambiguity. RhGH, testosterone and artificial cycle can be used accordingly.
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China; Email: jingtaodou@sohu.com.
authors.forename: Jingtao
authors.initials: J
authors.lastname: Dou
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Yang
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Weijun
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zang
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Jin
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Xianling
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Lyu
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jianming
authors.initials: J
authors.lastname: Ba
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Juming
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Jiangyuan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Changyu
authors.initials: C
authors.lastname: Pan
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Mu
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006060:Gonadal Dysgenesis, Mixed / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D009030:Mosaicism; D010641:Phenotype; D012189:Retrospective Studies; D014424:Turner Syndrome