17-beta-hydroxysteroid dehydrogenase deficiency

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17-beta-hydroxysteroid dehydrogenase deficiency
Classification and external resources
OMIM 264300
DiseasesDB 32638

17-beta-hydroxysteroid dehydrogenase deficiency-3 is a rare disorder of sexual development affecting testosterone biosynthesis, which can produce impaired virilization (traditionally termed male pseudohermaphroditism) of genetically male infants and children and excessive virilization of female adults.

It is an autosomal recessive condition and is one of the few disorders of sexual development that can affect the primary and/or secondary sex characteristics of both males and females.

Contents

[edit] Prevalence

In the Netherlands, 17-beta-hydroxysteroid dehydrogenase deficiency is estimated to occur 1:147.000 newborns.[1]

[edit] Clinical characteristics

17-beta-hydroxysteroid dehydrogenase deficiency-3 is clinically characterized by either ambiguous external genitalia or complete female external genitalia at birth; as a consequence of impaired male sexual differentiation in 46,XY individuals. Further investigations on ambiguous genitalia will eventually lead to findings of intersexuality. Severely impaired virilization (often complete absence of male sexual differentiation) can lead to development of female external genitalia. These children are raised as female, and their diagnosis is often discovered when there is absence of menarche (first menstruation) and when they begin to virilize during puberty (slowly become more like a man; deepening of the voice, acne, male musculature etc). At careful examination, testis can often be found in the inguinal channel.

[edit] Biochemistry

17-beta-hydroxysteroid dehydrogenase deficiency-3 is biochemically characterized by decreased levels of testosterone and increased levels of androstenedione as a result of the defect in conversion of androstenedione into testosterone. This leads to clinically important higher ratio of androstenedione to testosterone (A'dion/T) (see figure).

Biochemical effects of 17β-hydroxysteroid deficiency-3 in testosterone biosynthesis. Typically levels of androstenedione are significantly increased, whilst testosterone levels are decreased, leading to male undervirilization.
Biochemical effects of 17β-hydroxysteroid deficiency-3 in testosterone biosynthesis. Typically levels of androstenedione are significantly increased, whilst testosterone levels are decreased, leading to male undervirilization.

[edit] Genetics

17-beta-hydroxysteroid dehydrogenase deficiency has an autosomal recessive pattern of inheritance.
17-beta-hydroxysteroid dehydrogenase deficiency has an autosomal recessive pattern of inheritance.

17-beta-hydroxysteroid dehydrogenase deficiency-3 is caused by gene mutations found in the 17Beta Hydroxysteroid dehydrogenase (17BHSD3). 17BHSD3 deficiency-3 is an autosomal recessive disorder.

[edit] References

  1. ^ Boehmer A et al (1999). "17Beta-hydroxysteroid dehydrogenase-3 deficiency: diagnosis, phenotypic variability, population genetics, and worldwide distribution of ancient and de novo mutations". J Clin Endocrinol Metab 84 (12): 4713–21. doi:10.1210/jc.84.12.4713. PMID 10599740. 

[edit] External links