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. 1997 Dec;73(866):802–807. doi: 10.1136/pgmj.73.866.802

Male pseudohermaphroditism due to 5 alpha-reductase-2 deficiency in an Arab kindred.

H M al-Attia 1
PMCID: PMC2431528  PMID: 9497950

Abstract

Six Arabs subjects (three postpubertal, two prepubertal and one pubertal) from three interrelated Omani families with male pseudohermaphroditism due to 5 alpha-reductase-2 deficiency were evaluated. These subjects had been raised as girls since birth as they were born with a clitoral-like phallus and ambiguous external genitalia of pseudovaginal perineoscrotal hypospadias with separate urethral and vaginal orifices. They underwent variable degrees of increased muscular habitus and phallic enlargement during puberty and beyond. Gynaecomastia was absent and the body and facial hair was insignificant. After diagnosis, a transition to male social sex occurred in two cases, one of which was interventional. Two retained the female social sex, one of which was also interventional, while the other two maintained an equivocal gender status. This report provides new data on the characterisation of 5 alpha-reductase-2 deficiency in various clusters.

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Selected References

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  1. Akgun S., Ertel N. H., Imperato-McGinley J., Sayli B. S., Shackleton C. Familial male pseudohermaphroditism due to 5-alpha-reductase deficiency in a Turkish village. Am J Med. 1986 Aug;81(2):267–274. doi: 10.1016/0002-9343(86)90262-7. [DOI] [PubMed] [Google Scholar]
  2. Davis R. M. Localisation of male determining factors in man: a thorough review of structural anomalies of the Y chromosome. J Med Genet. 1981 Jun;18(3):161–195. doi: 10.1136/jmg.18.3.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Griffin J. E. Androgen resistance--the clinical and molecular spectrum. N Engl J Med. 1992 Feb 27;326(9):611–618. doi: 10.1056/NEJM199202273260906. [DOI] [PubMed] [Google Scholar]
  4. Hsu L. Y., Benn P. A., Tannenbaum H. L., Perlis T. E., Carlson A. D. Chromosomal polymorphisms of 1, 9, 16, and Y in 4 major ethnic groups: a large prenatal study. Am J Med Genet. 1987 Jan;26(1):95–101. doi: 10.1002/ajmg.1320260116. [DOI] [PubMed] [Google Scholar]
  5. Imperato-McGinley J., Guerrero L., Gautier T., Peterson R. E. Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science. 1974 Dec 27;186(4170):1213–1215. doi: 10.1126/science.186.4170.1213. [DOI] [PubMed] [Google Scholar]
  6. Imperato-McGinley J., Miller M., Wilson J. D., Peterson R. E., Shackleton C., Gajdusek D. C. A cluster of male pseudohermaphrodites with 5 alpha-reductase deficiency in Papua New Guinea. Clin Endocrinol (Oxf) 1991 Apr;34(4):293–298. doi: 10.1111/j.1365-2265.1991.tb03769.x. [DOI] [PubMed] [Google Scholar]
  7. Imperato-McGinley J., Peterson R. E., Gautier T., Arthur A., Shackleton C. Decreased urinary C19 and C21 steroid 5 alpha-metabolites in parents of male pseudohermaphrodites with 5 alpha-reductase deficiency: detection of carriers. J Clin Endocrinol Metab. 1985 Mar;60(3):553–558. doi: 10.1210/jcem-60-3-553. [DOI] [PubMed] [Google Scholar]
  8. Imperato-McGinley J., Peterson R. E., Gautier T., Cooper G., Danner R., Arthur A., Morris P. L., Sweeney W. J., Shackleton C. Hormonal evaluation of a large kindred with complete androgen insensitivity: evidence for secondary 5 alpha-reductase deficiency. J Clin Endocrinol Metab. 1982 May;54(5):931–941. doi: 10.1210/jcem-54-5-931. [DOI] [PubMed] [Google Scholar]
  9. Imperato-McGinley J., Peterson R. E., Leshin M., Griffin J. E., Cooper G., Draghi S., Berenyi M., Wilson J. D. Steroid 5 alpha-reductase deficiency in a 65-year-old male pseudohermaphrodite: the natural history, ultrastructure of the testes, and evidence for inherited enzyme heterogeneity. J Clin Endocrinol Metab. 1980 Jan;50(1):15–22. doi: 10.1210/jcem-50-1-15. [DOI] [PubMed] [Google Scholar]
  10. Imperato-McGinley J., Peterson R. E., Stoller R., Goodwin W. E. Male pseudohermaphroditism secondary to 17 beta-hydroxysteroid dehydrogenase deficiency: gender role change with puberty. J Clin Endocrinol Metab. 1979 Sep;49(3):391–395. doi: 10.1210/jcem-49-3-391. [DOI] [PubMed] [Google Scholar]
  11. Ivarsson S. A., Nielsen M. D., Lindberg T. Male pseudohermaphroditism due to 5 alpha-reductase deficiency in a Swedish family. Eur J Pediatr. 1988 Jun;147(5):532–535. doi: 10.1007/BF00441984. [DOI] [PubMed] [Google Scholar]
  12. Izquierdo G., Glassberg K. I. Gender assignment and gender identity in patients with ambiguous genitalia. Urology. 1993 Sep;42(3):232–242. doi: 10.1016/0090-4295(93)90610-m. [DOI] [PubMed] [Google Scholar]
  13. Jukier L., Kaufman M., Pinsky L., Peterson R. E. Partial androgen resistance associated with secondary 5 alpha-reductase deficiency: identification of a novel qualitative androgen receptor defect and clinical implications. J Clin Endocrinol Metab. 1984 Oct;59(4):679–688. doi: 10.1210/jcem-59-4-679. [DOI] [PubMed] [Google Scholar]
  14. Mendonca B. B., Bloise W., Arnhold I. J., Batista M. C., Toledo S. P., Drummond M. C., Nicolau W., Mattar E. Male pseudohermaphroditism due to nonsalt-losing 3 beta-hydroxysteroid dehydrogenase deficiency: gender role change and absence of gynecomastia at puberty. J Steroid Biochem. 1987 Dec;28(6):669–675. doi: 10.1016/0022-4731(87)90396-7. [DOI] [PubMed] [Google Scholar]
  15. Mendonca B. B., Inacio M., Costa E. M., Arnhold I. J., Silva F. A., Nicolau W., Bloise W., Russel D. W., Wilson J. D. Male pseudohermaphroditism due to steroid 5alpha-reductase 2 deficiency. Diagnosis, psychological evaluation, and management. Medicine (Baltimore) 1996 Mar;75(2):64–76. doi: 10.1097/00005792-199603000-00003. [DOI] [PubMed] [Google Scholar]
  16. Ng W. K., Taylor N. F., Hughes I. A., Taylor J., Ransley P. G., Grant D. B. 5 alpha-reductase deficiency without hypospadias. Arch Dis Child. 1990 Oct;65(10):1166–1167. doi: 10.1136/adc.65.10.1166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ogata T., Tyler-Smith C., Purvis-Smith S., Turner G. Chromosomal localisation of a gene(s) for Turner stigmata on Yp. J Med Genet. 1993 Nov;30(11):918–922. doi: 10.1136/jmg.30.11.918. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Peterson R. E., Imperato-McGinley J., Gautier T., Shackleton C. Urinary steroid metabolites in subjects with male pseudohermaphroditism due to 5 alpha-reductase deficiency. Clin Endocrinol (Oxf) 1985 Jul;23(1):43–53. doi: 10.1111/j.1365-2265.1985.tb00181.x. [DOI] [PubMed] [Google Scholar]
  19. Peterson R. E., Imperato-McGinley J., Gautier T., Sturla E. Male pseudohermaphroditism due to steroid 5-alpha-reductase deficiency. Am J Med. 1977 Feb;62(2):170–191. doi: 10.1016/0002-9343(77)90313-8. [DOI] [PubMed] [Google Scholar]
  20. Pinsky L., Kaufman M., Straisfeld C., Zilahi B., Hall C. S. 5alpha-reductase activity of genital and nongenital skin fibroblasts from patients with 5alpha-reductase deficiency, androgen insensitivity, or unknown forms of male pseudohermaphroditism. Am J Med Genet. 1978;1(4):407–416. doi: 10.1002/ajmg.1320010404. [DOI] [PubMed] [Google Scholar]
  21. Russell D. W., Wilson J. D. Steroid 5 alpha-reductase: two genes/two enzymes. Annu Rev Biochem. 1994;63:25–61. doi: 10.1146/annurev.bi.63.070194.000325. [DOI] [PubMed] [Google Scholar]
  22. Rösler A., Kohn G. Male pseudohermaphroditism due to 17 beta-hydroxysteroid dehydrogenase deficiency: studies on the natural history of the defect and effect of androgens on gender role. J Steroid Biochem. 1983 Jul;19(1B):663–674. doi: 10.1016/0022-4731(83)90233-9. [DOI] [PubMed] [Google Scholar]
  23. Skare J., Drwinga H., Wyandt H., vanderSpek J., Troxler R., Milunsky A. Interstitial deletion involving most of Yq. Am J Med Genet. 1990 Aug;36(4):394–397. doi: 10.1002/ajmg.1320360405. [DOI] [PubMed] [Google Scholar]
  24. Thigpen A. E., Silver R. I., Guileyardo J. M., Casey M. L., McConnell J. D., Russell D. W. Tissue distribution and ontogeny of steroid 5 alpha-reductase isozyme expression. J Clin Invest. 1993 Aug;92(2):903–910. doi: 10.1172/JCI116665. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Wigley W. C., Prihoda J. S., Mowszowicz I., Mendonca B. B., New M. I., Wilson J. D., Russell D. W. Natural mutagenesis study of the human steroid 5 alpha-reductase 2 isozyme. Biochemistry. 1994 Feb 8;33(5):1265–1270. doi: 10.1021/bi00171a029. [DOI] [PubMed] [Google Scholar]
  26. Wilson J. D., Griffin J. E., Russell D. W. Steroid 5 alpha-reductase 2 deficiency. Endocr Rev. 1993 Oct;14(5):577–593. doi: 10.1210/edrv-14-5-577. [DOI] [PubMed] [Google Scholar]

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