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Testotoxicosis: Report of Two Cases, One with a Novel Mutation in LHCGR Gene

Authors: Özcabı, Bahar; Tahmiscioğlu Bucak, Feride; Ceylaner, Serdar; Özcan, Rahşan; Büyükünal, Cenk; Ercan, Oya; Tüysüz, Beyhan; +1 Authors

Testotoxicosis: Report of Two Cases, One with a Novel Mutation in LHCGR Gene

Abstract

Testotoxicosis is a rare disorder which presents as isosexual peripheral precocious puberty in males. Despite the pattern of autosomal dominant inheritance, sporadic cases also may occur. Due to activating mutation in luteinizing hormone (LH))/choriogonadotropin receptor (LHCGR) gene, early virilization and advancement in bone age are common with increased serum testosterone levels above adult ranges, despite low LH and follicular-stimulating hormone (FSH) levels. There are different treatment regimens, such as combination of bicalutamide (antiandrogen agent) and a third-generation aromatase inhibitor, that are reported to be well-tolerated and successful in slowing bone age advancement and preventing progression of virilization. We report here two patients who presented with peripheral precocious puberty and an activating mutation in the LHCGR gene: one with a family history and previously determined mutation and the other without family history and with a novel mutation (c.830G>T). Combination of bicalutamide+anastrozole was ineffective in slowing pubertal progression and bone age. Short-term results were better with ketoconazole.

Keywords

Male, Aromatase Inhibitors, Infant, Puberty, Precocious, Case Report, Androgen Antagonists, Sequence Analysis, DNA, Anastrozole, Receptors, LH, Triazoles, Tosyl Compounds, Ketoconazole, Mutation, Nitriles, Cytochrome P-450 CYP3A Inhibitors, Humans, Anilides, Genetic Predisposition to Disease, Testosterone

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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
19
Top 10%
Top 10%
Top 10%
Green
gold