ESPE Abstracts (2019) 92 FC10.3

Sex Differentiation, Gonads and Gynaecology or Sex Endocrinology

Mutations in the DEAH-box RNA Helicase DHX37 are a Frequent Cause of 46,XY Gonadal Dysgenesis and 46,XY Testicular Regression Syndrome

Ken McElreavey1, Anne Jorgensen2, Caroline Eozenou1, Tiphanie Merel1, Joelle Bignon-Topalovic1, Daisy Tan3, Denis Houzelstein1, Federica Buonocore4, Nigel Warr5, Raissa Kay5, Mathieu Peycelon6, Jean-Pierre Siffroi6, Inas Mazen7, John Achermann4, Yuliya Shcherbak8, Julienne Leger9, Agnes Sallai10, Jean-Claude Carel9, Laetitia Martinerie9, Romain Le Ru11, Gerald Conway4, Brigitte Mignot11, Lionel Van Maldergem11, Rita Bertalan10, Evgenia Globa12, Raja Brauner13, Ralf Jauch3, Serge Nef14, Andy Greenfield5, Anu Bashamboo1


1Institut Pasteur, Paris, France. 2Rigshospitalet, Copenhagen, Denmark. 3University of Hong Kong, Hong Kong, Hong Kong. 4UCL GOS Institute of Child Health, London, United Kingdom. 5Medical Research Council Harwell Institute, Oxfordshire, United Kingdom. 6Sorbonne Université, Paris, France. 7National Research Center, Cairo, Egypt. 8National Hospital OHMATDYT, Kyiv, Ukraine. 9Hospital Robert Debre, Paris, France. 10Semmelweis University, Budapest, Hungary. 11University of Franche-Comté, Besancon, France. 12Ukrainian Center of Endocrine Surgery, Endocrine Organs and Tissue Transplantation, MoH of Ukraine, Kyiv, Ukraine. 13Fondation Ophtalmologique Adolphe de Rothschild, Paris, France. 14University of Geneva, Geneva, Switzerland

XY individuals with Disorders/Differences of Sex development (DSD) are characterized by reduced androgenization caused, in some children, by gonadal dysgenesis or, more rarely, testis regression during early fetal development. The genetic etiology for most patients with 46,XY gonadal dysgenesis and for all patients with testicular regression syndrome (TRS) is unknown. Identification of novel genes involved in DSD is crucial for providing an accurate clinical diagnosis, aiding patient management and understanding the biological processes involved. We performed exome and/or Sanger sequencing in 145 individuals with 46,XY DSD of unknown etiology gonadal dysgenesis (n=81), TRS (n=16), boys with penoscrotal hypospadias (n=33) or anorchia (n=15). Thirteen children carried heterozygous missense mutations involving the RNA helicase DHX37, which is essential for ribosome biogenesis in yeast. Enrichment of rare/novel DHX37 missense mutations in 46,XY DSD is highly significant compared to controls (P value = 5.8x10-10). Five mutations are de novo (P value = 1.5x10-5). Twelve mutations are grouped in two highly conserved functional domains and are predicted to disrupt biological function. Mutations were specifically associated with gonadal dysgenesis (9/81, 11%) and TRS (4/16, 25%). Consistent with a role in early testis development, DHX37 is expressed specifically in somatic cells of the developing human and mouse testis. DHX37 mutations are a relatively common cause of an autosomal dominant form of 46,XY DSD, which includes both gonadal dysgenesis and TRS, showing that these conditions are part of a clinical spectrum. This raises the possibility that some forms of DSD may be a ribosomopathy.

Volume 92

58th Annual ESPE meeting

Vienna, Austria
19 Sep 2019 - 21 Sep 2019

European Society for Paediatric Endocrinology 

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