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Moniez S, Pienkowski C, Lepage B, Hamdi S, Daudin M, Oliver I, Jouret B, Cartault A, Diene G, Verloes A, Cavé H, Salles JP, Tauber M, Yart A, Edouard T. Noonan syndrome males display Sertoli cell-specific primary testicular insufficiency. Eur J Endocrinol 2018; 179:409-418. [PMID: 30325180 DOI: 10.1530/eje-18-0582] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/01/2018] [Indexed: 01/13/2023]
Abstract
Context Abnormalities in the hypothalamo-pituitary-gonadal axis have long been reported in Noonan syndrome (NS) males with only few data available in prepubertal children. Objective The aim of this study was to describe the gonadal function of NS males from childhood to adulthood. Design It is a retrospective chart review. Patients and methods A total of 37 males with a genetically confirmed diagnosis of NS were included. Clinical and genetic features, as well as serum hormone levels (LH, FSH, testosterone, anti-Müllerian hormone (AMH), and inhibin B) were analysed. Results Of the 37 patients, 16 (43%) children had entered puberty at a median age of 13.5 years (range: 11.4-15.0 years); age at pubertal onset was negatively correlated with BMI SDS (r = -0.541; P = 0.022). In pubertal boys, testosterone levels were normal suggesting a normal Leydig cell function. In contrast, NS patients had significant lower levels of AMH (mean SDS: -0.6 ± 1.1; P = 0.003) and inhibin B (mean SDS: -1.1 ± 1.2; P < 0.001) compared with the general population, suggesting a Sertoli cell dysfunction. Lower AMH and inhibin B levels were found in NS-PTPN11 patients, whereas these markers did not differ from healthy children in SOS1 patients. No difference was found between cryptorchid and non-cryptorchid patients for AMH and inhibin B levels (P = 0.43 and 0.62 respectively). Four NS-PTPN11 patients had a severe primary hypogonadism with azoospermia/cryptozoospermia. Conclusions NS males display Sertoli cell-specific primary testicular insufficiency, whereas Leydig cell function seems to be unaffected.
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Affiliation(s)
- Sophie Moniez
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
| | | | - Benoit Lepage
- Department of Epidemiology, CECOS Midi-Pyrénées, EA 3694 Human Fertility Research Group, Toulouse University Hospital, Toulouse, France
| | - Safouane Hamdi
- Laboratory of Biochemistry and Hormonology, CECOS Midi-Pyrénées, EA 3694 Human Fertility Research Group, Toulouse University Hospital, Toulouse, France
- Fertility Centre, CECOS Midi-Pyrénées, EA 3694 Human Fertility Research Group, Toulouse University Hospital, Toulouse, France
| | - Myriam Daudin
- Fertility Centre, CECOS Midi-Pyrénées, EA 3694 Human Fertility Research Group, Toulouse University Hospital, Toulouse, France
| | - Isabelle Oliver
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
| | - Béatrice Jouret
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
| | - Audrey Cartault
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
| | - Gwenaelle Diene
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
| | - Alain Verloes
- Department of Genetics, Robert-Debré University Hospital, APHP, Paris, France
| | - Hélène Cavé
- Department of Genetics, Robert-Debré University Hospital, APHP, Paris, France
| | - Jean-Pierre Salles
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
- INSERM UMR 1043, Centre of Pathophysiology of Toulouse Purpan (CPTP)
| | - Maithé Tauber
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
- INSERM UMR 1043, Centre of Pathophysiology of Toulouse Purpan (CPTP)
| | - Armelle Yart
- INSERM UMR 1048, Institute of Cardiovascular and Metabolic Diseases (I2MC), University of Toulouse Paul Sabatier, Toulouse, France
| | - Thomas Edouard
- Endocrine, Bone Diseases, and Genetics Unit, Children's Hospital
- INSERM UMR 1043, Centre of Pathophysiology of Toulouse Purpan (CPTP)
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