Cryptic genomic rearrangements in three patients with 46,XY disorders of sex development

PLoS One. 2013 Jul 8;8(7):e68194. doi: 10.1371/journal.pone.0068194. Print 2013.

Abstract

Background: 46,XY disorders of sex development (46,XY DSD) are genetically heterogeneous conditions. Recently, a few submicroscopic genomic rearrangements have been reported as novel genetic causes of 46,XY DSD.

Methodology/principal findings: To clarify the role of cryptic rearrangements in the development of 46,XY DSD, we performed array-based comparative genomic hybridization analysis for 24 genetic males with genital abnormalities. Heterozygous submicroscopic deletions were identified in three cases (cases 1-3). A ∼8.5 Mb terminal deletion at 9p24.1-24.3 was detected in case 1 that presented with complete female-type external genitalia and mental retardation; a ∼2.0 Mb interstitial deletion at 20p13 was identified in case 2 with ambiguous external genitalia and short stature; and a ∼18.0 Mb interstitial deletion at 2q31.1-32 was found in case 3 with ambiguous external genitalia, mental retardation and multiple anomalies. The genital abnormalities of case 1 could be ascribed to gonadal dysgenesis caused by haploinsufficiency of DMRT1, while those of case 3 were possibly associated with perturbed organogenesis due to a deletion of the HOXD cluster. The deletion in case 2 affected 36 genes, none of which have been previously implicated in sex development.

Conclusions/significance: The results indicate that cryptic genomic rearrangements constitute an important part of the molecular bases of 46,XY DSD and that submicroscopic deletions can lead to various types of 46,XY DSD that occur as components of contiguous gene deletion syndromes. Most importantly, our data provide a novel candidate locus for 46,XY DSD at 20p13.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child, Preschool
  • Comparative Genomic Hybridization
  • Disorder of Sex Development, 46,XY / genetics*
  • Female
  • Gene Rearrangement / genetics*
  • Genome, Human / genetics*
  • Heterozygote
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Sequence Deletion

Grants and funding

This work was supported by the Grant-in-Aid for Scientific Research on Innovative Areas (22132004) from the Ministry of Education, Culture, Sports, Science and Technology, by the Grant for Research on Intractable Diseases from the Ministry of Health, Labor and Welfare, by the Grant-in-Aid for Scientific Research (B) (23390249) and for Young Scientists (B) (24791103) from the Japan Society for the Promotion of Science (JSPS), by the Grant from the Takeda Foundation and by the Grant from National Center for Child Health and Development (23A-1 and 24-7). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.