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Prevalence of olfactory and other developmental anomalies in patients with central hypogonadotropic hypogonadism.
[kallmann syndrome]
Hypogonadotropic
hypogonadism
(
HH
)
is
a
heterogeneous
disease
caused
by
mutations
in
several
genes
.
Based
on
the
presence
of
hyposmia
/
anosmia
it
is
distinguished
into
Kallmann
syndrome
(
KS
)
and
isolated
HH
.
The
prevalence
of
other
developmental
anomalies
is
not
well
established
.
We
studied
36
patients
with
HH
(
31
males
,
5
females
,
mean
age
41
.
5
)
,
9
with
familial
and
27
with
sporadic
HH
(
33
congenital
,
3
adult-onset
)
,
by
physical
examination
,
smell
test
(
BSIT
Sensonics
)
,
audiometry
,
renal
ultrasound
,
and
magnetic
resonance
imaging
of
the
olfactory
structures
.
Based
on
the
smell
test
,
patients
were
classified
as
normosmic
(
n
 
=
 
21
,
58
.
3
%
)
and
hypo
/
anosmic
(
n
 
=
 
15
,
41
.
6
%
)
.
Hypoplasia
/
agenesis
of
olfactory
bulbs
was
found
in
40
%
of
patients
(
10
/
25
;
75
%
hypo
/
anosmic
,
7
.
6
%
normosmic
,
p
 
<
 
0
.
01
,
Fisher
's
test
)
.
Remarkably
,
olfactory
structures
were
normal
in
two
anosmic
patients
,
while
one
normosmic
patient
presented
a
unilateral
hypoplastic
bulb
.
Fourteen
of
33
patients
(
42
.
4
%
)
presented
neurosensorial
hearing
loss
of
various
degrees
(
28
.
5
%
hypo
/
anosmic
,
52
.
6
%
normosmic
,
p
 
=
 
NS
)
.
Renal
ultrasound
revealed
27
.
7
%
of
cases
with
renal
anomalies
(
26
.
6
%
hypo
/
anosmic
,
28
.
5
%
normosmic
,
p
 
=
 
NS
)
.
At
least
one
midline
defect
was
found
in
50
%
of
the
patients
(
53
.
3
%
hypo
/
anosmic
,
47
.
6
%
normosmic
,
p
 
=
 
NS
)
,
including
abnormal
palate
,
dental
anomalies
,
pectus
excavatum
,
bimanual
synkinesis
,
iris
coloboma
,
and
absent
nasal
cartilage
.
Anamnestically
4
/
31
patients
reported
cryptorchidism
(
25
%
hypo
/
anosmic
,
5
.
2
%
normosmic
,
p
 
=
 
NS
)
.
Hypo
/
anosmia
is
significantly
related
to
anatomical
anomalies
of
the
olfactory
bulbs
/
tracts
but
the
prevalence
of
other
developmental
anomalies
,
especially
midline
defects
and
neurosensorial
hearing
loss
,
is
high
both
in
HH
and
KS
and
independent
of
the
presence
of
anosmia
/
hyposmia
.
From
the
clinical
standpoint
KS
and
normosmic
HH
should
be
considered
as
the
same
complex
,
developmental
disease
.
Diseases
Validation
Diseases presenting
"hearing loss"
symptom
22q11.2 deletion syndrome
achondroplasia
adrenomyeloneuropathy
alexander disease
benign recurrent intrahepatic cholestasis
canavan disease
cohen syndrome
congenital toxoplasmosis
dentinogenesis imperfecta
fabry disease
familial mediterranean fever
heparin-induced thrombocytopenia
hirschsprung disease
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
kabuki syndrome
kallmann syndrome
neonatal adrenoleukodystrophy
pendred syndrome
von hippel-lindau disease
wolf-hirschhorn syndrome
This symptom has already been validated