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Macroorchidism in childhood and adolescence: an update.
[aromatase deficiency]
In
the
last
30
years
,
scientific
literature
has
been
enriched
with
studies
which
demonstrate
the
importance
of
evaluating
testis
volume
to
recognize
certain
genetic
and
endocrine
diseases
.
Macroorchidism
is
defined
as
an
increase
of
testicular
volume
at
least
twice
the
norm
for
age
.
In
clinical
practice
,
when
macroorchidism
is
suspected
,
the
testicular
volume
may
be
evaluated
with
the
Prader
orchidometer
and
/
or
US
,
calculated
by
this
formula
:
L
x
W
x
H
x
0
.
71
and
the
resulting
value
should
be
compared
with
a
table
of
percentiles
for
each
age
.
Macroorchidism
is
a
relatively
uncommon
sign
;
however
,
when
present
,
it
almost
always
has
clinical
relevance
.
Five
groups
of
conditions
are
reviewed
:
genetic
,
endocrine
,
idiopathic
and
secondary
to
neoplasm
or
testicular
torsions
.
An
X-
linked
mental
retardation
syndrome
must
be
suspected
in
all
patients
with
macrorchidism
,
phenotypic
abnormalities
,
and
mental
retardation
.
Furthermore
,
it
is
important
to
identify
other
males
affected
in
the
same
family
to
confirm
the
X-
linked
transmission
.
In
these
cases
,
the
patient
must
be
referred
to
specialized
cytogenetic
centres
for
determination
of
fragile
sites
.
Other
possible
etiologies
of
macroorchidism
are
long
-standing
primary
hypothyroidism
,
adrenal
remnants
in
congenital
adrenal
hyperplasia
,
follicle
stimulating
hormone
(
FSH
)
-
secreting
pituitary
macroadenomas
,
local
tumors
,
lymphomas
,
and
aromatase
deficiency
.
Early
diagnosis
is
important
in
order
to
identify
and
reduce
the
incidence
of
X-
linked
mental
retardation
in
affected
families
and
to
begin
treatment
in
endocrinologic
,
tumoral
and
surgical
disorders
.
Diseases
Validation
Diseases presenting
"adrenal remnants in congenital adrenal hyperplasia"
symptom
aromatase deficiency
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