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Aromatase and estrogen receptor α deficiency.
[aromatase deficiency]
Studies
on
the
phenotypes
of
women
and
men
with
mutations
disrupting
estrogen
biosynthesis
and
action
have
significantly
advanced
our
knowledge
of
the
physiologic
roles
of
estrogen
in
humans
.
Aromatase
deficiency
results
from
autosomal
recessive
inheritance
of
mutations
in
the
CYP
19
A
1
gene
.
It
gives
rise
to
ambiguous
genitalia
in
46
,
XX
fetuses
.
At
puberty
,
affected
girls
have
hypergonadotropic
hypogonadism
,
do
not
develop
secondary
sexual
characteristics
,
and
exhibit
progressive
virilization
.
The
affected
46
,
XY
men
have
normal
male
sexual
differentiation
and
pubertal
maturation
.
These
men
,
however
,
are
extremely
tall
and
have
eunucoid
proportions
with
continued
linear
growth
into
adulthood
,
severely
delayed
epiphyseal
closure
,
and
osteoporosis
due
to
estrogen
deficiency
.
Although
estrogen
has
been
shown
to
be
essential
for
normal
sperm
production
and
function
in
mice
,
its
role
in
fertility
is
not
clear
in
men
.
Thus
far
,
one
man
and
an
unrelated
woman
with
estrogen
resistance
due
to
mutations
in
the
estrogen
receptor
α
(
ESR
1
)
gene
have
been
described
.
Their
clinical
presentations
are
similar
to
that
of
aromatase-
deficient
men
and
women
.
Diseases
Validation
Diseases presenting
"do not develop secondary sexual characteristics"
symptom
aromatase deficiency
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