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Kennedy's disease: clinical significance of tandem repeats in the androgen receptor.
[aromatase deficiency]
Kennedy
's
disease
(
KD
)
or
spinobulbar
muscular
atrophy
is
a
hereditary
X-
linked
,
progressive
neurodegenerative
condition
caused
by
an
expansion
of
the
CAG
triplet
repeat
in
the
first
exon
of
the
androgen
receptor
gene
.
The
phenotype
in
its
full
form
is
only
expressed
in
males
and
presents
as
weakness
and
wasting
of
the
upper
and
lower
limbs
and
bulbar
muscles
associated
with
absent
reflexes
.
Sensory
disturbances
are
present
.
Various
endocrine
abnormalities
including
decreased
fertility
and
gynecomastia
are
common
and
amongst
the
first
features
of
KD
.
Animal
models
of
KD
have
demonstrated
improvement
on
withdrawal
of
testosterone
,
indicating
that
this
agonist
of
the
androgen
receptor
is
required
for
the
toxic
effect
.
Potential
therapies
based
on
testosterone
withdrawal
in
humans
have
shown
some
promise
,
but
efficacy
remains
to
be
proven
.
Potential
clinical
factors
,
pathogenesis
and
future
approaches
to
therapy
are
reviewed
in
this
chapter
.
Diseases
Validation
Diseases presenting
"indicating that this agonist of the androgen receptor is required for the toxic effect"
symptom
aromatase deficiency
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