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Ambiguous genitalia, impaired steroidogenesis, and Antley-Bixler syndrome in a patient with P450 oxidoreductase deficiency.
[aromatase deficiency]
Cytochrome
P
450
oxidoreductase
deficiency
is
a
recently
established
autosomal
recessive
disease
characterised
by
ambiguous
genitalia
,
impaired
steroidogenesis
,
and
skeletal
malformations
,
referred
to
as
Antley-
Bixler
syndrome
.
Clinical
manifestations
in
affected
patients
are
highly
variable
.
We
report
on
a
girl
with
P
450
oxidoreductase
deficiency
who
presented
with
virilisation
at
birth
.
There
was
transient
maternal
virilisation
during
pregnancy
as
well
.
She
was
initially
diagnosed
with
congenital
adrenal
hyperplasia
caused
by
21
-
hydroxylase
deficiency
and
/
or
aromatase
deficiency
.
At
1
year
of
age
,
skeletal
abnormalities
suggestive
of
Antley-
Bixler
syndrome
were
detected
.
Molecular
analysis
of
the
fibroblast
growth
factor
receptor
2
(
FGFR
2
)
gene
was
normal
but
POR
gene
analysis
showed
that
she
was
homozygous
for
an
R
457
H
missense
mutation
.
The
diagnosis
,
P
450
oxidoreductase
deficiency
,
was
confirmed
.
Results
of
her
endocrine
studies
and
urinary
steroid
profiling
are
also
presented
.
Diseases
Validation
Diseases presenting
"skeletal abnormalities"
symptom
22q11.2 deletion syndrome
aromatase deficiency
child syndrome
dentin dysplasia
dentinogenesis imperfecta
erdheim-chester disease
gm1 gangliosidosis
holt-oram syndrome
kabuki syndrome
kallmann syndrome
kindler syndrome
neonatal adrenoleukodystrophy
primary hyperoxaluria type 1
wolf-hirschhorn syndrome
zellweger syndrome
This symptom has already been validated