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Aromatase deficiency in men: a clinical perspective.
[aromatase deficiency]
Human
aromatase
deficiency
is
a
very
rare
syndrome
characterized
by
congenital
estrogen
deprivation
that
is
caused
by
loss
-of-function
mutations
in
CYP
19
A
1
,
which
encodes
aromatase
.
Here
,
we
review
the
presentation
,
diagnosis
and
treatment
of
aromatase
deficiency
in
men
to
provide
useful
advice
for
clinical
management
of
the
condition
.
At
presentation
,
all
men
with
aromatase
deficiency
have
tall
stature
,
delayed
bone
maturation
,
osteopenia
or
osteoporosis
and
eunuchoid
skeletal
proportions
.
Diagnosis
of
the
condition
is
supported
by
the
presence
of
unfused
epiphyses
and
undetectable
serum
estradiol
levels
;
the
condition
can
be
further
substantiated
by
genetic
sequencing
of
CYP
19
A
1
.
Transdermal
estradiol
treatment
at
a
daily
dose
of
about
25
microg
might
be
adequate
for
lifelong
replacement
therapy
.
BMD
and
levels
of
serum
estradiol
,
luteinizing
hormone
and
testosterone
should
be
monitored
carefully
and
considered
powerful
biochemical
markers
of
adequate
estrogen
substitution
in
clinical
practice
.
Early
diagnosis
is
important
to
initiate
estrogen
therapy
as
soon
after
puberty
as
possible
to
avoid
the
skeletal
complications
that
are
associated
with
this
condition
.
Diseases
Validation
Diseases presenting
"very rare syndrome"
symptom
aromatase deficiency
erdheim-chester disease
kindler syndrome
oligodontia
papillon-lefèvre syndrome
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