Type II Leydig cell hypoplasia caused by LHCGR gene mutation: a case report

JIN Ke-Xin, SU Zhe, JIAO Yan-Hua, PAN Li-Li, JIANG Xian-Ping, YIN Jian-Chun, LI Jia-Qiang

Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (2) : 225-228.

PDF(798 KB)
HTML
PDF(798 KB)
HTML
Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (2) : 225-228. DOI: 10.7499/j.issn.1008-8830.2410074
CASE REPORT

Type II Leydig cell hypoplasia caused by LHCGR gene mutation: a case report

  • JIN Ke-Xin, SU Zhe, JIAO Yan-Hua, PAN Li-Li, JIANG Xian-Ping, YIN Jian-Chun, LI Jia-Qiang
Author information +
History +

Abstract

The patient, assigned female at birth and aged 1 year and 7 months, presented with clinical manifestations of 46,XY disorders of sex development. The external genitalia exhibited a severely undermasculinized phenotype. Laboratory tests and gonadal biopsy indicated poor Leydig cell function and good Sertoli cell function. Genetic testing revealed compound heterozygous mutations of c.867-2A>C and c.547G>A (p.G183R) in the LHCGR gene. The patient was ultimately diagnosed with type II Leydig cell hypoplasia. Type II Leydig cell hypoplasia presents a broad spectrum of clinical phenotypes, characterized by a lack of parallel function between Leydig cells and Sertoli cells, and significant individual variability in spermatogenesis and gender assignment. This condition should be considered when there is poor Leydig cell function but good development of Wolffian duct derivatives.

Key words

Leydig cell hypoplasia / LHCGR gene / 46,XY disorders of sex development / Toddler

Cite this article

Download Citations
JIN Ke-Xin, SU Zhe, JIAO Yan-Hua, PAN Li-Li, JIANG Xian-Ping, YIN Jian-Chun, LI Jia-Qiang. Type II Leydig cell hypoplasia caused by LHCGR gene mutation: a case report[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(2): 225-228 https://doi.org/10.7499/j.issn.1008-8830.2410074

References

1 Golombok S, Rust J. The measurement of gender role behaviour in pre-school children: a research note[J]. J Child Psychol Psychiatry, 1993, 34(5): 805-811. PMID: 8340446. DOI: 10.1111/j.1469-7610.1993.tb01072.x.
2 王秋菊, 沈亦平, 邬玲仟, 等. 遗传变异分类标准与指南[J]. 中国科学(生命科学), 2017, 47(6): 668-688. DOI: 10.1360/N052017-00099.
3 Aktar Karakaya A, ?ay?r A, Unal E, et al. A rare cause of primary amenorrhea: LHCGR gene mutations[J]. Eur J Obstet Gynecol Reprod Biol, 2022, 272: 193-197. PMID: 35366614. DOI: 10.1016/j.ejogrb.2022.03.033.
4 Mendonca BB, Costa EMF, Belgorosky A, et al. 46, XY DSD due to impaired androgen production[J]. Best Pract Res Clin Endocrinol Metab, 2010, 24(2): 243-262. PMID: 20541150. DOI: 10.1016/j.beem.2009.11.003.
5 Jahan S, Abul Hasanat M, Alam F, et al. Leydig cell hypoplasia: a unique paradox in the diagnosis of 46, XY disorders of sex development[J]. AACE Clin Case Rep, 2020, 6(3): e117-e122. PMID: 32524024. PMCID: PMC7282282. DOI: 10.4158/ACCR-2019-0152.
6 Vezzoli V, Duminuco P, Vottero A, et al. A new variant in signal peptide of the human luteinizing hormone receptor (LHCGR) affects receptor biogenesis causing Leydig cell hypoplasia[J]. Hum Mol Genet, 2015, 24(21): 6003-6012. PMID: 26246498. DOI: 10.1093/hmg/ddv313.
7 Martens JW, Verhoef-Post M, Abelin N, et al. A homozygous mutation in the luteinizing hormone receptor causes partial Leydig cell hypoplasia: correlation between receptor activity and phenotype[J]. Mol Endocrinol, 1998, 12(6): 775-784. PMID: 9626653. DOI: 10.1210/mend.12.6.0124.
8 Misrahi M, Meduri G, Pissard S, et al. Comparison of immunocytochemical and molecular features with the phenotype in a case of incomplete male pseudohermaphroditism associated with a mutation of the luteinizing hormone receptor[J]. J Clin Endocrinol Metab, 1997, 82(7): 2159-2165. PMID: 9215288. DOI: 10.1210/jcem.82.7.4039.
9 Themmen APN, Verhoef-Post M. LH receptor defects[J]. Semin Reprod Med, 2002, 20(3): 199-204. PMID: 12428200. DOI: 10.1055/s-2002-35384.
10 Richard N, Leprince C, Gruchy N, et al. Identification by array-comparative genomic hybridization (array-CGH) of a large deletion of luteinizing hormone receptor gene combined with a missense mutation in a patient diagnosed with a 46, XY disorder of sex development and application to prenatal diagnosis[J]. Endocr J, 2011, 58(9): 769-776. PMID: 21720050. DOI: 10.1507/endocrj.k11e-119.
11 Pals-Rylaarsdam R, Liu G, Brickman W, et al. A novel double mutation in the luteinizing hormone receptor in a kindred with familial Leydig cell hypoplasia and male pseudohermaphroditism[J]. Endocr Res, 2005, 31(4): 307-323. PMID: 16433250. DOI: 10.1080/07435800500430890.
12 Leung MY, Al-Muslim O, Wu SM, et al. A novel missense homozygous inactivating mutation in the fourth transmembrane helix of the luteinizing hormone receptor in Leydig cell hypoplasia[J]. Am J Med Genet A, 2004, 130A(2): 146-153. PMID: 15372531. DOI: 10.1002/ajmg.a.20681.
13 Salameh W, Choucair M, Guo TB, et al. Leydig cell hypoplasia due to inactivation of luteinizing hormone receptor by a novel homozygous nonsense truncation mutation in the seventh transmembrane domain[J]. Mol Cell Endocrinol, 2005, 229(1-2): 57-64. PMID: 15607529. DOI: 10.1016/j.mce.2004.09.005.
14 Gromoll J, Eiholzer U, Nieschlag E, et al. Male hypogonadism caused by homozygous deletion of exon 10 of the luteinizing hormone (LH) receptor: differential action of human chorionic gonadotropin and LH[J]. J Clin Endocrinol Metab, 2000, 85(6): 2281-2286. PMID: 10852464. DOI: 10.1210/jcem.85.6.6636.
15 Kossack N, Troppmann B, Richter-Unruh A, et al. Aberrant transcription of the LHCGR gene caused by a mutation in exon 6A leads to Leydig cell hypoplasia type II[J]. Mol Cell Endocrinol, 2013, 366(1): 59-67. PMID: 23232123. DOI: 10.1016/j.mce.2012.11.018.
16 杨宇帆, 赵亚玲, 王曦, 等. LHCGR基因复合杂合突变导致小阴茎1例[J]. 基础医学与临床, 2022, 42(10): 1492-1496. DOI: 10.16352/j.issn.1001-6325.2022.10.1492.
PDF(798 KB)
HTML

Accesses

Citation

Detail

Sections
Recommended

/