Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

A Case of Primary Hypogonadism with Features of Albright’s Syndrome

Authors
1 Department of Biochemistry, IQ City Medical College and Narayana Multispeciality Hospital, Durgapur, West Bengal, India
2 Department of Endocrinology, Mission Hospital, Durgapur, West Bengal, India
Abstract
Background: McCune Albright syndrome is rare with an estimated prevalence of 1 in 100,000 to 1 in 1,000,000 persons. The classical clinical triad consists of fibrous dysplasia of the bone, café-au-lait skin spots and precocious puberty. However, in rare cases, there may be primary hypogonadism and amenorrhea. Case Presentation: An eighteen-year-old female presented with amenorrhea. She had a short stature, round face, thick neck, and short fourth metacarpals and metatarsals. The secondary sexual characters were absent. Serum calcium, phosphorus and parathyroid concentrations were normal, but gonadotropin hormones were very low. X-ray examination revealed short fourth and fifth metacarpals, short left metatarsal, and short fibula. Conclusion: These local bony abnormalities along with the biochemical findings helped us to diagnose this case as an unusual presentation of primary hypogonadism with features of McCune Albright’s syndrome where there was amenorrhea rather than preocious puberty.
Keywords

  1. Pereda A, Garin I, Garcia-Barcina M, Gener B, Beristain E, Ibanez AM, et al. Brachydactyly E: isolated or as a feature of a syndrome. Orphanet J Rare Dis. 2013;8:141.
  2. Simon A, Koppeschaar HP, Roijers JF, Hoppener JW, Lips CJ. Pseudohypoparathyroidism type Ia. Albright hereditary osteodystrophy: a model for research on G protein-coupled receptors and genomic imprinting. Neth J Med. 2000;56(3):100-9.
  3. Cho SY, Yoon YA, Ki CS, Huh HJ, Yoo HW, Lee BH, et al. Clinical characterization and molecular classification of 12 Korean patients with pseudohypoparathyroidism and pseudopseudohypoparathyroidism. Exp Clin Endocrinol Diabe-tes. 2013;121(9):539-45.
  4. Archibald RM, Finby N, De Vito F. Endocrine significance of short metacarpals. J Clin Endocrinol Metab. 1959;19:1312-22.
  5. Kirkos JM. Idiopathic symmetrical shortening of the fourth and fifth metacarpal and metatarsal bilaterally. A case report. Acta Orthop Belg. 1999;65(4):532-5.
  6. Gandhi P, Gupta RC, Chaudhary HR, Jain R, Gupta RK. Brachydactyly. J Indian Acad Clin Med. 2002;3(1):89-90.
  7. Valizadeh N, Mehdizadeh A, Nazarbaghi S. Short fourth and fifth metacarpals in a case of idiopathic primary hypoparathyroidism. Indian J Endocrinol Metab. 2013;17(5):924-6.
  8. Tzaveas A, Paraskevas G, Gekas C, Vrettakos A, Antoniou K, Spyridakis I. Anatomical variation of co-existence of 4th and 5th short metacarpal bones, sesamoid ossicles and exostoses of ulna and radius in the same hand: a case report. Cases J. 2008;1(1):281.
  9. Wu YL, Hwang DY, Hsiao HP, Ting WH, Huang CY, Tsai WY, et al. Mutations in pseudohypoparathyroidism 1a and pseudopseudohypoparathyroidism in ethnic Chinese. PLoS One. 2014;9(3):e90640.
  10. Kottler ML. [Paternal GNAS mutations: Which phenotypes? What genetic counseling?]. Ann Endocrinol (Paris). 2015;76(2):105-9. French.
  11. Turan S, Thiele S, Tafaj O, Brix B, Atay Z, Abali S, et al. Evidence of hormone resistance in a pseudo-pseudohypoparathyroidism patient with a novel paternal mutation in GNAS. Bone. 2015;71:53-7.