Aromatase Deficiency

Overview


Plain-Language Overview

Aromatase Deficiency is a rare genetic condition that affects the body's ability to produce estrogen, a hormone important for sexual development and bone health. This condition involves the endocrine system, specifically the enzyme aromatase, which converts androgens into estrogens. People with this deficiency may experience delayed or absent puberty, ambiguous genitalia in genetic females, and tall stature due to delayed bone maturation. In genetic males, it can cause continued growth and osteoporosis. The lack of estrogen also affects the reproductive system and can lead to infertility. Overall, this condition disrupts normal hormone balance and development.

Clinical Definition

Aromatase Deficiency is an autosomal recessive disorder caused by mutations in the CYP19A1 gene, leading to deficient activity of the aromatase enzyme. Aromatase catalyzes the conversion of androgens to estrogens, and its deficiency results in low estrogen levels and elevated androgen levels. This hormonal imbalance causes ambiguous genitalia in 46,XX individuals, virilization of female fetuses, and delayed epiphyseal closure leading to tall stature. In 46,XY individuals, it may cause delayed bone maturation and osteoporosis due to lack of estrogen's role in bone homeostasis. The condition also leads to maternal virilization during pregnancy due to excess androgens crossing the placenta. Diagnosis is important for managing endocrine and reproductive complications.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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