Aromatase deficiency in an Ontario Old Order Mennonite family

J Pediatr Endocrinol Metab. 2021 Aug 5;34(12):1615-1618. doi: 10.1515/jpem-2021-0229. Print 2021 Dec 20.

Abstract

Objectives: Aromatase deficiency is a rare autosomal recessive disease that results in the absence of aromatase. In females it presents with ambiguous genitalia and lack of secondary sexual characteristics during puberty. Aromatase deficiency is not attributed to any specific population, but it is more commonly seen in consanguineous parents. Herein, we report the first Old Order Mennonite family with that diagnosis.

Case presentation: Our proband is an Old Order Mennonite female born with ambiguous genitalia who was identified to carry novel homozygous variant in the CYP19A1 gene c.1304G>A (p. Arg435His). Her older brother was later confirmed with the same genetic diagnosis.

Conclusions: Recognizing the cultural sensitivity, unrecognized affected cases, and late presentation of males affected with aromatase deficiency, this condition may be more prevalent than believed in that population.

Keywords: Old Order Mennonite; ambiguous genitalia; aromatase deficiency.

Publication types

  • Case Reports

MeSH terms

  • 46, XX Disorders of Sex Development / diagnosis*
  • 46, XX Disorders of Sex Development / enzymology
  • 46, XX Disorders of Sex Development / genetics
  • Adult
  • Aromatase / deficiency*
  • Aromatase / genetics
  • Female
  • Gynecomastia / diagnosis*
  • Gynecomastia / enzymology
  • Gynecomastia / genetics
  • Homozygote
  • Humans
  • Infant, Newborn
  • Infertility, Male / diagnosis*
  • Infertility, Male / enzymology
  • Infertility, Male / genetics
  • Male
  • Metabolism, Inborn Errors / diagnosis*
  • Metabolism, Inborn Errors / enzymology
  • Metabolism, Inborn Errors / genetics
  • Mutation*
  • Virilism

Substances

  • Aromatase
  • CYP19A1 protein, human

Supplementary concepts

  • Aromatase deficiency