R. Luboshitzky et al., Decreased melatonin secretion in a phenotypically male 46,XX patient with classic 21-hydroxylase deficiency, EXP CL E D, 108(3), 2000, pp. 237-240
Citations number
18
Categorie Soggetti
Endocrinology, Nutrition & Metabolism
Journal title
EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES
The possible role of gonadal steroids and gonadotropins in regulating melat
onin secretion has been suggested in clinical syndromes of the hypothalamic
-pituitary-gonadal axis. We describe the results of melatonin secretion in
a 37-year old male patient who presented with azoospermia. The patient was
an XX male, had classic simple virilizing form of 21-hydroxylase deficiency
, which led to a masculine phenotype. He was ovariectomized at the age of t
hree years and reared as a male. Melatonin production (aMT6s) was determine
d at baseline and during 12 months of replacement therapy. Results were com
pared with those obtained in age-matched male controls. Pretreatment aMT6s
values were decreased (14.3 mu g/24h vs. 29.0+/-5.5 in controls). Dexametha
sone replacement was associated with an increase in aMT6s values (19.3-20.9
mu g/24 h). The addition of testosterone to dexamethasone replacement resu
lted in normalization of aMT6s (27.6-33.1 mu g/24 h) and serum 17OH progest
erone, testosterone and estradiol levels.
The present data indicate that androgen excess due to 21 hydroxylase defici
ency is associated with decreased melatonin secretion. These results suppor
t the hypothesis that sex steroids modulate melatonin secretion.