Delayed puberty and estrogen resistance in a woman with estrogen receptor alpha variant.
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Quaynor SD, Stradtman EW Jr, Kim HG, Shen Y, Chorich LP, Schreihofer DA, Layman LC
Delayed puberty and estrogen resistance in a woman with estrogen receptor alpha variant.
N Engl J Med. 2013 Jul 11;369(2):164-71. doi: 10.1056/NEJMoa1303611.
- PubMed ID
- 23841731 [ View in PubMed]
- Abstract
Although androgen resistance has been characterized in men with a normal chromosome complement and mutations in the androgen-receptor gene, a mutation in the gene encoding estrogen receptor alpha (ESR1) was previously described only in one man and not, to our knowledge, in a woman. We now describe an 18-year-old woman without breast development and with markedly elevated serum levels of estrogens and bilateral multicystic ovaries. She was found to have a homozygous loss-of-function ESR1 mutation in a completely conserved residue that interferes with estrogen signaling. Her clinical presentation was similar to that in the mouse orthologue knockout. This case shows that disruption of ESR1 causes profound estrogen resistance in women. (Funded by the National Institutes of Health.).