Clinical characteristics and genetic analysis of a patient with Kennedy disease with secondary infertility as the initial symptom.
10.3760/cma.j.cn511374-20250703-00400
- Author:
Jie CHEN
1
,
2
;
Yinshan JIN
;
Xuebao ZHANG
;
Yuanqing CUI
;
Xiong WANG
Author Information
1. Reproductive Medicine Center, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong 264000, China. wx83905@
2. com.
- Publication Type:English Abstract
- MeSH:
Humans;
Male;
Bulbo-Spinal Atrophy, X-Linked/diagnosis*;
Adult;
Infertility, Male/genetics*;
Receptors, Androgen/genetics*;
Exome Sequencing;
Mutation;
Pedigree;
Trinucleotide Repeats
- From:
Chinese Journal of Medical Genetics
2025;42(12):1496-1501
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the clinical features and genetic basis of a male patient with Kennedy disease(KD) presenting as secondary infertility.
METHODS:A male patient who had presented at Yantai Yuhuangding Hospital in August 2023 for secondary infertility for 5 years was selected as the study subject. Clinical data, laboratory findings, and auxiliary examination of the patient were collected. Peripheral blood samples were obtained from the patient and his family members. Following DNA extraction, whole-exome sequencing (WES) was carried out. Pathogenicity of candidate variant was predicted by bioinformatics analysis. Fluorescence probe PCR-capillary electrophoresis was employed to analyze the trinucleotide CAG repeat sequence variation in the AR gene to rule out dynamic mutation. This study was approved by the Ethics Committee of Yantai Yuhuangding Hospital (Ethics No.: 2024-697).
RESULTS:The patient had presented with non-obstructive azoospermia and elevated androgen sensitivity index. Ultrasound scan indicated small testicular volume and seminal vesicle atrophy. WES and bioinformatics analysis revealed abnormal amplification in the patient's AR gene. Fluorescence probe PCR and capillary electrophoresis confirmed that both the proband and his nephew had harbored 52 CAG trinucleotide repeats in exon 1 of the AR gene, confirming the diagnosis of KD. The proband's mother, elder sister, and daughter were identified as carriers of the variant, while his second elder sister did not carry the mutation.
CONCLUSION:As a rare X-linked recessive genetic disease, KD mainly manifests with muscle weakness, myasthenia gravis and myofascial tremor, while cases with infertility and non-obstructive azoospermia as the initial symptoms are rare and can be easily missed. Diagnosis made by genetic testing needs to be taken seriously by the clinicians.
