4/22/2020 PedsUroFLO lecture highlights: Dr. Hittelman on DSD

Following is not a summary of the talk, but some points I wanted to write down for future reference.

  • Leydig cells make testosterone
  • Sertoli cells make MIS. MIS works locally –paracrine– (i.e, if one testis is dysgenetic, you will have mullerian structures on that side).
  • Leave testicles in CAIS patients to help them get through puberty.
  • Some patients with PAIS develop breast enlargement due to conversion of excess testosterone to estrogen. Consider aromatase inhibitor.
  • The book Middlesex was about a patient with 5-alpha reductase deficiency.
  • Persistent mullerian structures (hernia uteri inguinale): problem with MIS or MIS receptor. Rx histerectomy, versus partial hysterctomy, vs split uterus (to preserve vas).
  • Streak gonads + Y chromosome = gonadectomy.

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