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.