Svayer syndrome: features of the disease and treatment options
Svayer syndrome is a fairly rare congenital disease, the development of which indicates a violation of the structure of the yerk chromosome( it is a question of the absence of a specific gene or its isolated mutation).
Causes of the disease
As a rule, the immediate cause of the disease is a point mutation of a particular gene located in the short arm of the yerk chromosome, or the complete loss of this gene. This region of the chromosome is responsible for the synthesis of the protein that takes part in the development of the sex of the embryo in the male type. As a result, since the effect of male sex hormones is absent, the fetus remains the only option - to be formed according to the female type. As a result, the child born has a female phenotype with the karyotype "XY".
Mutation or absence of the SRY gene leads to a malfunction in the differentiation of Sertoli cells, and, as a consequence, to the underdevelopment of the seminiferous tubules.
As a result, despite the "male" karyotype of XY, the genitals of the fetus are laid and formed according to the female type.
Clinical manifestations of
Until the onset of puberty, signs of Swayer's syndrome are outwardly virtually indistinguishable. And only in the process of growing up girls are beginning to manifest certain features:
- Inadequacy of hairy armpits and axillary areas of the external genitalia.
- Insufficient, mild breast development.
- Various degrees of underdevelopment, infantilism of the uterus.
- Hypoplasia of the vagina( occurs less frequently).Slightly expressed secondary sexual characteristics are "eunuch-like" or intersexual body type.
- Hypotrophy or atrophy of the mucous membrane of the genital organs.
- Underdevelopment of the external genitalia( labia and clitoris).
- Genital infantilism.
- In a number of cases, the body and its individual parts are growing excessively active: the lower jaw, the shoulder girdle( which results in the formation of broad shoulders), and muscle mass.
- The onset of puberty in girls with Svayer syndrome is impossible because of the absence of estrogens in their bodies.
- Complete sterility.
In the vast majority of cases, the disease is diagnosed at the age of 15-16 years, during puberty, when it becomes obvious that the patient does not have secondary sexual characteristics.
At the same time, girls who have such a mutation, reaching this age, begin to contact the gynecologist with complaints of a delay in the onset of menstruation.
Sometimes the diagnosis is due to dysplasia and malignancy of the underdeveloped gonads.
The diagnosis of "Svayer syndrome" is based on the following factors:
- Physical examination of the patient.
- Ultrasound examination.
However, confirmation of the diagnosis is possible only through the study of sexual chromatin, which reveals the presence of a male karyotype in the female phenotype.
Treatment of the Swayer syndrome is carried out in several ways.
- First of all, the removal of the ovaries is made - in view of the high probability of their transformation into malignant tumors.
- After ovariectomy, substitution treatment with hormonal drugs is prescribed. This contributes to the development of secondary sexual characteristics.
- In the case when the uterus is developed enough, there is the possibility of bearing and the birth of a healthy child( pregnancy occurs as a result of in vitro fertilization).
This disease should be distinguished from the similar in name of the Svayer-James-McLeod syndrome. This condition, like the lymphangioliomyomatosis, which is similar in manifestations, is a pathology that affects the lung tissue. Svayer syndrome and lymphangioleiomyomatosis are different diseases.