Skip to main content

Aromatase Excess Syndrome (AES)

Description

Aromatase excess syndrome is a condition characterized by elevated levels of the female sex hormone estrogen in both males and females. Males with aromatase excess syndrome experience breast enlargement (gynecomastia) in late childhood or adolescence. The bones of affected males grow and develop more quickly and stop growing sooner than usual (advanced bone age). As a result males have an early growth spurt, typically during late childhood, with short stature as an adult. Affected females rarely show signs and symptoms of the condition, but they may have increased breast growth (macromastia), irregular menstrual periods, and short stature. The ability to have children (fertility) is usually normal in both males and females with aromatase excess syndrome.


Causes

Rearrangements of genetic material involving the CYP19A1 gene cause aromatase excess syndrome. The CYP19A1 gene provides instructions for making an enzyme called aromatase. This enzyme converts a class of hormones called androgens, which are involved in male sexual development, to different forms of estrogen. In females, estrogen guides female sexual development before birth and during puberty. In both males and females, estrogen plays a role in regulating bone growth.

The condition can result from several types of genetic rearrangements involving the CYP19A1 gene. These rearrangements alter the activity of the gene and lead to an increase in aromatase production. In affected males, the increased aromatase and subsequent conversion of androgens to estrogen are responsible for the gynecomastia and limited bone growth characteristic of aromatase excess syndrome. Increased estrogen in females can cause symptoms such as irregular menstrual periods and short stature.

Key Clinical Features

In Males: The most distinct sign is bilateral breast enlargement (gynecomastia) that appears in late childhood or adolescence and persists for life. Affected boys also experience an early growth spurt, advanced bone age, and early fusion of the growth plates, which ultimately causes short stature as an adult. They may also experience mild testosterone deficiency.

In Females: Females usually show few, if any, outward signs of the condition. However, some may experience increased breast growth (macromastia), irregular periods, and short adult stature.

Fertility: Despite hormone imbalances, fertility is generally unimpaired in both sexes

The condition is inherited in an autosomal dominant pattern. It results from genetic rearrangements (such as duplications, deletions, or inversions) near the CYP19A1 gene. These rearrangements cause the aromatase enzyme—which converts androgens into estrogens—to be overactive or expressed in tissues where it shouldn't be


Diagnosis

Diagnosis relies on:

  • Hormone Testing: Elevated levels of circulating estrogens (estradiol and estrone).
  • Bone Age Assessment: X-rays showing accelerated bone maturation.
  • Genetic Testing: Molecular analysis verifying structural abnormalities in the CYP19A1 gene

Management

Management often requires a multidisciplinary approach involving pediatric endocrinologists and may include:

Aromatase Inhibitors: Medications such as anastrozole or letrozole are frequently prescribed to block the excess conversion of androgens into estrogens, thereby reducing gynecomastia and preventing premature bone closure.

Surgery: Cosmetic or reconstructive mastectomy is sometimes performed to remove excess breast tissue, especially to alleviate psychological distress


Comments

Post a Comment

Popular posts from this blog

Charge Syndrome

Overview CHARGE syndrome is a recognizable genetic syndrome with known pattern of features. It is an extremely complex syndrome, involving extensive medical and physical difficulties that differ from child to child. CHARGE syndrome is correlated with genetic mutation to CHD7 and the prevalence of CHARGE syndrome is 1:10,000-1:15,000 live births. Babies with CHARGE syndrome are often born with life-threatening birth defects. They spend many months in the hospital and undergo many surgeries and other treatments. Swallowing and breathing problems make life difficult even when they come home. Most have hearing two little girls sitting on a carpet, one girl has a trach and is biting her finger.loss, vision loss, and balance problems that delay their development and communication. Despite these seemingly insurmountable obstacles, children with CHARGE syndrome often far surpass their medical, physical, educational, and social expectations. One of the hidden features of CHARGE syndrome is the ...
7 comments
Read more

Dehydration Due to Diarrheal Diseases

Overview Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration. This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults. Dehydration also can occur in any age group if you don't drink enough water during hot weather — especially if you are exercising vigorously. You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment. ...
Post a Comment
Read more

Vogt-Koyanagi-Harada (VKH) Disease

  Vogt-Koyanagi-Harada (VKH) Disease Disease Overview Vogt-Koyanagi-Harada disease is a rare disorder of unknown origin that affects many body systems, including as the eyes, ears, skin, and the covering of the brain and spinal cord (the meninges). The most noticeable symptom is a rapid loss of vision. There may also be neurological signs such as severe headache, vertigo, nausea, and drowsiness. Loss of hearing, and loss of hair (alopecia) and skin color may occur along, with whitening (loss of pigmentation) of the hair and eyelashes (poliosis). Signs & Symptoms Vogt-Koyanagi-Harada disease is initially characterized by headaches, very deep pain in the eyes, dizziness (vertigo), and nausea. These symptoms are usually followed in a few weeks by eye inflammation (uveitis) and blurring of vision. This may occur in both eyes at the same time or in one eye first and, a few days later, in the other. The retina may detach and hearing loss may become apparent. The chronic stage follows...
Post a Comment
Read more