<strong>Background:</strong> We report a rare case of congenital bilateral testicular agenesis who presented with a suicide attempt. We pose the question of testosterone therapy could improve his mental he...<strong>Background:</strong> We report a rare case of congenital bilateral testicular agenesis who presented with a suicide attempt. We pose the question of testosterone therapy could improve his mental health. <strong>Case Report: </strong>A 36-year-old man was admitted to a psychiatric ward after the suicide attempt. An endocrinology consult is requested to address if hormone replacement therapy could improve his depression and future suicide attempts. His past medical history is significant for gonadal agenesis, testicular implants placement at age 16, bipolar type 1 diagnosed 2 years ago before the presentation. The patient received testosterone replacement treatment at age 13 - 15 years. Since that time, he has not been placed on any testosterone therapy. Physical exam revealed minimal axillary and pubic hair, testicular implants with a microphallus. Laboratory values reflect hypergonadotropic hypogonadism consistent with testicular agenesis. He was suicidal and testosterone treatment was deferred. <strong>Discussion:</strong> It is a rare case of congenital testicular agenesis with bipolar disorder which was resistant to therapy. The patient had profound hypogonadism, which needed testosterone replacement therapy. However, the therapy was deferred because of an acute psychotic condition. This case also highlights that there is no strong evidence of the effect of hormonal therapy on mental health in this group.展开更多
Klippel-Trenaunay syndrome (KTS) is not a common congenital vascular abnormality. A trio of capillary malformation, venous varicosities, and bony or soft-tissue hypertrophy define this syndrome. Significant morbiditie...Klippel-Trenaunay syndrome (KTS) is not a common congenital vascular abnormality. A trio of capillary malformation, venous varicosities, and bony or soft-tissue hypertrophy define this syndrome. Significant morbidities associated with this illness include bleeding, deep vein thrombosis, and embolic consequences. Angiokeratoma circumscriptum naeviforme (ACN) is indeed a congenital variant of angiokeratoma that appears as a hyperkeratotic plaque on the lower extremity. Bilateral congenital anorchia (BCA) is the total lack of testicular tissue in a male with a normal phenotype and karyotype. KTS has been linked to ACN. Here we presented an 8-year-old male child who came with a swollen left thigh and the right side of his face with overlying blackish nodules on his left thigh and scrotum. The patient was diagnosed as KTS with angiokeratoma circumscriptum naeviforme and bilateral congenital anorchia based on his history, imaging studies and the typical clinical features of the disease.展开更多
文摘<strong>Background:</strong> We report a rare case of congenital bilateral testicular agenesis who presented with a suicide attempt. We pose the question of testosterone therapy could improve his mental health. <strong>Case Report: </strong>A 36-year-old man was admitted to a psychiatric ward after the suicide attempt. An endocrinology consult is requested to address if hormone replacement therapy could improve his depression and future suicide attempts. His past medical history is significant for gonadal agenesis, testicular implants placement at age 16, bipolar type 1 diagnosed 2 years ago before the presentation. The patient received testosterone replacement treatment at age 13 - 15 years. Since that time, he has not been placed on any testosterone therapy. Physical exam revealed minimal axillary and pubic hair, testicular implants with a microphallus. Laboratory values reflect hypergonadotropic hypogonadism consistent with testicular agenesis. He was suicidal and testosterone treatment was deferred. <strong>Discussion:</strong> It is a rare case of congenital testicular agenesis with bipolar disorder which was resistant to therapy. The patient had profound hypogonadism, which needed testosterone replacement therapy. However, the therapy was deferred because of an acute psychotic condition. This case also highlights that there is no strong evidence of the effect of hormonal therapy on mental health in this group.
文摘Klippel-Trenaunay syndrome (KTS) is not a common congenital vascular abnormality. A trio of capillary malformation, venous varicosities, and bony or soft-tissue hypertrophy define this syndrome. Significant morbidities associated with this illness include bleeding, deep vein thrombosis, and embolic consequences. Angiokeratoma circumscriptum naeviforme (ACN) is indeed a congenital variant of angiokeratoma that appears as a hyperkeratotic plaque on the lower extremity. Bilateral congenital anorchia (BCA) is the total lack of testicular tissue in a male with a normal phenotype and karyotype. KTS has been linked to ACN. Here we presented an 8-year-old male child who came with a swollen left thigh and the right side of his face with overlying blackish nodules on his left thigh and scrotum. The patient was diagnosed as KTS with angiokeratoma circumscriptum naeviforme and bilateral congenital anorchia based on his history, imaging studies and the typical clinical features of the disease.
