Wednesday, 18 April 2012

Complete androgen insensitivity syndrome (CAIS)


Complete androgen insensitivity syndrome (CAIS)

Definition?
Complete androgen insensitivity syndrome (CAIS) is a condition that results in the complete inability of the cell to respond to androgens.[1][2][3] 

What happened?
·        The unresponsiveness of the cell to the presence of androgenic hormones prevents the masculinization of male genitalia in the developing fetus, as well as the development of male secondary sexual characteristics at puberty,
·        but does not significantly impair female genital or sexual development.[3][4] 

As such, the insensitivity to androgens is only clinically significant when it occurs in genetic males (i.e. individuals with a Y chromosome, or more specifically, an SRY gene).[1] 

All affected individuals are phenotypically female; they develop a normal female habitus, despite the presence of a Y chromosome.

clasificaion
CAIS is one of three types of androgen insensitivity syndrome, which is divided into three categories that are differentiated by the degree of genital masculinization:
·        complete androgen insensitivity syndrome (CAIS) is indicated when the external genitalia is that of a normal female, 


Androgen insensitivity syndrome is the largest single entity that leads to 46,XYundermasculinization.

Diagnosis
CAIS can only be diagnosed in normal phenotypic females.[2] 
·        It is not usually suspected unless the menses fail to develop at puberty, or an inguinal hernia presents during premenarche.[1][2] 
·        As many as 1-2% of prepubertal girls that present with an inguinal hernia will also have CAIS.[1][18]
·        A diagnosis of CAIS or Swyer syndrome can be made in utero by comparing akaryotype obtained by amniocentesis with the external genitalia of the fetus during a prenatal ultrasound.[2][61] 

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