Gonadotropin-releasing hormone insensitivity: Difference between revisions

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{{Infobox medical condition (new)
 
| name           =  
{{Infobox medical condition
| synonyms       =
| name                   = Gonadotropin-releasing hormone insensitivity
| image          =
| synonyms               = GnRH insensitivity, Hypogonadotropic hypogonadism
| caption        =
| field                   = [[Endocrinology]]
| pronounce      =  
| symptoms               = [[Delayed puberty]], [[infertility]], [[anosmia]]
| field           = endocrinology
| complications           = [[Osteoporosis]], [[infertility]]
| symptoms       =  
| onset                   = [[Birth]] or [[adolescence]]
| complications   =  
| duration               = [[Lifelong]]
| onset           =  
| causes                 = [[Genetic mutation]]
| duration       =
| risks                   = [[Family history]]
| types          =  
| diagnosis               = [[Hormone level testing]], [[genetic testing]]
| causes         =  
| differential           = [[Kallmann syndrome]], [[Constitutional delay of growth and puberty]]
| risks           =  
| treatment               = [[Hormone replacement therapy]], [[assisted reproductive technology]]
| diagnosis       =  
| prognosis               = [[Variable]], depending on treatment
| differential   =
| frequency               = Rare
| prevention      =  
| treatment       =
| medication      =  
| prognosis       =  
| frequency       =
| deaths          =  
}}
}}
'''Gonadotropin-releasing hormone''' ('''GnRH''') '''insensitivity''' is a rare [[autosomal recessive]] [[genetic disorder|genetic]] and [[endocrine disease|endocrine]] [[syndrome]] which is characterized by inactivating [[genetic mutation|mutation]]s of the [[gonadotropin-releasing hormone receptor]] (GnRHR) and thus an insensitivity of the receptor to [[gonadotropin-releasing hormone]] (GnRH), resulting in a partial or complete loss of the ability of the [[gonad]]s to synthesize the [[sex hormone]]s. The condition manifests itself as [[isolated hypogonadotropic hypogonadism]] (IHH), presenting with symptoms such as [[delayed puberty|delayed, reduced, or absent puberty]], low or complete lack of [[libido]], and [[infertility]], and is the predominant cause of IHH when it does not present alongside [[anosmia]].<ref name="pmid21645587">{{cite journal |vauthors=Chevrier L, Guimiot F, de Roux N | title = GnRH receptor mutations in isolated gonadotropic deficiency | journal = Molecular and Cellular Endocrinology | volume = 346 | issue = 1–2 | pages = 21–8 |date=October 2011 | pmid = 21645587 | doi = 10.1016/j.mce.2011.04.018 }}</ref><ref name="pmid22229029">{{cite journal |vauthors=Beate K, Joseph N, Nicolas de R, Wolfram K | title = Genetics of isolated hypogonadotropic hypogonadism: role of GnRH receptor and other genes | journal = International Journal of Endocrinology | volume = 2012 | issue = | pages = 1–9 | year = 2012 | pmid = 22229029 | pmc = 3249753 | doi = 10.1155/2012/147893 | url = }}</ref><ref name="pmid17161329">{{cite journal | author = de Roux N | title = GnRH receptor and GPR54 inactivation in isolated gonadotropic deficiency | journal = Best Practice & Research. Clinical Endocrinology & Metabolism | volume = 20 | issue = 4 | pages = 515–28 |date=December 2006 | pmid = 17161329 | doi = 10.1016/j.beem.2006.10.005 }}</ref>
{{Short description|A condition characterized by the body's inability to respond to gonadotropin-releasing hormone}}
 
'''Gonadotropin-releasing hormone insensitivity''' (GnRH insensitivity) is a rare [[endocrine disorder]] characterized by the body's inability to respond to [[gonadotropin-releasing hormone]] (GnRH). This condition leads to a deficiency in the production of [[gonadotropins]], which are crucial for the normal functioning of the [[reproductive system]].
==See also==
==Pathophysiology==
* [[Gonadotropin-releasing hormone|GnRH]] and [[gonadotropin]]s
GnRH is a [[decapeptide]] hormone produced by the [[hypothalamus]]. It plays a critical role in the regulation of the [[pituitary gland]], stimulating the secretion of [[luteinizing hormone]] (LH) and [[follicle-stimulating hormone]] (FSH). These hormones are essential for [[gonadal function]], including the production of [[sperm]] in males and the regulation of the [[menstrual cycle]] in females.
In individuals with GnRH insensitivity, there is a disruption in the signaling pathway of GnRH, leading to inadequate stimulation of the pituitary gland. This results in low levels of LH and FSH, causing [[hypogonadism]] and affecting [[puberty]] and [[fertility]].
==Causes==
GnRH insensitivity can be caused by mutations in the [[GnRH receptor]] gene, which impair the receptor's ability to bind to GnRH or transduce the signal. These mutations can be inherited in an [[autosomal recessive]] manner, meaning that both copies of the gene must be affected for the condition to manifest.
==Clinical Presentation==
The clinical presentation of GnRH insensitivity varies depending on the severity of the receptor defect. Common features include:
* Delayed or absent [[puberty]]
* [[Infertility]]
* Low levels of [[sex steroids]] such as [[testosterone]] in males and [[estrogen]] in females
* Underdeveloped [[secondary sexual characteristics]]
==Diagnosis==
Diagnosis of GnRH insensitivity involves a combination of clinical evaluation, hormonal assays, and genetic testing. Low levels of LH and FSH in the presence of low sex steroids suggest a central cause of hypogonadism. Genetic testing can confirm mutations in the GnRH receptor gene.
==Treatment==
Management of GnRH insensitivity focuses on hormone replacement therapy to induce and maintain secondary sexual characteristics and support fertility. In males, [[testosterone replacement therapy]] is commonly used, while females may receive [[estrogen]] and [[progesterone]] therapy. Assisted reproductive technologies may be necessary for individuals seeking to achieve fertility.
==Prognosis==
With appropriate treatment, individuals with GnRH insensitivity can lead normal lives, although fertility may remain a challenge. Early diagnosis and intervention are crucial for optimal outcomes.
==Related pages==
* [[Hypogonadotropic hypogonadism]]
* [[Hypogonadotropic hypogonadism]]
* [[Hypopituitarism]]
* [[Endocrinology]]
* [[Inborn errors of steroid metabolism]]
* [[Reproductive endocrinology]]
* [[Kallmann syndrome]]
[[Category:Endocrine disorders]]
* [[Leydig cell hypoplasia]]
[[Category:Reproductive system]]
* [[Sex hormone]]s
 
==References==
{{reflist}}
== External links ==
{{Medical resources
|  DiseasesDB    =
|  ICD10          =
|  ICD9          =
|  ICDO          =
|  OMIM          =
|  MedlinePlus    =
|  eMedicineSubj  = article
|  eMedicineTopic = 255152
|  MeshID        =
}}
{{Endocrine pathology}}
{{Receptor deficiencies}}
 
[[Category:Autosomal recessive disorders]]
[[Category:Endocrine gonad disorders]]
[[Category:Gonadotropin-releasing hormone and gonadotropins]]
[[Category:Rare diseases]]
[[Category:Syndromes]]
 
 
{{Genetic-disorder-stub}}
{{dictionary-stub1}}

Latest revision as of 23:38, 3 April 2025


Gonadotropin-releasing hormone insensitivity
Synonyms GnRH insensitivity, Hypogonadotropic hypogonadism
Pronounce N/A
Specialty N/A
Symptoms Delayed puberty, infertility, anosmia
Complications Osteoporosis, infertility
Onset Birth or adolescence
Duration Lifelong
Types N/A
Causes Genetic mutation
Risks Family history
Diagnosis Hormone level testing, genetic testing
Differential diagnosis Kallmann syndrome, Constitutional delay of growth and puberty
Prevention N/A
Treatment Hormone replacement therapy, assisted reproductive technology
Medication N/A
Prognosis Variable, depending on treatment
Frequency Rare
Deaths N/A


A condition characterized by the body's inability to respond to gonadotropin-releasing hormone


Gonadotropin-releasing hormone insensitivity (GnRH insensitivity) is a rare endocrine disorder characterized by the body's inability to respond to gonadotropin-releasing hormone (GnRH). This condition leads to a deficiency in the production of gonadotropins, which are crucial for the normal functioning of the reproductive system.

Pathophysiology[edit]

GnRH is a decapeptide hormone produced by the hypothalamus. It plays a critical role in the regulation of the pituitary gland, stimulating the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are essential for gonadal function, including the production of sperm in males and the regulation of the menstrual cycle in females. In individuals with GnRH insensitivity, there is a disruption in the signaling pathway of GnRH, leading to inadequate stimulation of the pituitary gland. This results in low levels of LH and FSH, causing hypogonadism and affecting puberty and fertility.

Causes[edit]

GnRH insensitivity can be caused by mutations in the GnRH receptor gene, which impair the receptor's ability to bind to GnRH or transduce the signal. These mutations can be inherited in an autosomal recessive manner, meaning that both copies of the gene must be affected for the condition to manifest.

Clinical Presentation[edit]

The clinical presentation of GnRH insensitivity varies depending on the severity of the receptor defect. Common features include:

Diagnosis[edit]

Diagnosis of GnRH insensitivity involves a combination of clinical evaluation, hormonal assays, and genetic testing. Low levels of LH and FSH in the presence of low sex steroids suggest a central cause of hypogonadism. Genetic testing can confirm mutations in the GnRH receptor gene.

Treatment[edit]

Management of GnRH insensitivity focuses on hormone replacement therapy to induce and maintain secondary sexual characteristics and support fertility. In males, testosterone replacement therapy is commonly used, while females may receive estrogen and progesterone therapy. Assisted reproductive technologies may be necessary for individuals seeking to achieve fertility.

Prognosis[edit]

With appropriate treatment, individuals with GnRH insensitivity can lead normal lives, although fertility may remain a challenge. Early diagnosis and intervention are crucial for optimal outcomes.

Related pages[edit]