GATA-4 Variants in Two Unrelated Cases with 46, XY Disorder of Sex Development and Review of the Literature

Abstract

The genetic cause of 46, XY disorder of sex development (DSD) still cannot be determined in about half of the cases. GATA-4 haploinsufficiency is one of the rare causes of DSD in genetic males (46, XY). Twenty-two cases with 46, XY DSD due to GATA-4 haploinsufficiency (nine missense variant, two copy number variation) have been previously reported. In these cases, the phenotype may range from a mild undervirilization to complete female external genitalia. The haploinsufficiency may be caused by a sequence variant or copy number variation (8p23 deletion). The aim of this study was to present two unrelated patients with DSD due to GATA-4 variants and to review the phenotypic and genotypic characteristics of DSD cases related to GATA-4 deficiency.

Keywords: Disorder of sex development; GATA-4; Gonad; heart.

Figure 1

Integrative Genomics Viewer (IGV) images of NGS results of GATA-4 gene located at chromosome 8. a) Shows the heterozygous c.337 A>C variant (p.Thr113Pro) in the GATA-4 gene in Case 1. b, c) The relevant gene variant was not detected in parents of Case 1. d) Shows the c.487 C>T variant (p.Pro487Ser) in the GATA-4 gene in Case 2. e) The relevant gene variant was not detected in mother of the Case 2 (the analysis could not be done for the father)