Sudan Journal of Medical Sciences

ISSN: 1858-5051

High-impact research on the latest developments in medicine and healthcare across MENA and Africa

Unexpected Diagnosis of Complete Androgen Insensitivity Syndrome (CAIS) During Inguinal Hernia Repair in 11-year-old-girl

Published date: Mar 31 2021

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 16 (2021), Issue No. 1

Pages: 70-75

DOI: 10.18502/sjms.v16i1.8938

Authors:

Rayan KhalidEmail: N/A
Affiliation: Sudanese Intersex Working Group, Sudan, Khartoum, Sudan
Biography:

Alaa M. SiddigEmail: N/A
Affiliation: Department of Pediatric Surgery, Khartoum Teaching Hospital, Khartoum, Sudan
Biography:

Abdelrahman A. AbudoamEmail: N/A
Affiliation: Department of Psychiatry, International University of Africa, Khartoum, Sudan
Biography:

Abdel Bagi AlzainEmail: N/A
Affiliation: Sudanese Intersex Working Group, Sudan, Khartoum, Sudan
Biography:

Imad Fadl-ElmulaEmail: N/A
Affiliation: Department of Surgery, Assafa College, Khartoum, Sudan
Biography:

Rayan Khalid

Alaa M. Siddig

Abdelrahman A. Abudoam

Abdel Bagi Alzain

Imad Fadl-Elmula

Abstract:

Complete Androgen Insensitivity Syndrome (CAIS) is an X-link recessive genetic mutation of androgen receptor (AR) gene leading to complete inability of cell to respond to the androgens. CAIS occurs in 1 out of 20,400 XY live-birth babies, and affects about 1–2% of prepubertal girls that present with an inguinal hernia. Although individuals with CAIS have XY, those with grades 6 and 7 on the Quigley scale are born phenotypically female, without any signs of genital masculinization. Thus, individuals affected by CAIS develop a normal external female phenotype with normal female external genitalia, well-developed breast, absent uterus, and bilateral undescended testicles. The question of CAIS diagnosis does not come forward until the absent menses at the puberty is noted or accidentally during an inguinal hernia repair in a premenarchal girl. The present study reports a case of inguinal hernia repair on 11-year-old girl, which led to unexpected intraoperative notion of CAIS. The diagnostic work-up, genetic counseling, sex assignment, and the need for preoperative CAIS screening in girls with bilateral inguinal hernia are described and discussed.

Keywords: DSD, CAIS, bilateral inguinal hernia, gonadectomy

References:

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