PEDIATRICS Vol. 60 No. 1 July 1977, pp. 55-59
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Ambiguous Genitalia in XX Male Children: Report of Two Infants

Thomas F. Roe M.D.1 and Omar S. Alfi M.D.1

1 Divisions of Endocrinology and Metabolism and Medical Genetics, Childrens Hospital of Los Angeles, and the Department of Pediatrics, University of Southern California School of Medicine, Los Angeles

Two infants with ambiguous genitalia were recognized to have the XX male syndrome. Although most xx males have normal penile development, a review of the reported cases showed that eight of the 14 affected children, diagnosed before age 15 years, had penile abnormalities, most commonly hypospadias and/or chordee. This syndrome should be considered in children with incomplete genital differentiation. The available indirect evidence suggests that deficient testosterone production by the fetal testes accounts for the genital ambiguity. Although no explanation has been established for the presence of testes in the apparent absence of the Y chromosome, studies of the X-linked Xg blood group in XX males demonstrate a high frequency of unusual inheritance patterns. This implies that the abnormality in the transmission of maleness in affected families may also be X-related rather than autosomal.

Submitted on June 14, 1976
Accepted on August 18, 1976