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American Academy of Pediatrics
Case Report

XY Gonadal Dysgenesis in a Phenotypic Female Identified by Direct-to-Consumer Genetic Testing

Ahlee Kim, Katherine Abell, Jodie Johnson, Stephanie Cizek, Lesley Breech, Michelle M. Ernst, Robert J. Hopkin, Kimberly Kennedy, Jerzy Stanek, Andrew C. Strine and Meilan M. Rutter
Pediatrics October 2020, e20193302; DOI: https://doi.org/10.1542/peds.2019-3302
Ahlee Kim
aDivisions of Endocrinology,
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Katherine Abell
bHuman Genetics,
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Jodie Johnson
bHuman Genetics,
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Stephanie Cizek
cPediatric and Adolescent Gynecology,
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Lesley Breech
cPediatric and Adolescent Gynecology,
dDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Michelle M. Ernst
dDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio
eBehavioral Medicine and Clinical Psychology,
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Robert J. Hopkin
bHuman Genetics,
dDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Kimberly Kennedy
fPediatric Urology, and
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Jerzy Stanek
dDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio
gPathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; and
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Andrew C. Strine
dDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio
fPediatric Urology, and
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Meilan M. Rutter
aDivisions of Endocrinology,
dDepartment of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Abstract

We report a 16-year-old phenotypic female with 46,XY complete gonadal dysgenesis and metastatic dysgerminoma, unexpectedly discovered through direct-to-consumer (DTC) commercial genetic testing. This case underscores the importance of timely interdisciplinary care, including psychosocial intervention and consideration of gonadectomy, to optimize outcomes for individuals with differences of sex development. Her unique presentation highlights the implications of DTC genetic testing in a new diagnostic era and informs general pediatricians as well as specialists of nongenetic services about the value, capabilities, and limitations of DTC testing.

  • Accepted March 30, 2020.
  • Copyright © 2020 by the American Academy of Pediatrics

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Pediatrics
Vol. 147, Issue 1
1 Jan 2021
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XY Gonadal Dysgenesis in a Phenotypic Female Identified by Direct-to-Consumer Genetic Testing
Ahlee Kim, Katherine Abell, Jodie Johnson, Stephanie Cizek, Lesley Breech, Michelle M. Ernst, Robert J. Hopkin, Kimberly Kennedy, Jerzy Stanek, Andrew C. Strine, Meilan M. Rutter
Pediatrics Oct 2020, e20193302; DOI: 10.1542/peds.2019-3302

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XY Gonadal Dysgenesis in a Phenotypic Female Identified by Direct-to-Consumer Genetic Testing
Ahlee Kim, Katherine Abell, Jodie Johnson, Stephanie Cizek, Lesley Breech, Michelle M. Ernst, Robert J. Hopkin, Kimberly Kennedy, Jerzy Stanek, Andrew C. Strine, Meilan M. Rutter
Pediatrics Oct 2020, e20193302; DOI: 10.1542/peds.2019-3302
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