Endocrine Abstracts

Endocrine disrupting chemicals are substances, both natural and artificial to which we are all exposed, even in a low dose in our everyday life. Health effects attributed to endocrine disrupting compounds include immune dysfunctions, various cancers, neurological effects and behaviour disorders, reproductive problems, early puberty, etc. Over the past 50 years, an increase in urogenital tract abnormalities in males has been noted. We present a 4 year old boy case report, born at term, by caesarean section, addressed to the Endocrinology Department for micropenis, hypospadias and overweight. His mother was diagnosed with PCOS but she never took anti androgenic treatment before the patient was conceived; she is working in a paint factory. The first consultation revealed: micropenis: 3 cm (−2,5 DS), hypospadias, bilateral descended testicles and normal developed scrotum. Workup: normal pituitary function; DHEAS slightly increased, normal 17OH progesterone; normal abdominal, pelvic and testicular ultrasounds; normal karyotype. We took in consideration next diagnostic assumptions: i) late-onset 3 β-hydroxysteroid dehydrogenase deficiency: excluded – androstendione in limits. ii) 5 α reductase deficiency: hCG stimulation: DHT=252 pg/ml – borderline values, testosterone/DHT=12.77 infirm this diagnosis. iii) Androgen partial resistance: the patient has descended testicles; no genetic tests available in our country; good response after androgen treatment iv) Intersexuality due to endocrine disruptors. He received treatment with testosterone enanthate 50 mg at 3 weeks, for 3 months, and his penis increased: 5 cm; is scheduled for hypospadias correction intervention.

Conclusions: Endocrine disruptor pathology must always remain a diagnostic hypothesis in reproductive tract abnormalities in children.