• PMID: 18160472
• Gene Name: KAL1
• Condition: Kallmann's syndrome (KS)
• Association: KAL1 mutations result in a more severe reproductive phenotype than FGFR1/KAL2 mutations. The latter are associated with a broader spectrum of pubertal development and with less severe impairment of gonadotropin secretion.
• Mutation: Mutations in KAL1, FGFR1/KAL2
• Population size: 39
• Population details: 39 (21 had mutations in KAL1 and 18 in FGFR1/KAL2)
• Sex: Male
• Infertility type: Male infertility
• Associated genes: KAL1, FGFR1/KAL2
• Other associated phenotypes: Kallmann's syndrome (KS)

Kallmann's syndrome: a comparison of the reproductive phenotypes in men carrying KAL1 and FGFR1/KAL2 mutations

Salenave S, Chanson P, Bry H, Pugeat M, Cabrol S, Carel JC, Murat A, Lecomte P, Brailly S, Hardelin JP, Dodé C, Young J.

CONTEXT: Kallmann's syndrome (KS) is a genetically heterogeneous disorder consisting of congenital hypogonadotropic hypogonadism (CHH) with anosmia or hyposmia. OBJECTIVE: Our objective was to compare the reproductive phenotypes of men harboring KAL1 and FGFR1/KAL2 mutations. DESIGN AND PATIENTS: We studied the endocrine features reflecting gonadotropic-testicular axis function in 39 men; 21 had mutations in KAL1 and 18 in FGFR1/KAL2, but none had additional mutations in PROK-2 or PROKR-2 genes. RESULTS: Puberty failed to occur in the patients with KAL1 mutations, all of whom had complete CHH. Three patients with FGFR1/KAL2 mutations had normal puberty, were eugonadal, and had normal testosterone and gonadotropin levels. Cryptorchidism was more frequent (14 of 21 vs. 3 of 15; P<00.1) and testicular volume (2.4+/-1.1 vs. 5.4+/-2.4 ml; P<0.001) was smaller in CHH subjects with KAL1 mutations than in subjects with FGFR1/KAL2 mutations. The mean basal plasma FSH level (0.72+/-0.47 vs. 1.48+/-0.62 IU/liter; P<0.05), serum inhibin B level (19.3+/-10.6 vs. 39.5+/-19.3 pg/ml; P<0.005), basal LH plasma level (0.57+/-0.54 vs. 1.0+/-0.6 IU/liter; P<0.01), and GnRH-stimulated LH plasma level (1.2+/-1.0 vs. 4.1+/-3.5 IU/liter; P<0.01) were significantly lower in the subjects with KAL1 mutations. LH pulsatility was studied in 13 CHH subjects with KAL1 mutations and seven subjects with FGFR1/KAL2 mutations; LH secretion was nonpulsatile in all the subjects, but mean LH levels were lower in those with KAL1 mutations. CONCLUSION: KAL1 mutations result in a more severe reproductive phenotype than FGFR1/KAL2 mutations. The latter are associated with a broader spectrum of pubertal development and with less severe impairment of gonadotropin secretion. FAU - Salenave, Sylvie AU - Salenave S AD - Assistance Publique-Hôpitaux de Paris, and Univ Paris-Sud, France. FAU - Chanson, Philippe AU - Chanson P FAU - Bry, Hélène AU - Bry H FAU - Pugeat, Michel AU - Pugeat M FAU - Cabrol, Sylvie AU - Cabrol S FAU - Carel, Jean Claude AU - Carel JC FAU - Murat, Arnaud AU - Murat A FAU - Lecomte, Pierre AU - Lecomte P FAU - Brailly, Sylvie AU - Brailly S FAU - Hardelin, Jean-Pierre AU - Hardelin JP FAU - Dodé, Catherine AU - Dodé C