A Case of Klinefelter's Syndrome

Lee, Hee Yong; Min, Hun Ki

Abstract

A case of Klinefelter's syndrome was reported and recent related literatures were reviewed. Case report: T. B., a 29 year-old Korean unmarried man, complained of small testes and gynecomastia. The history revealed no significant antecedent episodes which could have related to his problem. He was born when his father was 40 and his mother was 38 years old. He has no brothers nor sisters. He graduated from a university four years ago with poor record. He has been employed as a clerk of a bank Physical examination revealed a well-nourished and developed man: height, 166cm.; symphysis pubis to floor, 97 cm.; span, 168 cm.; breadth of hips, 43 cm.; breadth of shoulders, 42 cm.; hips. 92 cm.; bast, 93 cm.; weight, 67 kg. Body hairs, beard and axillary hairs were rudimentary. Pubic escutcheon was of female type and breasts were also of female type. Fatty tissue was distributed so well around the hips and breasts, that he was of female body constitution. No abnormalities were demonstrated on eyes, chest and abdomen. The penis was 5.7cm. in length. Each testis in the scrotum was palpated as a bean size. Epididymes were almost normal but prostate gland was felt flat and small. Frequency of ejaculations was once a week. (fig. 1) Laboratory examinations: routine blood and urine tests were within normal ranges. A semen sample was devoid of spermatozoa. VDRL was negative. Urinary gonadotropins for 24 hours were elevated. Urinary 17-ketosteroid for 24 hours showed 11.09 mg. The oral mucosal smear revealed that 25 per cent of the cells contained a single chromatin masses (Barr bodies). Testicular biopsies revealed characteristic findings of the syndrome. There were hyalinized seminiferous tubules, occasional tubules which contained only Sertoli ells and an increased number of interstitial cells for the most part appearing in clumps adjacent to the larger seminiferous tubules containing cells. (fig. 2) The recent literatures related to pathogenesis, terminology, sex differentiation, sex chromosome. sex chromatin, signs and symptoms of the syndrome were reviewed.