Comment on “Complete Androgen Insensitivity Syndrome: Optimizing Diagnosis and Management”

Response to: Comment on “Complete Androgen Insensitivity Syndrome: Optimizing Diagnosis and Management”

“…As far as sex hormone binding globulin (SHBG) is concerned, it is reported by Audi and colleagues [ 4 ] that it could be very low in AIS patients (in particular, refer to CAIS patient number 5 and PAIS patient number 11 of Audi et al's work). Considering all these evidences from the works cited by Balsamo et al [ 1 ], it is very easy to verify that the hormonal status of our reported patient is fully compatible with CAIS diagnosis. In the work by Melo et al [ 3 ], seven postpubertal women with CAIS with intact testes began breast development at the age of 11–15 years.…”

“…We appreciate Balsamo and colleagues' interest [ 1 ] in our recent paper [ 2 ] about a case of complete androgen insensitivity syndrome (CAIS). We are grateful for their insightful comments and the opportunity to clarify a number of elements from our work.…”

“…Since after three months we did not obtain any clinical response (persistence of primary amenorrhea), we reevaluated the patient to reestablish the correct diagnosis. Balsamo et al [ 1 ] arbitrarily stated that we reported “absence of Leydig cells” in the histological examination of the removed gonads. We are really surprised because this statement is not reported in our paper.…”

Late diagnosed case of testicular feminization with sertoli leydig tumor

“…Yapılan çalışmalar inkomplet TF olgularının daha erken teşhis edilmesi sonucu çocuk cerrahisi tarafından opere edildiği, ve olası malignite riskinin azaldığı gözlemlenmiştir [3]. Bugün için önerilen gonadların puberteye kadar bırakılması böylece sekonder seks karakterlerinin gelişmesi, puberte sonrası bilateral gonadektomi yapılmasıdır [4]. Gonadektomi sonrası artan osteoporoz riskine karşı bu hastalara östrojen replasman tedavisi önerilmektedir [4].…”

“…Bugün için önerilen gonadların puberteye kadar bırakılması böylece sekonder seks karakterlerinin gelişmesi, puberte sonrası bilateral gonadektomi yapılmasıdır [4]. Gonadektomi sonrası artan osteoporoz riskine karşı bu hastalara östrojen replasman tedavisi önerilmektedir [4].…”