AUTHOR=Cattoni Alessandro , Spano Alice , Tulone Anna , Boneschi Annalisa , Masera Nicoletta , Maitz Silvia , Di Blasio Anna Maria , Persani Luca , Guizzardi Fabiana , Rossetti Raffaella 

TITLE=The Potential Synergic Effect of a Complex Pattern of Multiple Inherited Genetic Variants as a Pathogenic Factor for Ovarian Dysgenesis: A Case Report

JOURNAL=Frontiers in Endocrinology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.540683

DOI=10.3389/fendo.2020.540683

ISSN=1664-2392

ABSTRACT=<p>Non-syndromic primary ovarian insufficiency due to ovarian dysgenesis in 46,XX patients is an uncommon finding in the general population, even though several monogenic variants have been reported as causative factors. Here, we describe a 15-year-old patient diagnosed with gonadal dysgenesis possibly due to the interaction of three potentially pathogenic variants of genes involved in ovarian maturation, namely <italic>factor in the germline alpha</italic> (<italic>FIGLA</italic>), <italic>newborn ovary homeobox-encoding</italic> (<italic>NOBOX</italic>) and <italic>nuclear receptor subfamily 5 group A member 1</italic> (<italic>NR5A1</italic>). We also describe a different degree of residual ovarian function within the proband's family, whose female members carry one to three demonstrated variations in the aforementioned genes in a clinical <italic>spectrum</italic> potentially dependent on the number of alleles involved. Our results support the hypothesis that the severity of the clinical picture of the proband, resulting in complete ovarian dysgenesis, may be due to a synergic detrimental effect of inherited genetic variants.</p>