The syndrome of anosmia with hypogonadotropic hypogonadism: a genetic study of 18 new families and a review.

Among 18 NIH probands with anosmia and hypogonadotropic hypogonadism (AHH), seven had affected relatives and three had consanguineous parents. Both sexes were equally affected and parents were phenotypically normal. Parental age was not increased. Cleft lip and palate occurred in both eugonadal and hypogonadal persons, a previously reported association that may represent variable expression of AHH. Diabetes mellitus, usually insulin-dependent, was frequent in probands and their families. Other common traits included obesity, cryptorchidism, and hearing loss. All probands were chromosomally normal. The frequency of some dermatoglyphic traits of probands differed from normal, but no trait was unique to AHH. Segregation analysis of our proband sibships was consistent with a hypothesis of autosomal-recessive inheritance with variable expression. However, genetic heterogeneity was apparent when previous reports of familial AHH were surveyed. An X-linked or male sex-limited autosomal-dominant form with unilateral renal agenesis, mental retardation, and hypotelorism has been observed. The infrequent reports of direct male-to-male transmission limit characterization of an autosomal-dominant form of AHH. Our phenotypic analysis suggests that the traits of mental retardation, renal anomalies, hypotelorism, diabetes, and hearing loss may help to distinguish various forms of AHH, whereas cryptorchidism, clefts, and obesity appear in several types of families. At present, genetic counseling is dependent upon establishing inheritance pattern after examination for the known associated anomalies.

HLA-compatible paternity in two "fertile eunuchs" with congenital hypogonadotropic hypogonadism and anosmia (the Kallmann syndrome).

Two men are described who fulfill the criteria for both the Kallmann and the fertile eunuch syndrome, and we report the erythrocyte and HLA phenotypes of these men and their children. There were no paternal exclusions noted in red blood cell phenotypes encompassing seven separate red cell systems. The HLA phenotypes indicate that the probability that these men were the fathers of the children was greater than 99.99%.

Ultrastructural concomitants of sodium butyrate-enhanced ectopic production of chorionic gonadotropin and its alpha subunit human bronchogenic carcinoma (ChaGo) cells.

Sodium butyrate treatment of cultures of ChaGo (human lung cancer) cells resulted in increased production of human chorionic gonadotropin (hCG) and its alpha subunit (hCG-alpha) and induced a variety of morphologic changes. Elongation and flattening of cells were seen by light microscopy. Immunocytochemistry with antisera against hCG and against hCG-alpha showed an increase in cells containing stainable hCG-alpha. Scanning electron microscopy demonstrated enhanced adhesion of cells to glass cover slips, with elongation, flattening, and decreased cytoplasmic blebs. Ultrastructural changes were examined by transmission electron microscopy and evaluated quantitatively by an unbiased observer. Significant findings included increases in perinuclear tonofilaments, smooth endoplasmic reticulum vesicles, dense mitochondrial inclusions, and lipid granules, as well as decreases in intercellular desmosomes, free polyribosomes, mitochondrial dense granules, and Golgi complexes. The most notable change, a marked decrease in condensed chromatin clumps, may have reflected a butyrate-induced biochemical modification of chromatin leading to enhanced accessibility of certain genes for transcription.

The syndrome of basal encephalocele and hypothalamic-pituitary dysfunction.

We documented hypothalamic-pituitary dysfunction in three patients with congenital herniation of the brain through the base of the skull (basal encephalocele). All had growth hormone deficiency, although one has attained normal height. One had diabetes insipidus. Two had hypogonadotropic hypogonadism. Prolactin secretion was elevated in one, normal in another, and borderline low in the third. Two patients were euthyroid, but in response to thyrotropin-releasing hormone (TRH) injection, one patient's thyrotropin (TSH) level increased to levels exceeding normal while the other's did not attain normal levels. In the third patient, TSH response to TRH went from subnormal to normal after treatment with growth hormone and thyroxine. No patient had evidence of ACTH deficiency. These heterogeneous findings do not permit assignment of an unequivocal anatomic or functional site to the endocrine defect(s). Pituitary function should be evaluated in all patients with basal encephalocele, and this entity should be considered in the differential diagnosis of central endocrine malfunction.

Maintenance of ectopic chorionic gonadotropin and alpha subunit secretion by a human lung cancer cell line (ChaGo) transplanted into nude mice.

ChaGo cells, derived from a human primary carcinoma of the lung, were successfully transplanted into nude mice without any change in morphologic characteristics over four generations and with continued ectopic secretion of human chorionic gonadotropin (HCG) and HCG alpha subunit (HCG-alpha). The concentration of free HCG-alpha was 1,100-fold higher than that of complete HCG in the original ChaGo culture medium but only 35-fold higher in nude mouse plasma, possibly due to slower metabolic clearance of complete HCG. Tumor weights correlated with plasma HCG-alpha but not with HCG. Tumor-bearing mice had significantly heavier uteri than did control mice.

Ectopic and eutopic secretion of chorionic gonadotropin and its sub-nits in vitro: comparison of clonal strains from carcinomas of lung and placenta.

We compared rates of secretion in vitro of human chorionic gonadotropin (HCG) and its subunits alpha and beta by established clonal cell lines of a bronchogenic carcinoma (ChaGo) and a choriocarcinoma (JEG). Clones showing the highest secretion rates of either HCG or its subunits were studied: ChaGo-K1, a new clonal strain, and ChaGo-C5 and JEG-3, two previously reported clonal lines. Cells were grown under identical conditions in the same laboratory. Hormone and subunit concentrations were measured by radioimmunoassays. ChaGo-K1 and ChaGo-C5 secreted only alpha-subunit whereas JEG-3 secreted only HCG. Average peak secretion rates in picomoles/day/mg protein were: for ChaGo-K1, HCG less than 0.3, alpha=290, and beta less than 0.5; for ChaGo-C5, HCG less than 0.3, alpha=21, and beta less than 0.5; and for JEG-3, HCG=18, alpha less than 0.7, and beta less than 0.5. The ChaGo-K1 secretion rate of alpha was greater than that of any of out previously reported ChaGo clones. Significant quantities of estradiol and progesterone accumulated in the media of all three cell lines; however, only JEG-3 secreted detectable quantities of placental lactogen. Thus under identical culture conditions, a bronchogenic carcinoma clonal line secreted only alpha-subunit, whereas a choriocarcinoma line secreted only HCG; these findings implied major differences in cellular control mechanisms. Moreover, the ectopic secretions of alpha exceeded the eutopic trophoblastic secretion of HCG, which suggested that in certain cases ectopic protein production may be even more efficient than nonectopic production.