A 30yo man and wife present to the reproductive endocrine clinic because of infertility. The man
is tall, has bilateral gynecomastia. Examination of the testes reveals bilateral small, firm testes.
Which of the following inv is most helpful in dx?
a. CT of pituitary
b. Chromosomal analysis
c. Measure of serum gonadotropins
d. Measure of serum testosterone
Q. 1. What is the key?
Q. 2. What is the diagnosis?
Q. 3. What are the points in favour of your diagnosis?
Ans. 1. The key is B. Chromosomal analysis.
Ans. 2. The diagnosis is Klinefelter’s syndrome. (xxy)
Ans. 3. The points in favour are: i) Infertility ii) Tall stature iii) Bilateral gynaecomastia iv) Bilateral small
firm testes.