I. Estrogen excess states |
A. Gonadal origin |
1. True hermaphroditism |
2. Gonadal stromal (nongerminal) neoplasms of the testis |
a. Leydig cell (interstitial) |
b. Sertoli cell |
c. Granulosa-theca cell |
3. Germ cell tumors |
a. Choriocarcinoma |
b. Seminoma, teratoma |
c. Embryonal carcinoma |
B. Nontesticular tumors |
1. Adrenal cortical neoplasms |
2. Lung carcinoma |
3. Hepatocellular carcinoma |
C. Endocrine disorders |
D. Diseases of the liver—nonalcoholic and alcoholic cirrhosis |
E. Nutrition alteration states |
II. Androgen deficiency states |
A. Senescence |
B. Hypoandrogenic states (hypogonadism) |
1. Primary testicular failure |
a. Klinefelter's syndrome (XXY) |
b. Reifenstein's syndrome |
c. Rosewater-Gwinup-Hamwi familial gynecomastia |
d. Kallmann syndrome |
e. Kennedy's disease with associated gynecomastia |
f. Eunuchoidal state (congenital anorchia) |
g. Hereditary defects of androgen biosynthesis |
h. Adrenocorticotropic hormone deficiency |
2. Secondary testicular failure |
a. Trauma |
b. Orchitis |
c. Cryptorchidism |
d. Irradiation |
C. Renal failure |
III. Drug effects |
IV. Systemic diseases with idiopathic mechanisms |
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