The use of mouth brushings for screening girls who present with inguinal hernia for complete androgen insensitivity syndrome

Eur J Pediatr Surg. 2012 Apr;22(2):136-8. doi: 10.1055/s-0032-1308691. Epub 2012 Apr 19.

Abstract

Introduction: Published guidance recommends that all girls with inguinal hernia should be screened for complete androgen insensitivity syndrome (CAIS). We report a novel, noninvasive screening technique.

Methods: Retrospective review of all girls undergoing inguinal herniotomy from April 2009 to October 2010. Those screened using the novel technique of extraction of Y chromosome specific DNA from a buccal mucosal sample obtained by mouth brushing are reported.

Results: A total of 29 girls were screened by mouth brushing at median age 2.9 years (range 29 days to 9.3 years). Of the 29 samples, 25 were adequate for DNA extraction; 4 were inadequate and screening was repeated (3 repeat mouth brushing, 1 perioperative blood test). Mouth brushing was well tolerated by children and acceptable to parents. A preoperative blood test was avoided in all girls who had a mouth brushing. None of the girls in this study had CAIS. Turn-around time for mouth brushing was mean 4.9 days compared with a minimum of 10 days for a karyotype. This technique is cheaper than a karyotype (£ 87 vs. £ 205).

Conclusion: Extraction of Y chromosome specific DNA from a mouth brushing sample is effective for screening girls with inguinal hernia for CAIS. It is acceptable, cheaper, and quicker than alternatives.

MeSH terms

  • Amelogenin / genetics
  • Androgen-Insensitivity Syndrome / diagnosis*
  • Child
  • Child, Preschool
  • Chromosomes, Human, Y / genetics
  • DNA / genetics*
  • DNA / isolation & purification
  • Female
  • Genes, sry
  • Genetic Testing / methods*
  • Hernia, Inguinal / complications*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mouth Mucosa / chemistry
  • Mouth Mucosa / cytology*
  • Retrospective Studies
  • Sequence Analysis, DNA

Substances

  • AMELY protein, human
  • Amelogenin
  • DNA