Background: Autoimmune polyglandular syndrome type 1 (APS-1) (OMIM 240300) is a rare autosomal recessive disorder associated with three major manifestations: chronic mucocutaneous candidiasis, hypoparathyroidism, and adrenal insufficiency. There are, however, multiple minor components of APS-1 that induce significant phenotype variability. Subsequently, the diagnosis of APS-1 during early stages is often challenging. Aim: We aimed to provide clinical and mutational data for a large number of APS-1 patients in the Russian population. Methods: We analyzed clinical variations and component prevalence in APS-1 patients. DNA screening for autoimmune regulator (AIRE) gene mutations was performed in established APS-1 patients and in patients with the single components of chronic mucocutaneous candidiasis, hypoparathyroidism, adrenal insufficiency, or alopecia. Results: We identified 46 patients from 42 families with APS-1. Eighteen different components were present in the patients, including very rare conditions – bone dysplasia and retinitis pigmentosa. We identified 10 different mutations, 3 of which were novel (M1T, E298K, c1053_1060del). The common Finnish mutation, R257X, was the most frequent in our population, present in 64/92 (70%) of the alleles. Conclusion: We found that the R257X AIRE mutation is common in Russian APS-1 patients. The majority of children with hypoparathyroidism and chronic mucocutaneous candidiasis were carriers of the AIRE mutations.

According to publications in the foreign literature, the incidence of secondary testicular structures in the patients with congenital adrenal cortical dysfunction (CACD) amounts to 90%. In this country, the scheduled screening for TART tumours in the male patients presenting with CACD is not carried out. At the same time, the late consequences of this pathology (infertility, obstructive testicular diseases) require increasingly more attention starting from the early childhood.

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Дефицит 21-гидроксилазы, наиболее распро-страненная форма врожденной дисфункции коры надпочечников (ВДКН), по данным неонатального скрининга, встречается в РФ с частотой 1 на 9500 новорожденных [1]. Фермент 21-гидроксилаза не участвует в синтезе андрогенов и не экспрессирует-ся в гонадах. Длительное время считалось, что при дефиците 21-гидроксилазы репродуктивная система мужчин (в отличие от женщин) не страдает от над-почечниковой гиперандрогении.По данным литературы [2-6], фертильность мужчин с ВДКН варьирует от нормальной до значи- Introduction. Compromised fertility is one of the main health-related problems encountered by men suffering from 21-hydroxylase deficient congenital adrenal hyperplasia (CAH). This condition can be attributed either to the disease itself or to the presence of the testicular adrenal rest tissue (TART