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Background: Androgen insensitivity syndrome is an X-linked genetic disease characterized by resistance to the actions of androgen in an individual with 46, XY karyotype. It is one of the most common causes of Disorders of sex development (DSD). Clinical Description: A 10-year-7-month-old child, reared as female, was incidentally detected with minor virilization of external genitalia. She had achieved thelarche and adrenarche with a Prader Stage 2. Management and Outcome: Routine investigations showed normal hemogram and kidney and liver functions, as also normal values of serum electrolytes. Ultrasonogram showed the absence of Mullerian structures and the presence of prostate- and testis-like structures. Karyotyping showed 46, XY. There were grossly elevated levels of testosterone and dihydrotestosterone, as well as raised follicle-stimulating hormone and luteinizing hormone levels. Diagnostic laparoscopy showed inguinal testis-like structures and biopsy from the same confirmed testicular tissue. Parents were counseled regarding the prognosis, need for gonadectomy, and hormone replacement. Conclusion: Our case creates awareness regarding the importance of early identification of minor virilizing features in a child, so as to avoid late revelation of an underlying DSD leading to undue anxiety and psychological trauma to parents and child.

Background: The brain and kidney have similar microvascular structure, which makes them susceptible to certain common pathophysiological processes. In this study, we examined several indicators of kidney injury/function associated with cognitive function in older diabetic patients in the hope of finding effective markers for detecting cognitive impairment (CI)., Methods: A total of 2209 older participants (aged ≥60 years) from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) were analyzed for the association between diabetes and CI using a multiple linear regression analysis model. Using the same approach, we also analyzed the relationship between indicators of kidney injury/function and cognitive function (Animal Fluency Test, Digit Symbol Substitution Test) in the diabetic population., Results: Diabetes was associated with CI. In age-adjusted model, older diabetics performed significantly poorer on tests of cognitive function compared to normoglycaemic individuals (1.145 points lower on the Animal Fluency Test ( P = 0.005) and 7.868 points reduced on the Digit Symbol Substitution Test ( P < 0.001)). In diabetics, we found elevated serum creatinine (SCr) (especially at SCr≥300uM) was associated with lower scores on cognitive function tests after strict adjustment for potential influences on cognitive function. While, albumin/creatinine ratio (ACR) was only associated with Digit Symbol Substitution score (DSS) not Animal Fluency score (AFS), and estimated glomerular filtration rate (eGFR) was only associated with CI (AFS and DSS) at the end-stage renal disease., Conclusion: SCr, as a sensitive indicator of kidney injury, was significantly associated with CI and can potentially be used as an effective marker for screening CI in older diabetics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Xiao, Devakumar, Xu, Liu, Mo and Hong.)

Competing Interests: Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.