Evidence to exclude SOX9 as a candidate gene for XY sex reversal without skeletal malformation

The skeletal malformation syndrome campomelic dysplasia (CMD1) is caused by mutations within the SOX9 gene or chromosomal rearrangement breakpoints outside SOX9. Approximately three quarters of cases of CMD1 in XY subjects show complete or partial sex reversal. As some mutations cause CMD1 alone and others cause CMD1 and sex reversal, it is conceivable that some mutations might cause sex reversal in the absence of CMD1. In this study, we have investigated this possibility by screening the entire coding region of SOX9 in 30 patients with a spectrum of XY sex reversal phenotypes. No mutations were identified, suggesting that SOX9 should not be considered a candidate gene for XY sex reversal without skeletal malformation.