Ref: Harrison 19th p 2350
Approximately 1/500 newborn males has a 47, XXY chromosome complement, representing the most common sex chromosomal aneuploidy in males. The incidence approximates 1% among the mentally retarded, clustering among patients with IQs greater than 50 and in infertile males.
The chromosomal aberration most often results from meiotic nondisjunction of an X chromosome during parental gametogenesis; the extra X chromosome is maternal in origin in 54% and paternal in origin in 46% of patients.
XX male is thought to occur in 1 in 20, 000 newborn males. Affected individuals have a male phenotype, small testes, a small phallus, and no evidence of ovarian or miillerian duct tissue; they appear, therefore, to be distinct from the ovotesticular disorder of sexual development. This disorder resembles Klinefelter syndrome, but stature is greater in the latter. Undescended testes and hypospadias occur in a minority of patients. The histologic features of the testes are essentially the same as in Klinefelter syndrome. Patients with the condition usually come to medical attention in adult life because of hypogonadism, gynecomastia, or infertility. Hypergonadotropic hypogonadism occurs secondary testicular failure.