{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:55:18Z","timestamp":1791460518858,"version":"4.3.4"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Klinefelter syndrome (KS) is a sex chromosome abnormality disease, with a reported incidence of 0.1%\u20130.2%, while the prevalence of KS in male infertility patients is about 3.1%. Patients with KS are prone to experience metabolic abnormalities over time, such as obesity, diabetes, and metabolic syndrome, along with sexual dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>This report describes a case in which diabetic ketoacidosis (DKA) developed in an individual with KS. Specifically, the case report concerns a 29-year-old male who presented to our hospital with a 3-day history of headache and poor appetite accompanied by a half-day of nausea and vomiting. After excluding issues with the patient\u2019s digestive system, DKA was suspected, and the patient was admitted to the hospital. Upon abdominal CT, it was noted by chance that the patient had small testicles and a small penis, and an interview with the patient and their family revealed that he had previously been diagnosed with Kallmann syndrome. After extra examination, including chromosome examination, it was revealed that the patient had an extra X chromosome (47, XXY), and Klinefelter syndrome was diagnosed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case report provides case experience that can improve physicians\u2019 understanding of Klinefelter syndrome, including the differential diagnosis and treatment of the disease and its further progression, as well as the emergence and treatment of other diseases that may occur in subsequent developments and changes in such patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1651488","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T06:39:47Z","timestamp":1768372787000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Diabetic ketoacidosis in a patient with Klinefelter syndrome: a rare and complex presentation"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuwen","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Zhongnan Hospital of Wuhan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haohua","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Zhongnan Hospital of Wuhan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiazhong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Zhongnan Hospital of Wuhan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Zhongnan Hospital of Wuhan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1210\/er.2017-00212","article-title":"Klinefelter syndrome: integrating genetics, neuropsychology, and endocrinology","volume":"39","author":"Gravholt","year":"2018","journal-title":"Endocr Rev"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(04)16678-6","article-title":"Klinefelter\u2019s syndrome","volume":"364","author":"Lanfranco","year":"2004","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"744","DOI":"10.3390\/genes13050744","article-title":"An adolescent boy with klinefelter syndrome and 47,Xxy\/46,Xx mosaicism: case report and review of 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syndrome (Ks): genetics, clinical phenotype and hypogonadism","volume":"40","author":"Bonomi","year":"2017","journal-title":"J Endocrinol Invest"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/cen.15200","article-title":"Klinefelter syndrome: A review","volume":"102","author":"Blackburn","year":"2025","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad730","article-title":"From klinefelter syndrome to high grade aneuploidies: expanding the gene-dosage effect of supernumerary X chromosomes","volume":"109","author":"Spaziani","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad281","article-title":"Altered thyroid feedback loop in klinefelter syndrome: from infancy through the transition to adulthood","volume":"108","author":"Carlomagno","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-320831","article-title":"Klinefelter syndrome: going beyond the diagnosis","volume":"108","author":"Butler","year":"2023","journal-title":"Arch Dis Child"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2017.10.012","article-title":"Kallmann syndrome: phenotype and genotype of hypogonadotropic hypogonadism","volume":"86","author":"Stamou","year":"2018","journal-title":"Metabolism"},{"key":"B13","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.cnur.2018.04.006","article-title":"Male and female hypogonadism","volume":"53","author":"Richard-Eaglin","year":"2018","journal-title":"Nurs Clin North Am"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-53-3-654","article-title":"Decreased insulin binding to erythrocytes in subjects with klinefelter\u2019s syndrome","volume":"53","author":"Breyer","year":"1981","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","article-title":"Insulin resistance in patients with Klinefelter\u2019s syndrome and idiopathic gonadotropin deficiency","volume":"97","author":"Pei","year":"1998","journal-title":"J Formos Med Assoc"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2016.03.015","article-title":"Extranuclear actions of the androgen receptor enhance glucosestimulated insulin secretion in the male","volume":"23","author":"Navarro","year":"2016","journal-title":"Cell Metab"}],"updated-by":[{"DOI":"10.3389\/fendo.2026.1986450","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000}}],"container-title":["Frontiers in 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