Electron microscopic observations of the nasal olfactory area in Kallmann syndrome.

A 52-year-old man with Kallmann syndrome (olfacto-genital dysplasia) had abnormally low serum gonadotropic hormone and testosterone levels. The LH-RH test revealed little response.Small pieces of mucosa were experimentally resected from the olfactory area of both sides of the nasal cavity and examined morphologically with scanning and transmission electron microscopes. Ciliated cells, mucus secreting (goblet) cells, and basal cells, which are characteristic epithelial cells of the respiratory system, were densely distributed, but no olfactory epithelial cells or their neural processes were seen. In this case, these observations indicate a complete olfactory deficiency caused by agenesis of at least the peripheral portion of the neural olfactory system. Further investigations are necessary to determine the relationship between the pathology and the degree of olfactory disturbance in Kallmann syndrome.