Startseite Clinical presentation and treatment response to diazoxide in two siblings with congenital hyperinsulinism as a result of a novel compound heterozygous ABCC8 missense mutation
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Clinical presentation and treatment response to diazoxide in two siblings with congenital hyperinsulinism as a result of a novel compound heterozygous ABCC8 missense mutation

  • Sonya Galcheva EMAIL logo , Violeta Iotova , Sian Ellard , Sarah E. Flanagan , Irina Halvadzhiyan , Chayka Petrova und Khalid Hussain
Veröffentlicht/Copyright: 22. März 2017

Abstract

Background:

Congenital hyperinsulinism (CHI) can present with considerable clinical heterogeneity which may be due to differences in the underlying genetic etiology. We present two siblings with hyperinsulinaemic hypoglycaemia (HH) and marked clinical heterogeneity caused by compound heterozygosity for the same two novel ABCC8 mutations.

Case presentation:

The index patient is a 3-year-old boy with hypoglycaemic episodes presenting on the first day of life. HH was diagnosed and treatment with intravenous glucose and diazoxide was initiated. Currently he has normal physical and neurological development, with occasional hypoglycaemic episodes detected following continuous fasting on treatment with diazoxide. The first-born 8-year-old sibling experienced severe postnatal hypoglycaemia, generalised seizures and severe brain damage despite diazoxide treatment. The latter was stopped at 6-months of age with no further registered hypoglycaemia. Genetic testing showed that both children were compound heterozygotes for two novel ABCC8 missense mutations p.I60N (c.179T>A) and p.G1555V (c.4664G>T).

Conclusions:

These ABCC8 missense mutations warrant further studies mainly because of the variable clinical presentation and treatment response.


Corresponding author: Dr. Sonya Galcheva, Department of Paediatrics, Medical University of Varna, 55 Marin Drinov street, Varna 9002, Bulgaria, Phone: +00359-52-30-2889, Fax: +00359-52-302889

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: The genetic studies were funded by the Medical Research Council (Grant Number 98144). SEF has a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (Grant Number: 105636/Z/14/Z).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Senniappan S, Arya VB, Hussain K. The molecular mechanisms, diagnosis and management of congenital hyperinsulinism. Indian J Endocrinol Metab 2013;17:19–30.10.4103/2230-8210.107822Suche in Google Scholar

2. Kapoor RR, Flanagan SE, Arya VB, Shield JP, Ellard S, et al. Clinical and molecular characterization of 300 patients with congenital hyperinsulinism. Eur J Endocrinol 2013;168:557–64.10.1530/EJE-12-0673Suche in Google Scholar

3. Nessa A, Rahman SA, Hussain K. Hyperinsulinemic hypoglycemia – the molecular mechanisms. Front Endocrinol (Lausanne) 2016;31:7–29.10.3389/fendo.2016.00029Suche in Google Scholar

4. Yorifuji T. Congenital hyperinsulinism: current status and future perspectives. Ann Pediatr Endocrinol Metab 2014;19:57–68.10.6065/apem.2014.19.2.57Suche in Google Scholar

5. Flanagan SE, Kapoor RR, Hussain K. Genetics of congenital hyperinsulinemic hypoglycemia. Semin Pediatr Surg 2011;20:13–7.10.1053/j.sempedsurg.2010.10.004Suche in Google Scholar

6. Usher R, Mclean F. Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr 1969;74:901–10.10.1016/S0022-3476(69)80224-6Suche in Google Scholar

7. Kuczmarksi RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, et al. CDC growth charts: United States. Adv Data 2000:1–27. Available at: https://www.cdc.gov/growthcharts/cdc_charts.htm.Suche in Google Scholar

8. Fournet JC, Mayaud C, de Lonlay P, Gross-Morand MS, Verkarre V, et al. Unbalanced expression of 11p15 imprinted genes in focal forms of congenital hyperinsulinism: association with a reduction to homozygosity of a mutation in ABCC8 or KCNJ11. Am J Pathol 2001;158:2177–84.10.1016/S0002-9440(10)64689-5Suche in Google Scholar

9. Flanagan SE, Clauin S, Bellanne-Chantelot C, de Lonlay P, Harries LW, et al. Update of mutations in the genes encoding the pancreatic b-cell K (ATP) channel subunits Kir6.2 (KCNJ11) and sulfonylurea receptor 1 (ABCC8) in diabetes mellitus and hyperinsulinism. Hum Mutat 2009;30:170–80.10.1002/humu.20838Suche in Google Scholar PubMed

10. Kapoor RR, Flanagan SE, Ellard S, Hussain K. Congenital hyperinsulinism: marked clinical heterogeneity in siblings with identical mutations in the ABCC8 gene. Clin Endocrinol (Oxf) 2012;76:312–3.10.1111/j.1365-2265.2011.04203.xSuche in Google Scholar PubMed

11. Stanley CA, Thornton PS, Ganguly A, MacMullen C, Underwood P, et al. Preoperative evaluation of infants with focal or diffuse congenital hyperinsulinism by intravenous acute insulin response tests and selective pancreatic arterial calcium stimulation. J Clin Endocrinol Metab 2004;89:288–96.10.1210/jc.2003-030965Suche in Google Scholar PubMed

12. Lucas A, Morley R, Cole TJ. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. Br Med J 1988;297:1304–8.10.1136/bmj.297.6659.1304Suche in Google Scholar PubMed PubMed Central

13. Basu P, Som S, Choudhuri N, Das H. Contribution of the blood glucose level in perinatal asphyxia. Eur J Pediatr 2009;168:833–8.10.1007/s00431-008-0844-5Suche in Google Scholar PubMed

14. Arya VB, Aziz Q, Nessa A, Tinker A, Hussain K. Congenital hyperinsulinism: clinical and molecular characterisation of compound heterozygous ABCC8 mutation responsive to Diazoxide therapy. Int J Pediatr Endocrinol 2014;2014:24.10.1186/1687-9856-2014-24Suche in Google Scholar PubMed PubMed Central

Received: 2016-8-31
Accepted: 2017-1-30
Published Online: 2017-3-22
Published in Print: 2017-4-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Pediatric endocrinology is pediatrics is public health
  4. Original Articles
  5. Total body fat, abdominal fat, body fat distribution and surrogate markers for health related to adipocyte fatty acid-binding protein (FABP4) in children
  6. Vitamin D supplementation, the metabolic syndrome and oxidative stress in obese children
  7. Vitamin D status in Egyptian children with type 1 diabetes and the role of vitamin D replacement in glycemic control
  8. Cross-sectional analysis of universal vitamin D supplementation in former East Germany during the first year of life
  9. Ethnicity and incidence of congenital hypothyroidism in the capital of Macedonia
  10. Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy
  11. Leptin and adiponectin levels in discordant dichorionic twins at 72 hours of age-associations with anthropometric parameters and insulin resistance
  12. Analysis of growth hormone receptor gene expression in tall and short stature children
  13. Clinical features of girls with short stature among inv (9), Turner (45, X) and control individuals
  14. Hereditary vitamin D-resistant rickets in Lebanese patients: the p.R391S and p.H397P variants have different phenotypes
  15. Associations between obesity, adverse behavioral patterns and cardiovascular risk factors among adolescent inhabitants of a Greek island
  16. Increase of body mass index (BMI) from 1.5 to 3 years of age augments the degree of insulin resistance corresponding to BMI at 12 years of age
  17. Case Reports
  18. The variable clinical phenotype of three patients with hepatic glycogen synthase deficiency
  19. Molecular defects identified by whole exome sequencing in a child with atypical mucopolysaccharidosis IIIB
  20. Clinical presentation and treatment response to diazoxide in two siblings with congenital hyperinsulinism as a result of a novel compound heterozygous ABCC8 missense mutation
  21. Cushing’s syndrome in infancy due to ectopic ACTH secretion by a sacro-coccygeal teratoma
  22. Letters to the Editor
  23. Growth-hormone deficiency in mitochondrial disorders
  24. Response to Growth hormone deficiency in mitochondrial disorders
Heruntergeladen am 21.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpem-2016-0345/html
Button zum nach oben scrollen