Lee Soo-Chin, Chionh Siok-Bee, Chong Siew-Meng, Taschner Peter E M
Department of Hematology-Oncology, National University Hospital, Singapore.
Laryngoscope. 2003 Jun;113(6):1055-8. doi: 10.1097/00005537-200306000-00026.
OBJECTIVES/HYPOTHESIS: Hereditary paraganglioma is a rare condition that is inherited in an autosomal-dominant fashion. Four distinct loci have been associated with hereditary paraganglioma, including the SDHD, SDHC, and SDHB genes and a locus at 11q13. The SDHD, SDHC, and SDHB genes code for subunits of succinate dehydrogenase, which forms part of the mitochondrial respiratory chain. SDHD mutations are widely distributed along the gene with no apparent hot spots, although a founder effect has been described in the Dutch population.
Following a prior report of the SDHD M1I mutation in an Australian Chinese family, a second Chinese family with the same mutation is reported. The proband developed bilateral head and neck paragangliomas at age 34 years and a functioning adrenal pheochromocytoma and two extra-adrenal abdominal paragangliomas 7 years later. His brother had unilateral head and neck paraganglioma at age 39 years. Given the multicentricity of the proband's tumor and the familial clustering of paragangliomas, a clinical diagnosis of hereditary paraganglioma was made, and the proband was tested for a mutation in the SDHD gene.
The proband was found to be heterozygous for the SDHD MII mutation that removes the start codon, and his brother subsequently tested positive for the same mutation. The family is not related to the Australian Chinese family.
The finding suggests the possibility of a founder effect in the Chinese population and warrants further investigation.
目的/假设:遗传性副神经节瘤是一种罕见的常染色体显性遗传病。已发现四个不同的基因座与遗传性副神经节瘤相关,包括SDHD、SDHC和SDHB基因以及位于11q13的一个基因座。SDHD、SDHC和SDHB基因编码琥珀酸脱氢酶的亚基,该酶是线粒体呼吸链的一部分。SDHD突变在基因中广泛分布,没有明显的热点,尽管在荷兰人群中已描述了奠基者效应。
在先前报道一个澳大利亚华裔家庭存在SDHD M1I突变之后,现报道另一个具有相同突变的华裔家庭。先证者在34岁时发生双侧头颈部副神经节瘤,7年后发生功能性肾上腺嗜铬细胞瘤和两个肾上腺外腹部副神经节瘤。他的哥哥在39岁时发生单侧头颈部副神经节瘤。鉴于先证者肿瘤的多中心性和副神经节瘤的家族聚集性,做出了遗传性副神经节瘤的临床诊断,并对先证者进行了SDHD基因突变检测。
发现先证者为SDHD MII突变的杂合子,该突变去除了起始密码子,其哥哥随后检测出相同突变呈阳性。该家族与澳大利亚华裔家庭无亲缘关系。
这一发现提示在中国人群中存在奠基者效应的可能性,值得进一步研究。