Gazi Yaşargil Training and Research Hospital, Clinics of Paediatric Endocrinology, Diyarbakır, Turkey
Hacettepe University Faculty of Medicine, Department of Paediatric Endocrinology, Ankara, Turkey
J Clin Res Pediatr Endocrinol. 2020 Sep 2;12(3):319-328. doi: 10.4274/jcrpe.galenos.2019.2019.0142. Epub 2019 Nov 29.
A novel heterozygous IVS11-2A>C(c.1957-2A>C) mutation in the gene is reported. There was an extremely distinct phenotypical expression in two siblings and their father. The index case was a boy who developed cholestasis and hypoglycaemia in the neonatal period. He had bilateral postaxial polydactyly, mid-facial hypoplasia, high palatal arch, micropenis, and bilateral cryptorchidism. Laboratory examination revealed a diagnosis of multiple pituitary hormone deficiency. There was severe anterior pituitary hypoplasia, absent pituitary stalk and ectopic posterior pituitary on magnetic resonance imaging which suggested pituitary stalk interruption syndrome with no other midline structural abnormality. Molecular genetic analysis revealed a novel heterozygous splicing IVS11-2A>C(c.1957-2A>C) mutation detected in the gene. His father and a six-year-old brother with the identical mutation also had unilateral postaxial polydactyly and mid-facial hypoplasia although there was no pituitary hormone deficiency. This novel heterozygous mutation detected appears to present with an extremely variable clinical phenotype, even in related individuals with an identical mutation, suggesting incomplete penetrance of this mutation.
报道了一个新的杂合 IVS11-2A>C(c.1957-2A>C) 突变。两个兄弟姐妹及其父亲表现出极其明显的表型表达。先证者是一名男孩,在新生儿期出现胆汁淤积和低血糖。他患有双侧后轴多指畸形、中面部发育不良、高腭弓、小阴茎和双侧隐睾。实验室检查提示多发性垂体激素缺乏症。磁共振成像显示严重的前垂体发育不良,垂体柄缺失和异位后垂体,提示垂体柄中断综合征,无其他中线结构异常。分子遗传学分析显示在 基因中发现了一个新的杂合剪接 IVS11-2A>C(c.1957-2A>C) 突变。他的父亲和一个六岁的哥哥也有相同的突变,表现为单侧后轴多指畸形和中面部发育不良,尽管没有垂体激素缺乏。这种新的杂合 突变似乎表现出非常可变的临床表型,即使在具有相同突变的相关个体中也是如此,这表明该 突变的不完全外显率。