Department of Paediatrics, Centro Hospitalar São João, Porto, Portugal.
Faculty of Medicine, University of Porto, Porto, Portugal, Portugal.
Endokrynol Pol. 2021;72(4):353-356. doi: 10.5603/EP.a2021.0038. Epub 2021 May 19.
Wolfram syndrome (WFS) is a neurological and endocrinological degenerative disorder, also known as DIDMOAD (Diabetes Insipidus, early-onset Diabetes Mellitus, progressive Optic Atrophy, and Deafness) syndrome. It is an autosomal recessive disorder, mostly involving the Wolfram syndrome 1 gene (WFS1). The phenotypic pleiomorphism, rarity, and molecular complexity complicate the follow-up of these patients.
We aimed to describe the clinical characteristics and the follow-up of 11 patients with this disorder. We retrospectively analysed all WFS patients diagnosed between 1990 and 2020 in the Centro Hospitalar São João, a tertiary hospital in Northern Portugal.
Eleven patients were included. Four patients had all 4 components of DIDMOAD. The presentation was diabetes mellitus (DM) in 9 patients, optic atrophy (OA) in another patient, and diabetes insipidus (DI) in another one. The median age of DM and OA diagnosis was 6 and 14 years, respectively. Nine patients had diabetes mellitus, and the other 2 patients had impaired glucose tolerance. All patients had OA. Four patients presented DI, all of them diagnosed in adolescence. Four patients had hearing impairment, 5 had urological abnormalities, 5 had neurological disorders, and 8 had psychiatry disorders. Eight patients had a broad spectrum of recessive mutations in WFS1.
The information obtained in this study can facilitate further research in an attempt to improve prevention strategies for this devastating disease.
Wolfram 综合征(WFS)是一种神经内分泌退行性疾病,也称为 DIDMOAD(尿崩症、早发糖尿病、进行性视神经萎缩和耳聋)综合征。它是一种常染色体隐性遗传病,主要涉及 Wolfram 综合征 1 基因(WFS1)。表型多态性、罕见性和分子复杂性使这些患者的随访复杂化。
我们旨在描述 11 例该疾病患者的临床特征和随访情况。我们回顾性分析了 1990 年至 2020 年期间在葡萄牙北部三级医院 Centro Hospitalar São João 诊断的所有 WFS 患者。
共纳入 11 例患者。4 例患者具有 DIDMOAD 的所有 4 个成分。9 例患者表现为糖尿病(DM),另 1 例患者表现为视神经萎缩(OA),另 1 例患者表现为尿崩症(DI)。DM 和 OA 诊断的中位年龄分别为 6 岁和 14 岁。9 例患者患有糖尿病,另 2 例患者患有葡萄糖耐量受损。所有患者均有 OA。4 例患者出现 DI,均在青春期诊断。4 例患者听力受损,5 例患者存在泌尿系统异常,5 例患者存在神经紊乱,8 例患者存在精神疾病。8 例患者在 WFS1 中存在广泛的隐性突变。
本研究获得的信息可以促进进一步的研究,试图改善这种毁灭性疾病的预防策略。