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10 型 MODY 患者的糖尿病肾病、视网膜病变和功能性性腺功能减退症:病例报告。

Diabetic Nephropathy, Retinopathy, and Functional Hypogonadism in a Patient with MODY10: A Case Report.

机构信息

Unit of Endocrinology and Diabetes, Eugenio Espejo Hospital, Quito 170403, Ecuador.

Unit of Endocrinology, Dr. José Eleuterio González Hospital, Monterrey 64460, Mexico.

出版信息

Medicina (Kaunas). 2024 May 18;60(5):830. doi: 10.3390/medicina60050830.

DOI:10.3390/medicina60050830
PMID:38793013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11123248/
Abstract

(1) : Maturity-onset diabetes of the young (MODY) is a group of diabetes caused by gene defects related to insulin secretion. MODY1, MODY2, and MODY3 are the most common and account for approximately 80% of all cases. Other types are relatively rare. This study describes the clinical, analytical, and genetic characteristics of a patient with MODY10, and diabetic nephropathy, retinopathy, and functional hypogonadism diagnosis. (2) : A clinical case was analyzed and whole exome generation sequencing (WES) was used to detect mutations related to a monogenic variant. (3) : A seventeen-year-old male patient, who was diagnosed with apparent type 1 diabetes at the age of eight was started with insulin therapy. He came to the emergency room with glycemic decompensation, facial, and lower limb edema. During his evaluation, he had near-nephrotic range proteinuria of 2902 mg/24 h, a kidney ultrasound showing mild pyelocalyceal dilation, proliferative diabetic retinopathy, and was also diagnosed with functional hypogonadotropic hypogonadism. These comorbidities improved with adequate glycemic control. WES showed missense variant c.94G>A (p.Gly32Ser) in the INS gene, according to Clinvar corresponding to MODY10. It was a "de novo" variant not reported in his parents. (4) : Monogenic diabetes (MD) is rare and MODY10 is among the less frequent types. MODY should be suspected in patients with type 1 phenotype with negative autoimmunity even in the absence of a family history of diabetes. To the best of our knowledge, we present here the first patient with these phenotypic traits of MODY10 reported in Latin America.

摘要

(1):青年起病的成年型糖尿病(MODY)是一组由与胰岛素分泌相关的基因缺陷引起的糖尿病。MODY1、MODY2 和 MODY3 是最常见的类型,约占所有病例的 80%。其他类型则相对较少见。本研究描述了一位 MODY10 患者、糖尿病肾病、视网膜病变和功能性性腺功能减退症的临床、分析和遗传特征。

(2):对一个临床病例进行了分析,并使用全外显子组生成测序(WES)来检测与单基因变异相关的突变。

(3):一位 17 岁男性患者,8 岁时被诊断为明显的 1 型糖尿病,开始接受胰岛素治疗。他因血糖失代偿、面部和下肢水肿而来到急诊室。在评估过程中,他的蛋白尿接近肾病范围,为 2902mg/24h,肾脏超声显示轻度肾盂扩张,增殖性糖尿病视网膜病变,还被诊断为功能性促性腺激素低下性性腺功能减退症。这些合并症随着血糖的充分控制而改善。WES 显示 INS 基因中的错义变异 c.94G>A(p.Gly32Ser),根据 Clinvar 对应于 MODY10。这是一个“从头”变异,未在其父母中报告。

(4):单基因糖尿病(MD)较为罕见,MODY10 是较少见的类型之一。即使没有糖尿病家族史,对于 1 型表型且自身免疫阴性的患者也应怀疑为 MODY。据我们所知,我们在此首次报告了拉丁美洲具有这些 MODY10 表型特征的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/e64f9d4d3fc4/medicina-60-00830-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/fa4ea36675d8/medicina-60-00830-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/c4c2923af3d1/medicina-60-00830-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/672038f1a442/medicina-60-00830-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/e64f9d4d3fc4/medicina-60-00830-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/fa4ea36675d8/medicina-60-00830-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/c4c2923af3d1/medicina-60-00830-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/672038f1a442/medicina-60-00830-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4702/11123248/e64f9d4d3fc4/medicina-60-00830-g004.jpg

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本文引用的文献

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