Sakaguchi H, Sanke T, Ohagi S, Iiri T, Nanjo K
First Department of Medicine, Wakayama University of Medical Science, Japan.
J Clin Endocrinol Metab. 1998 May;83(5):1563-5. doi: 10.1210/jcem.83.5.4781.
We report a sporadic case of Albright's hereditary osteodystrophy (AHO)-like syndrome with several endocrinopathies. A 37-yr-old woman had an appearance of AHO but did not have renal PTH resistance. Her case was complicated by non-insulin-dependent diabetes mellitus with severe insulin resistance, central diabetes insipidus, and hyposecretion of GH. Most patients with AHO are found in a family of pseudohypoparathyroidism type-Ia and have a heterozygous mutation that inactivates the alpha-subunit of Gs (Gs alpha), the stimulatory regulator of adenylyl cyclase. Some sporadic cases occur in which patients with phenotype similar to AHO have a deletion of chromosome 2q37. However, in this patient, both the Gs alpha gene structure and the biological activity were normal. In addition, chromosome analysis revealed a normal pattern with no visible deletion of chromosome 2q37. Our findings suggest that one or more other factors may be involved in the pathogenesis of AHO-related disease.
我们报告了一例散发的伴有多种内分泌病的类奥尔布赖特遗传性骨营养不良(AHO)综合征病例。一名37岁女性有AHO的外观表现,但不存在肾性甲状旁腺激素抵抗。她的病例并发了严重胰岛素抵抗的非胰岛素依赖型糖尿病、中枢性尿崩症和生长激素分泌不足。大多数AHO患者见于I型假性甲状旁腺功能减退症家族,且有使腺苷酸环化酶的刺激调节因子Gs的α亚基失活的杂合突变。也有一些散发病例,其患者具有与AHO相似的表型,但存在2q37染色体缺失。然而,该患者的Gsα基因结构和生物学活性均正常。此外,染色体分析显示染色体模式正常,未见2q37染色体明显缺失。我们的研究结果提示,一个或多个其他因素可能参与了AHO相关疾病的发病机制。