DOI QR코드

DOI QR Code

A novel mutation in the DAX1 gene in a newborn with adrenal hypoplasia congenita in Korea

  • Lee, Juyeen (Department of Pediatrics, Daegu Fatima Hospital) ;
  • Kim, Won Duck (Department of Pediatrics, Daegu Fatima Hospital) ;
  • Kim, Hae Sook (Department of Pediatrics, Daegu Fatima Hospital) ;
  • Lee, Eun Kyung (Department of Pediatrics, Daegu Fatima Hospital) ;
  • Park, Hyung Doo (Department of Laboratory Medicine and Genetics, Samsung Medical Center)
  • Received : 2017.05.17
  • Accepted : 2017.06.09
  • Published : 2017.06.30

Abstract

Adrenal hypoplasia congenita (AHC) is a rare cause of adrenal insufficiency during neonatal period. Mutations in the gene coding for DAX1 cause X-linked adrenal hypoplasia. Most affected patients are shown to have salt wasting and hyperpigmentation on the skin during the neonatal period and require intensive medical care. In addition, it is usually associated with hypogonadotropic hypogonadism in adolescence. The DAX1 gene is expressed in the adrenal cortex, pituitary gland, hypothalamus, testis, and ovary. We report on a patient with genetically confirmed AHC whose initial clinical presentations were consistent with congenital adrenal hyperplasia. A point mutation in the DAX1 gene identified in this report resulted in a truncated DAX1 protein. Our patient was diagnosed with AHC.

Keywords

References

  1. Lehmann SG, Wurtz JM, Renaud JP, Sassone-Corsi P, Lalli E. Structure-function analysis reveals the molecular determinants of the impaired biological function of DAX-1 mutants in AHC patients. Hum Mol Genet 2003;12:1063-72. https://doi.org/10.1093/hmg/ddg108
  2. Reutens AT, Achermann JC, Ito M, Ito M, Gu WX, Habiby RL, et al. Clinical and functional effects of mutations in the DAX-1 gene in patients with adrenal hypoplasia congenita. J Clin Endocrinol Metab 1999;84:504-11.
  3. Metwalley KA, Farghaly HS. X-linked congenital adrenal hypoplasia associated with hypospadias in an Egyptian baby: a case report. J Med Case Rep 2012;6:428. https://doi.org/10.1186/1752-1947-6-428
  4. Nakae J, Tajima T, Kusuda S, Kohda N, Okabe T, Shinohara N, et al. Truncation at the C-terminus of the DAX-1 protein impairs its biological actions in patients with X-linked adrenal hypoplasia congenita. J Clin Endocrinol Metab 1996;81:3680-5.
  5. Oelkers W, Diederich S, Bahr V. Diagnosis and therapy surveillance in Addison's disease: rapid adrenocorticotropin (ACTH) test and measurement of plasma ACTH, rennin activity, and aldosterone. J Clin Endocrinol Metab 1992;75:259-64.
  6. Sperling MA. The adrenal cortex. Pediatric endocrinology. Pittsburgh: W.B. Saunders Company, 1996:301-5.
  7. Achermann JC, Silverman BL, Habiby RL, Jameson JL. Presymptomatic diagnosis of X-linked adrenal hypoplasia congenita by analysis of DAX1. J Pediatr 2000;137:878-81. https://doi.org/10.1067/mpd.2000.108567
  8. Mantovani RM, Pezzuti IL, Dias VMA, Silva IN. Identification of a novel mutation in DAX1/NR0B1 gene in two siblings with severe clinical presentation of adrenal hypoplasia congenita. Arq Bras Endocrinol Metabol 2009;53:771-6. https://doi.org/10.1590/S0004-27302009000600013
  9. Bae DS, Schaefer ML, Partan BW, Muglia L. Characterization of the mouse DAX-1 gene reveals evolutionary conservation of a unique amino-terminal motif and widespread expression in mouse tissue. Endocrinology 1996;137:3921-7. https://doi.org/10.1210/endo.137.9.8756567
  10. Peter M, Viemann M, Partsch CJ, Sippell WG. Congenital adrenal hypoplasia: clinical spectrum, experience with hormonal diagnosis, and report on new point mutations of the DAX-1 gene. J Clin Endocrinol Metab 1998;83:2666-74. https://doi.org/10.1210/jcem.83.8.5027
  11. Park SH, Hong YH, Kim SS. Primary adrenal insufficiency in a newborn with adrenal hypoplasia congenita caused by a mutation of the DAX1 gene. Neonatal Med 2016;23:53-8. https://doi.org/10.5385/nm.2016.23.1.53
  12. Davoodnejad M, Eshraghi P, vakili R, Hamzehloie T. Identification of mutations in Iranian patients' DAX-1 gene with X-linked adrenal hypoplasia congenital. Egypt J Med Hum Genet 2017:18:165-72. https://doi.org/10.1016/j.ejmhg.2016.05.002
  13. Abraham MB, Shetty VB, McKenzie F, Curran J. X-linked congenital adrenal hypoplasia with a novel NR0B1/DAX gene mutation. Indian Pediatr 2016;53:529-31. https://doi.org/10.1007/s13312-016-0885-1