ABCMdb

ABCC8 p.Met429*

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[hide] Clinical and histological heterogeneity of congeni... Eur J Endocrinol. 2014 Dec;171(6):685-95. doi: 10.1530/EJE-14-0353. Epub 2014 Sep 8. Arya VB, Guemes M, Nessa A, Alam S, Shah P, Gilbert C, Senniappan S, Flanagan SE, Ellard S, Hussain K
Clinical and histological heterogeneity of congenital hyperinsulinism due to paternally inherited heterozygous ABCC8/KCNJ11 mutations.
Eur J Endocrinol. 2014 Dec;171(6):685-95. doi: 10.1530/EJE-14-0353. Epub 2014 Sep 8., [PMID:25201519]

Abstract [show]
CONTEXT: Congenital hyperinsulinism (CHI) has two main histological types: diffuse and focal. Heterozygous paternally inherited ABCC8/KCNJ11 mutations (depending upon whether recessive or dominant acting and occurrence of somatic maternal allele loss) can give rise to either phenotype. However, the relative proportion of these two phenotypes in a large cohort of CHI patients due to paternally inherited heterozygous ABCC8/KCNJ11 mutations has not been reported. OBJECTIVE: The purpose of this study is to highlight the variable clinical phenotype and to characterise the distribution of diffuse and focal disease in a large cohort of CHI patients due to paternally inherited heterozygous ABCC8/KCNJ11 mutations. DESIGN: A retrospective chart review of the CHI patients due to heterozygous paternally inherited ABCC8/KCNJ11 mutations from 2000 to 2013 was conducted. RESULTS: Paternally inherited heterozygous ABCC8/KCNJ11 mutations were identified in 53 CHI patients. Of these, 18 (34%) either responded to diazoxide or resolved spontaneously. Fluorine-18 l-3, 4-dihydroxyphenylalanine positron emission tomography computerised tomography 18F DOPA-PET CT) scanning in 3/18 children showed diffuse disease. The remaining 35 (66%) diazoxide-unresponsive children either had pancreatic venous sampling (n=8) or 18F DOPA-PET CT (n=27). Diffuse, indeterminate and focal disease was identified in 13, 1 and 21 patients respectively. Two patients with suspected diffuse disease were identified to have focal disease on histology. CONCLUSIONS: Paternally inherited heterozygous ABCC8/KCNJ11 mutations can manifest as a wide spectrum of CHI with variable 18F DOPA-PET CT/histological findings and clinical outcomes. Focal disease was histologically confirmed in 24/53 (45%) of CHI patients with paternally inherited heterozygous ABCC8/KCNJ11 mutations.

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No. Sentence Comment
63 Extracellular M1V S12X Q54X E128K R74W M429X H627fs D855E R934X K890fs E995X *A1185V D1194V *L1431F R1437Q *D1472N A1493T *A1508P *E1507K *R54H R136fs Kir6.2 SUR1 CL3 linker Walker A p.? Login to comment
76 p.?/N (c.1333-1013AOG/N) Yes No Focal Hypoglycaemia resolved after removal of focal lesion 42 37, 4480 Female !1 1.7 5.6 A1263T/N (c.3787GOA/N) No Diffuse (PVS) Near-total pancreatectomy (95%) 45 39, 3960 Male !1 2.4 23.6 p.?/N (c.1-?_c.1176C1?/N) No Focal Hypoglycaemia resolved after removal of focal lesion 46 34, 3800 Male !1 0.8 201 D855E/N (c.2565COA/N) No Focal Hypoglycaemia resolved after removal of focal lesion 47 41, 4780 Male !1 2.4 15.9 M429X/N (c.1254_1284dup/N) No Focal Hypoglycaemia resolved after removal of focal lesion 48 40, 3800 Female !1 2.4 5.9 M429X/N (c.1254_1284dup/N) No Diffuse On octreotide at 7 months 49 40, 4100 Male !1 0.8 9.1 R74W/N (c.220COT/N) No Focal Hypoglycaemia resolved after removal of focal lesion 51 38, 3730 Female !1 1.9 21.6 E995X (c.2983GOT) No Focal Hypoglycaemia resolved after removal of focal lesion KCNJ11 7 38, 3780 Female !1 1.7 29.6 M209I/N (c.627GOA/N) Yes Diffuse On Dzx at 2.8 years 12 40, 3450 Male !1 2 6.7 R54H/N (c.161GOA/N) Yes - Off Dzx after 4 months 26 36, 3880 Male !1 !1.0 6.1 E292K/N (c.874GOA/N) No Diffuse (PVS) Near-total pancreatectomy (95%) 28 40, 4600 Male !1 1.3 38.87 R136fs/N (c.405dupG/N) No Diffuse (PVS) Near-total pancreatectomy (95%) 35 38, 4120 Female !1 2.2 12.0 T294M/N (c.881COT/N) No Diffuse (PVS) Near-total pancreatectomy (95%) 36 37, 3960 Male !1 1.9 7.0 G312C/N (c.934GOT/N) No Focal Hypoglycaemia resolved after removal of focal lesion 43 40, 4100 Female !1 1.0 35 I284del/N (c.850_852delATC/N) Yes Diffuse Off Dzx at 4 years of age 44 40, 4580 Female 32 2.2 7 p.*391Rext*94/N (c.1171TO C/N) No Focal Partial pancreatectomy, currently on Dzx 50 37, 3980 Male !1 0.5 2.9 T62M/N (c.185COT/N) Yes - Off Dzx at 1 month 52 40, 5190 Male !1 2.5 8.4 R177W/N (c.529AOT/N) Yes Diffuse On Dzx at 3 months of age 53 40, 3920 Male !1 2.1 9.2 E292K/N (c.874GOA/N) Yes Diffuse Off Dzx at 5 months of age Dzx, diazoxide; PET, positron emission tomography; PVS, pancreatic venous sampling; GA, gestational age; Wt, weight; LOH, loss of heterozygosity; Resp, responsiveness. Login to comment