一例家族性醛固酮增多症II型合并WFS1基因突变的诊疗和基因检测分析
收稿日期: 2022-08-09
修回日期: 2022-09-12
网络出版日期: 2022-09-22
Diagnosis, treatment and genetic analysis of a case of familial aldosteronism type II with WFS1 gene mutation
Received date: 2022-08-09
Revised date: 2022-09-12
Online published: 2022-09-22
原发性醛固酮增多症(primary aldosteronism, PA)又简称原醛症,是指肾上腺皮质分泌过量醛固酮(aldosterone,ALD),导致水钠潴留及肾素-血管紧张素系统受抑制,从而引起高血压、低血钾的一类疾病。家族性醛固酮增多症II型(familial hyperaldosteronism type II, FH-II)是PA的少见病因,为常染色体显性遗传病。本文收集1例自2014年起病以来反复高血压、低血钾的病例,该患者诊断结果一直未明确。2021年通过基因检测证实该患者存在CLCN2及WFS1基因突变,其母亲为杂合携带,父亲为野生型。结合内分泌功能试验结果及影像学资料,考虑患者为FH-II,同时合并WFS1基因突变。通过总结分析该病例特点及基因检测结果,对于临床难以明确病因的PA建议可行基因测序。该病例也为后续遗传学研究提供临床资料。
关键词: 家族性醛固酮增多症II型; CLCN2; WFS1
孙致连, 何俊莹, 程筱玲, 谭晓霞, 吴伟华 . 一例家族性醛固酮增多症II型合并WFS1基因突变的诊疗和基因检测分析[J]. 遗传, 2022 , 44(11) : 1072 -1078 . DOI: 10.16288/j.yczz.22-197
Primary aldosteronism (PA) is a disease characterized by hypertension and hypokalemia due to the excessive aldosterone secretion from the adrenal cortex, which leads to the retention of both water and sodium, and the inhibition of the renin-angiotensin system as well. Familial hyperaldosteronism type II (FH-II) is known as an autosomal dominant hereditary disease, which is a scarce cause of PA. In this report, we cllected the clinical data of a patient with repeated hypertension and hypokalemia of uncertain diagnosis since 2014. Nevertheless, we discovered by genetic sequencing in 2021 that the CLCN2 and WFS1 gene mutation of the patient, whose mother belongs to heterozygote genotype and father belongs to wild-type genotype. Combined with a series of endocrine function tests and imaging studies, the patient was finally certified her suffering from FH-II and WFS1 gene mutation. By summarizing and analyzing the characteristics and genetic test results of this case, we recommended gene sequencing for patients with PA whose etiology is difficult to be determined clinically. This case also provides new clinical data for subsequent genetic studies of the disease.
Key words: familial hyperaldosteronism type II; CLCN2; WFS1
| [1] | Chinese Society of Endocrinology.Expert consensus on the diagnosis and treatment of primary aldosteronism (2020). Chin J Endocrinol Metab, 2020, 36(9): 727-736. |
| [1] | 中华医学会内分泌学分会. 原发性醛固酮增多症诊断治疗的专家共识(2020版). 中华内分泌代谢杂志, 2020, 36(9): 727-736. |
| [2] | Wang HP, Tong AL. Research progress on gene mutation related primary aldosteronism. International Journal of Endocrinology and Metabolism, 2021, 41(2): 87-90. |
| [2] | 王慧萍, 童安莉. 原发性醛固酮增多症相关的基因突变研究进展. 国际内分泌代谢杂志, 2021, 41(2): 87-90. |
| [3] | Shaul O. How introns enhance gene expression. Int J Biochem Cell Biol, 2017, 91(Pt B):145-155. |
| [4] | Scholl UI, St?lting G, Schewe J, Thiel A, Tan H, Nelson- Williams C, Vichot AA, Jin SC, Loring E, Untiet V, Yoo T, Choi J, Xu SX, Wu AH, Kirchner M, Mertins P, Rump LC, Onder AM, Gamble C, Mckenney D, Lash RW, Jones DP, Chune G, Gagliardi P, Choi M, Gordon R, Stowasser M, Fahlke C, Lifton RP. CLCN2 chloride channel mutations in familial hyperaldosteronism type II. Nat Genet, 2018, 50(3): 349-354. |
| [5] | Fernandes-Rosa FL, Daniil G, Orozco IJ, G?ppner C, El ZR, Jain V, Boulkroun S, Jeunemaitre X, Amar L, Lefebvre H, Schwarzmayr T, Strom TM, Jentsch TJ, Zennaro MC. A gain-of-function mutation in the CLCN2 chloride channel gene causes primary aldosteronism. Nat Genet, 2018, 50(3): 355-361. |
| [6] | Arlt W, Lang K, Sitch AJ, Dietz AS, Rhayem Y, Bancos I, Feuchtinger A, Chortis V, Gilligan LC, Ludwig P, Riester A, Asbach E, Hughes BA, O'Neil DM, Bidlingmaier M, Tomlinson JW, Hassan-Smith ZK, Rees DA, Adolf C, Hahner S, Quinkler M, Dekkers T, Deinum J, Biehl M, Keevil BG, Shackleton CH, Deeks JJ, Walch AK, Beuschlein F, Reincke M. Steroid metabolome analysis reveals prevalent glucocorticoid excess in primary aldosteronism. JCI Insight, 2017, 2(8). |
| [7] | Wu VC, Chueh SJ, Chen L, Chang CH, Hu YH, Lin YH, Wu KD, Yang WS. Risk of new-onset diabetes mellitus in primary aldosteronism: a population study over 5 years. J Hypertens, 2017, 35(8): 1698-1708. |
| [8] | Hanslik G, Wallaschofski H, Dietz A, Riester A, Reincke M, Allolio B, Lang K, Quack I, Rump LC, Willenberg HS, Beuschlein F, Quinkler M, Hannemann A. Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn's Registry. Eur J Endocrinol, 2015, 173(5): 665-675. |
| [9] | Panfili E, Mondanelli G, Orabona C, Belladonna ML, Gargaro M, Fallarino F, Orecchini E, Prontera P, Proietti E, Frontino G, Tirelli E, Iacono A, Vacca C, Puccetti P, Grohmann U, Esposito S, Pallotta MT. Novel mutations in the WFS1 gene are associated with Wolfram syndrome and systemic inflammation. Hum Mol Genet, 2021, 30(3-4): 265-276. |
| [10] | Li MH, Wang SH, Xu KF, Chen Y, Fu Q, Gu Y, Shi Y, Zhang M, Sun M, Chen H, Han XQ, Li YX, Tang ZK, Cai LJ, Li ZQ, Shi YY, Yang T, Polychronakos C. High prevalence of a monogenic cause in Han Chinese diagnosed with type 1 diabetes, partly driven by nonsyndromic recessive WFS1 mutations. Diabetes, 2020, 69(1): 121- 126. |
| [11] | Yahaya TO, Salisu TF. A review of type 2 diabetes mellitus predisposing genes. Curr Diabetes Rev, 2019, 16(1): 52-61. |
| [12] | Gong X, Zhang C, Yiliyasi A, Shi Y, Yang XW, Nuersimanguli A, Guan YQ, Xu SH. A comparative analysis of genetic diversity of candidate genes associated with type 2 diabetes in worldwide populations. Hereditas(Beijing), 2016, 38(6): 543-559. |
| [12] | 弓弦, 张超, 伊利亚斯·艾萨, 时瑛, 杨雪唯, 努尔斯曼古丽奥斯曼, 关亚群, 徐书华. 2型糖尿病易感候选基因在世界不同人群中的多样性比较分析. 遗传, 2016, 38(6): 543-559. |
| [13] | Sch?fer SA, Müssig K, Staiger H, Machicao F, Stefan N, Gallwitz B, H?ring HU, Fritsche A. A common genetic variant in WFS1 determines impaired glucagon-like peptide- 1-induced insulin secretion. Diabetologia, 2009, 52(6): 1075-1082. |
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