医学
泌尿生殖系统
旅客8
移码突变
左旋甲状腺素
先天性甲状腺功能减退
内科学
甲状腺
肾积水
儿科
内分泌学
胃肠病学
泌尿系统
突变
遗传学
转录因子
基因
生物
作者
Kanako Tanase-Nakao,Koji Muroya,Masanori Adachi,Kodai Abe,Tomonobu Hasegawa,Shunji Narumi
出处
期刊:Clinical Pediatric Endocrinology
[The Japanese Society for Pediatric Endocrinology]
日期:2022-01-01
卷期号:31 (4): 250-255
标识
DOI:10.1297/cpe.2022-0030
摘要
PAX8 is a transcription factor that is expressed in the thyroid gland and kidneys. Monoallelic loss-of-function PAX8 variants cause congenital hypothyroidism (CH), and urogenital malformations are infrequent complications seen in less than 10% of PAX8 variant carriers. Herein, we report the case of a 3-yr-old female patient with CH who was diagnosed during newborn screening. She was treated with levothyroxine, and she showed normal growth and development at a minimal dose (0.7 µg/kg/d of levothyroxine at 3 yr of age). At 5 mo of age, she visited an emergency department for fever and was incidentally found to have differently sized kidneys by ultrasonography, which was subsequently diagnosed as unilateral multicystic dysplastic kidney. Her serum creatinine and cystatin C levels were normal. Next-generation sequencing-based genetic analysis revealed that the patient was heterozygous for a PAX8 frameshift variant (p.Thr320ProfsTer106) and a DUOX2 missense variant (p.Arg885Gln). Our patient is the first truncating PAX8 variant carrier to have a urogenital malformation with CH. Genetic analysis for PAX8 should be considered in patients with CH and urogenital malformations.
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