갑상샘비대 또는 정상 갑상샘을 동반한 일과성 또는 영구성 선천성 갑상샘저하증의 DUOX2 유전자 돌연변이의 빈도와 다유전자성 원인

갑상샘비대 또는 정상 갑상샘을 동반한 일과성 또는 영구성 선천성 갑상샘저하증의 DUOX2 유전자 돌연변이의 빈도와 다유전자성 원인

High frequency of DUOX2 mutations and oligogenic causes of transient or permanent congenital hypothyroidism with enlarged or normal-sized eutopic thyroid glands

(구연):
Release Date : 2013. 10. 18(금)
Yoo-Mi Kim¹, Ja Hye Kim¹, Sun-Hee Heo², Ju-Hyun Kim², Gu-Hwan Kim³,Hye Young Jin¹, Beom Hee Lee³, Jin-Ho Choi¹, Han-Wook Yoo¹-³
Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics¹, Genome Research Center for Birth defects and Genetic Diseases, Asan Institute for Life Sciences², Medical Genetics Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea³, Department of pediatrics, Daejeon Sun General Hospital, Daejeon, Korea⁴.
김유미¹, 김자혜¹, 허선희², 김주현², 김구환²,³, 진혜영⁴,이범희³ , 최진호¹, 유한욱¹-³
울산의대 서울아산병원 소아청소년병원 내분비대사과¹, 선천성 기형 및 유전질환 유전체연구센터², 의학유전클리닉³, 대전선병원 소아청소년과⁴

Abstract

Purpose: This study aimed to clarify the frequency, phenotypes and molecular spectrum of DUOX2, TPO, and TSHR mutations in patients with congenital hypothyroidism (CH) with enlarged or normal-sized eutopic thyroid glands. Methods: The study cohort included 43 infants and children from 41 unrelated families who had transient or permanent CH with eutopic thyroid glands. Mutation analyses of DUOX2, TPO, and TSHR were performed. In case of extremely low serum thyroglobulin levels, TG analysis was carried out. The functional capacities of novel missense variants of DUOX2 were verified by measuring H2O2 generation in vitro. Results: Of the 43 subjects, 28 (65%) had sequence variants in at least one gene. Twelve different DUOX2 sequence variants, including 7 novel variants were identified in 20 subjects. Sequence variants in TSHR and TPO were identified in 10 and 3 subjects. Of the 20 subjects with DUOX2 variants, 1 subject had transient CH, 9 had mild thyroid dysfunction, and 10 were found to have permanent CH at age 3. A functional analysis of the DUOX2 variants revealed that most variants, other than p.G206V and p.H678R, caused a significant reduction in H2O2 generation. Six of the 43 subjects (14%) had sequence variants in two different genes, suggesting oligogenic causes of CH with eutopic thyroid glands. Conclusions: DUOX2 variants are a relatively common cause of CH with normal-sized or enlarged eutopic thyroid glands. Variable phenotypes were associated with partial loss of functional activity of DUOX2 variants. Oligogenic causes were prominent feature in the development of dyshormonogenic CH.

Keywords: DUOX2, dyshormonogenic congenital hypothyroidism,