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A familial case of insulin-dependent diabetes mellitus with a mutation in the PTF1A gene

https://doi.org/10.14341/probl8635

Abstract

Diabetes mellitus (DM) is a genetically heterogeneous disease, and some cases of type 1 diabetes mellitus (T1DM) are caused by a mutation of one gene. The child has suffered from brittle diabetes since the age of 1 year and received insulin. The HbA1c level is 9.9—11.4%. The patient was examined at the age of 14 years; the disease duration is 13 years. The daily dose of insulin is 1.15—1.35 U/kg. DM complications include initial manifestations of distal diabetic polyneuropathy as well as cheiropathy. The mother (39 years) and grandmother (74 years) have T1DM with multiple complications. A genetic study revealed that all three family members had a heterozygous substitution p.P274 in the PTF1A gene with an unknown pathological significance.


At present, it can not be asserted that the identified mutation is the etiologic factor of diabetes in the described case. We can not exclude T1DM in this child because specific antibodies have not been tested. However, the mutation is detected in all three members of the same family with diabetes, which does not exclude the discovery of a new form of MODY, not described earlier.

About the Authors

Galina N. Svetlova

Endocrinology Research Centre


Russian Federation

MD, PhD



Tamara L. Kuraeva

Endocrinology Research Centre; I.M. Sechenov First Moscow State Medical University


Russian Federation

MD, PhD, Professor



Elena A. Sechko

Endocrinology Research Centre


Russian Federation

MD, PhD



Valentina A. Peterkova

Endocrinology Research Centre


Russian Federation

MD, PhD, Professor



References

1. International Diabetes F. IDF Diabetes Atlas. 6-th edn. Brussels, Belgium: International Diabetes F. 2013.

2. Fajans SS, Bell GI. Mody. Diabetes Care. 2011;34(8):1878-1884. doi: 10.2337/dc11-0035

3. Fajans SS, Bell GI, Polonsky KS. Molecular mechanisms and clinical pathophysiology of maturity-onset diabetes of the young. N Engl J Med. 2001;345(13):971-980. doi: 10.1056/NEJMra002168

4. Kavvoura FK, Owen KR. Monogenic diabetes. Medicine. 2014;42(12):692-697. doi: 10.1016/j.mpmed.2014.09.009

5. Craig ME, Jefferies C, Dabelea D, et al. ISPAD Clinical Practice Consensus Guidelines 2014. Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes. 2014;15 Suppl 20:4-17. doi: 10.1111/pedi.12186.

6. Watkins RA, Evans-Molina C, Blum JS, DiMeglio LA. Established and emerging biomarkers for the prediction of type 1 diabetes: a systematic review. Transl Res. 2014;164(2):110-121. doi: 10.1016/j.trsl.2014.02.004

7. Nguyen C, Varney MD, Harrison LC, Morahan G. Definition of high-risk type 1 diabetes HLA-DR and HLA-DQ types using only three single nucleotide polymorphisms. Diabetes. 2013;62(6):2135-2140. doi: 10.2337/db12-1398

8. Hemminki K, Li X, Sundquist J, Sundquist K. Familial association between type 1 diabetes and other autoimmune and related diseases. Diabetologia. 2009;52(9):1820-1828. doi: 10.1007/s00125-009-1427-3

9. Ellard S, Bellanne-Chantelot C, Hattersley AT, European Molecular Genetics Quality Network Mg. Best practice guidelines for the molecular genetic diagnosis of maturity-onset diabetes of the young. Diabetologia. 2008;51(4):546-553. doi: 10.1007/s00125-008-0942-y

10. Borg H, Marcus C, Sjöblad S, et al. Islet cell antibody frequency differs from that of glutamic acid decarboxylase antibodies/IA2 antibodies after diagnosis of diabetes. Acta Paediatrica. 2000;89(1):46-51. doi: 10.1111/j.1651-2227.2000.tb01186.x

11. Krapp A, Knofler M, Ledermann B, et al. The bHLH protein PTF1-p48 is essential for the formation of the exocrine and the correct spatial organization of the endocrine pancreas. Genes & Development. 1998;12(23):3752-3763. doi: 10.1101/gad.12.23.3752

12. Adell T, Gomez-Cuadrado A, Skoudy A, et al. Role of the basic helix-loop-helix transcription factor p48 in the differentiation phenotype of exocrine pancreas cancer cells. Cell Growth Differ. 2000;11(3):137-147.

13. Rose SD, Swift GH, Peyton MJ, et al. The role of PTF1-P48 in pancreatic acinar gene expression. J Biol Chem. 2001;276(47):44018-44026. doi: 10.1074/jbc.M106264200

14. Sellick GS, Barker KT, Stolte-Dijkstra I, et al. Mutations in PTF1A cause pancreatic and cerebellar agenesis. Nat Genet. 2004;36(12):1301-1305. doi: 10.1038/ng1475

15. Weedon MN, Cebola I, Patch AM, et al. Recessive mutations in a distal PTF1A enhancer cause isolated pancreatic agenesis. Nat Genet. 2014;46(1):61-64. doi: 10.1038/ng.2826

16. Al-Shammari M, Al-Husain M, Al-Kharfy T, Alkuraya FS. A novel PTF1A mutation in a patient with severe pancreatic and cerebellar involvement. Clin Genet. 2011;80(2):196-198. doi: 10.1111/j.1399-0004.2010.01613.x

17. Gonc EN, Ozon A, Alikasifoglu A, et al. Variable Phenotype of Diabetes Mellitus in Siblings with a Homozygous PTF1A Enhancer Mutation.Horm Res Paediatr. 2015;84(3):206-211. doi: 10.1159/000435782


Supplementary files

1. Bloodline of the proband family.
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Type Исследовательские инструменты
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For citations:


Svetlova G.N., Kuraeva T.L., Sechko E.A., Peterkova V.A. A familial case of insulin-dependent diabetes mellitus with a mutation in the PTF1A gene. Problems of Endocrinology. 2018;64(2):111-115. https://doi.org/10.14341/probl8635

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ISSN 0375-9660 (Print)
ISSN 2308-1430 (Online)