Mutations in hepatocyte nuclear factor-1β and their related phenotypes

• Published in: Journal of medical genetics Vol. 43; no. 1; pp. 84 - 90
• Main Authors: Edghill, E L, Bingham, C, Ellard, S, Hattersley, A T
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.01.2006; BMJ; BMJ Group
• Subjects: Biological and medical sciences; Cardiology. Vascular system; familial juvenile hyperuricaemic nephropathy; FJHN; GCKD; General aspects. Genetic counseling; genetics; glomerulocystic kidney disease; hepatocyte nuclear factor-1 beta; HNF-1β; maturity-onset diabetes of the young; Medical genetics; Medical Genetics in Practice; Medical sciences; MODY; RCAD; RCAD syndrome; renal cysts; renal cysts and diabetes; Human; Genetics; Phenotype; Mutation; Hepatocyte
• ISSN: 0022-2593; 1468-6244
• DOI: 10.1136/jmg.2005.032854

Background: Hepatocyte nuclear factor-1 beta (HNF-1β) is a widely distributed transcription factor which plays a critical role in embryonic development of the kidney, pancreas, liver, and Mullerian duct. Thirty HNF-1β mutations have been reported in patients with renal cysts and other renal developmental disorders, young-onset diabetes, pancreatic atrophy, abnormal liver function tests, and genital tract abnormalities. Methods: We sequenced the HNF-1β gene in 160 unrelated subjects with renal disease, 40% of whom had a personal/family history of diabetes. Results: Twenty three different heterozygous HNF-1β mutations were identified in 23/160 subjects (14%), including 10 novel mutations (V61G, V110G, S148L, K156E, Q176X, R276Q, S281fsinsC, R295P, H324fsdelCA, Q470X). Seven (30%) cases were proven to be due to de novo mutations. Renal cysts were found in 19/23 (83%) patients (four with glomerulocystic kidney disease, GCKD) and diabetes in 11/23 (48%, while three other families had a family history of diabetes. Only 26% of families met diagnostic criteria for maturity-onset diabetes of the young (MODY) but 39% had renal cysts and diabetes (RCAD). We found no clear genotype/phenotype relationships. Conclusion: We report the largest series to date of HNF-1β mutations and confirm HNF-1β mutations as an important cause of renal disease. Despite the original description of HNF-1β as a MODY gene, a personal/family history of diabetes is often absent and the most common clinical manifestation is renal cysts. Molecular genetic testing for HNF-1β mutations should be considered in patients with unexplained renal cysts (including GCKD), especially when associated with diabetes, early-onset gout, or uterine abnormalities.