Two novel mutations of the CYP11B2 gene in a Japanese patient with aldosterone deficiency type 1

Isolated hypoaldosteronism is a rare and occasionally life-threatening cause of salt wasting in infancy. A 2-month-old Japanese boy of unrelated parents was examined for failure to thrive and poor weight gain. Laboratory findings were hyponatremia, hyperkalemia, high plasma renin and low aldosterone...

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Published inEndocrine Journal Vol. 60; no. 1; pp. 51 - 55
Main Authors Kondo, Eisuke, Nakamura, Akie, Homma, Keiko, Hasegawa, Tomonobu, Yamaguchi, Takeshi, Narugami, Masahiko, Hattori, Tetsuo, Aoyagi, Hayato, Ishizu, Katsura, Tajima, Toshihiro
Format Journal Article
LanguageEnglish
Published Japan The Japan Endocrine Society 2013
Subjects
Aldosterone
Alleles
Asian Continental Ancestry Group - genetics
CYP11B2
Cytochrome P-450 CYP11B2 - deficiency
Cytochrome P-450 CYP11B2 - genetics
Humans
Hypoaldosteronism - genetics
Infant
Male
Mutation
Mutations
Urinary steroid profile
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Summary:Isolated hypoaldosteronism is a rare and occasionally life-threatening cause of salt wasting in infancy. A 2-month-old Japanese boy of unrelated parents was examined for failure to thrive and poor weight gain. Laboratory findings were hyponatremia, hyperkalemia, high plasma renin and low aldosterone levels. Spot urine analysis by gas chromatography-mass spectrometry (GC-MS) showed that urinary excretion of corticosterone metabolites was elevated. Whereas excretion of 18-hydroxycortricosterone metabolites was within the normal range, excretion of aldosterone metabolites was undetectable. The patient was therefore suspected to have aldosterone synthase deficiency type 1. Sequence analysis of CYP11B2, the gene encoding aldosterone synthase (CYP11B2), showed that the patient was a compound heterozygote for c.168G>A, p.W56X in exon 1 and c.1149C>T, p.R384X in exon 7. p.W56X was inherited from his mother and p.R384X was from his father. Since both alleles contain nonsense mutations, a lack of CYP11B2 activity was speculated to cause his condition. To our knowledge, this is the first Japanese patient in which the molecular basis of aldosterone synthase deficiency type 1 has been clarified. This case also indicates that spot urinary steroid analysis is useful for diagnosis.
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ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.EJ12-0248