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- Luo Jiewei
- Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, China
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- Yang Xiao
- Teaching and Research Office of Surgical Nursing, Department of Nursing, Fujian Health College, Fuzhou 350101, China
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- Liang Jixing
- Department of Endocrine and Kidney, Fujian Provincial Hospital, Fuzhou 350001, China
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- Li Weihua
- Department of Surgical Oncology, Provincial Hospital, Fujian Medical University, Fuzhou 350001, China
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抄録
Gitelman syndrome (GS) is a salt-wasting tubulointerstitial disease of autosomal recessive inheritance (OMIM613395) caused by genic mutation of SLC12A3, which codes thiazide-sensitive Na-Cl cotransporter (NCCT) gene. The gene mutation of the majority of GS patients is compound heterozygous. This study analyzes two cases of GS gene mutation and the clinical phenotype. Twenty patients of two GS pedigrees underwent direct sequence alignment of 26 exons of SLC12A3 to spot and locate mutant site. Proband A of Pedigree I had three mutant sites: Arg928Cys, a homozygote, missense mutation, and two homozygous silent mutations, Ala122Ala and Thr465Thr, and 8 members of Pedigree I carried Arg928Cy heterozygous mutation. Proband B of Pedigree II had a homozygote, Ser710X, and a termination codon was spotted, which would inevitably be translated into abridged and defective protein, and 7 members had Ser710X heterozygous mutation. The heterozygous mutation carriers of the two pedigrees often have stimulus-controlled hypokalemia after strenuous exercise. The parents of Proband A are cousins, a case of intermarriage. Both probands show hypokalemia, hypochloraemia, hypocalcinuria, hyperreninemia, and hyperaldosteronemia; Proband A has normal serum magnesium and increased urinary sodium excretion, while Proband B has hypomagnesemia and increased urinary magnesium ion excretion. Both probands have normal or lower blood pressure, weakness and numbness of lower extremities, muscular soreness, and occasional palpitations and chest discomfort. Proband A wearies easily and Proband B has occasional joint numbness and pain. These two homozygous mutations are responsible for the morbidity of two GS families and they show heterogenicity of clinical phenotype.
収録刊行物
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- Endocrine Journal
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Endocrine Journal 62 (1), 29-36, 2015
一般社団法人 日本内分泌学会