Hypertension is a characteristic complication of X-linked hypophosphatemia
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- Nakamura Yoshie
- Division of Genetic Research, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan Division of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan
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- Takagi Masaki
- Division of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan
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- Takeda Ryojun
- Division of Medical Genetics, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan
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- Miyai Kentaro
- Division of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan
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- Hasegawa Yukihiro
- Division of Genetic Research, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan Division of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan
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抄録
X-linked hypophosphatemia (XLH) is a group of rare disorders caused by defective proximal tubular reabsorption of phosphate. Mutations in the PHEX gene are responsible for the majority of cases. There are very few reports of long-term complications of XLH other than skeletal and dental diseases. The aim of this study was to identify the phenotypic presentation of XLH during adulthood including complications other than skeletal and dental diseases. The clinical and biochemical phenotype of 22 adult patients with a PHEX gene mutation were examined retrospectively from their medical records. 6 patients had hypertension. The average age of hypertension onset was 29.0 years. Secondary hyperparathyroidism preceded the development of hypertension in 5 patients. 1 patient developed tertiary hyperparathyroidism. 15 patients had nephrocalcinosis. 2 patients had chronic renal dysfunction. Patients with hypertension had a significantly lower eGFR (p=0.010) compared to patients without hypertension. No significant difference was found in any other parameters. To examine the genotype-phenotype correlation, 10 adult males were chosen for analysis. No significant genotype-phenotype correlation analysis was revealed in any of the complications. However, there was a possibility that the age at nephrocalcinosis onset was younger in the non-missense mutation group than in the missense mutation group (p=0.063). This study corroborated the view that early-onset hypertension could be one of the characteristic complications seen in XLH patients. Considering the limited number of our patients, further study is necessary to address a potential cause of hypertension. XLH patients require careful lifelong treatment.
収録刊行物
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- Endocrine Journal
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Endocrine Journal 64 (3), 283-289, 2017
一般社団法人 日本内分泌学会