Biallelic CYP24A1 variants presenting during pregnancy: clinical and biochemical phenotypes.

CYP24A1 mutation genetic mutation hypercalcaemia hypervitaminosis D phenotype vitamin D

Journal

Endocrine connections
ISSN: 2049-3614
Titre abrégé: Endocr Connect
Pays: England
ID NLM: 101598413

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 06 04 2020
accepted: 06 05 2020
pubmed: 7 5 2020
medline: 7 5 2020
entrez: 7 5 2020
Statut: ppublish

Résumé

Inactivating mutations in CYP24A1, encoding vitamin D-24-hydroxylase, can lead to an accumulation of active vitamin D metabolites and consequent hypercalcaemia. Patient (infantile and adult) presentation is varied and includes mild-severe hypercalcaemia, hypercalciuria, nephrocalcinosis and nephrolithiasis. This study aimed to characterize the clinical and biochemical phenotypes of a family with two CYP24A1 missense variants. The proband and seven family members underwent detailed clinical and biochemical evaluation. Laboratory measurements included serum calcium, intact parathyroid hormone (iPTH), vitamin D metabolites and urine calcium and creatinine. The proband presented during the second trimester of a planned pregnancy with flu-like symptoms. Laboratory tests showed elevated adjusted calcium of 3.27 (upper reference limit (URL: 2.30) mmol/L), suppressed iPTH (<6 ng/L), elevated 25(OH)D (264 (URL: 55) nmol/L) and elevated 1,25(OH)D (293 (URL: <280) pmol/L). Ionized calcium was 1.55 (URL: 1.28) mmol/L. Sanger sequencing revealed two heterozygous missense variants in the CYP24A1: p.(Arg439Cys), R439C and p.(Trp275Arg), W275R. The proband's brother and sister had the same genotype. The brother had intermittent hypercalcaemia and hypervitaminosis D. Only the sister had a history of nephrolithiasis. The proband's daughter and two nephews were heterozygous for the R439C variant. The proband and her brother frequently had elevated 25(OH)D:24,25(OH)2D ratios (>50) during follow-up. W275R is a new pathogenic CYP24A1 mutation in compound heterozygotic form with R439C in this family.

Identifiants

pubmed: 32375123
doi: 10.1530/EC-20-0150
pii: EC-20-0150
pmc: PMC7354719
doi:
pii:

Types de publication

Journal Article

Langues

eng

Pagination

530-541

Références

Pediatr Nephrol. 2015 Jan;30(1):145-52
pubmed: 25194629
J Steroid Biochem Mol Biol. 2020 Mar;197:105547
pubmed: 31756419
Front Endocrinol (Lausanne). 2018 Jul 17;9:373
pubmed: 30065699
Autoimmun Rev. 2010 Jun;9(8):547-52
pubmed: 20307690
Am J Med. 1986 Sep;81(3):451-6
pubmed: 3755867
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Bone. 2009 Mar;44(3):428-30
pubmed: 19059370
J Pediatr Endocrinol Metab. 2009 Aug;22(8):741-9
pubmed: 19845125
J Gerontol A Biol Sci Med Sci. 2020 Jan 14;:
pubmed: 31942614
J Clin Endocrinol Metab. 2017 May 1;102(5):1440-1446
pubmed: 28324001
BMJ. 2015 Jun 02;350:h2723
pubmed: 26037642
J Endocr Soc. 2018 Dec 17;3(2):387-396
pubmed: 30729229
J Clin Endocrinol Metab. 2015 Aug;100(8):2832-6
pubmed: 26097993
J Obstet Gynaecol Can. 2008 Dec;30(12):1146-1148
pubmed: 19175968
J Bone Miner Res. 2016 Oct;31(10):1841-1844
pubmed: 27105398
J Pediatr. 2013 Oct;163(4):1208-10
pubmed: 23768816
J Pediatr. 2010 Aug;157(2):296-302
pubmed: 20394945
J Paediatr Child Health. 2019 Feb;55(2):232-235
pubmed: 30218463
Annu Rev Biochem. 1976;45:631-66
pubmed: 183601
N Am J Med Sci. 2015 Nov;7(11):483-93
pubmed: 26713296
J Am Board Fam Med. 2009 Nov-Dec;22(6):698-706
pubmed: 19897699
Clin Kidney J. 2015 Aug;8(4):453-5
pubmed: 26251716
Nephrol Dial Transplant. 2014 Mar;29(3):636-43
pubmed: 24235083
Reprod Toxicol. 2006 Nov;22(4):578-9
pubmed: 16996245
J Clin Endocrinol Metab. 1992 Dec;75(6):1446-52
pubmed: 1464646
Ther Clin Risk Manag. 2015 Dec 04;11:1779-88
pubmed: 26675713
J Clin Endocrinol Metab. 2015 Oct;100(10):E1343-52
pubmed: 26214117
Genet Med. 2015 May;17(5):405-24
pubmed: 25741868
Hormones (Athens). 2011 Oct-Dec;10(4):280-91
pubmed: 22281884
Clin Case Rep. 2016 Sep 17;4(10):1001-1008
pubmed: 27761256
Kidney Int Rep. 2019 Mar 08;4(6):888-892
pubmed: 31194112
Drug Saf. 2001;24(7):553-65
pubmed: 11444726
N Engl J Med. 2011 Aug 4;365(5):410-21
pubmed: 21675912
Case Rep Endocrinol. 2019 Apr 8;2019:4982621
pubmed: 31089432
Genet Med. 2016 Nov;18(11):1165
pubmed: 26986878
J Antimicrob Chemother. 2015 Jan;70(1):14-22
pubmed: 25204341
J Appl Lab Med. 2019 Sep;4(2):264-269
pubmed: 31639673
J Steroid Biochem Mol Biol. 2019 Feb;186:4-21
pubmed: 30205156
Ann Clin Biochem. 2020 Mar;57(2):186-191
pubmed: 31842586
Endocrinol Metab Clin North Am. 2011 Dec;40(4):795-826
pubmed: 22108281
J Investig Med. 2011 Aug;59(6):872-80
pubmed: 21415774
J Nutr Biochem. 2017 Aug;46:21-29
pubmed: 28437713
J Clin Endocrinol Metab. 2012 Mar;97(3):E423-7
pubmed: 22337913
Endocrinol Diabetes Metab Case Rep. 2014;2014:140056
pubmed: 25298882

Auteurs

Tomás P Griffin (TP)

Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland.
Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland.

Caroline M Joyce (CM)

Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland.

Sumaya Alkanderi (S)

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

Liam M Blake (LM)

Department of Clinical Biochemistry, SUHCG, GUH, Galway, Ireland.

Derek T O'Keeffe (DT)

Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland.

Delia Bogdanet (D)

Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland.

Md Nahidul Islam (MN)

Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland.
Department of Clinical Biochemistry, SUHCG, GUH, Galway, Ireland.

Michael C Dennedy (MC)

Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland.
Lambe Institute for Translational Research, School of Medicine, NUIG, Galway, Ireland.

John E Gillan (JE)

Department of Histopathology, SUHCG, GUH, Galway, Ireland.

John J Morrison (JJ)

Department of Obstetrics and Gynaecology, SUHCG, GUH, Galway, Ireland.

Timothy O'Brien (T)

Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland.
Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland.

John A Sayer (JA)

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle upon Tyne, UK.
NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK.

Marcia Bell (M)

Centre for Endocrinology, Diabetes and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals (GUH), Galway, Ireland.

Paula M O'Shea (PM)

Department of Clinical Biochemistry, SUHCG, GUH, Galway, Ireland.

Classifications MeSH