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Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature

Cystic fibrosis–related diabetes (CFRD) is associated with worsening pulmonary function, lower body mass index, increased infection frequency, and earlier mortality. While the incidence of CFRD is rising, its development in patients under the age of 10 years is uncommon. We present a 9-year-old girl...

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Autores principales: Scully, Kevin J, Sawicki, Gregory, Kremen, Jessica, Putman, Melissa S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705871/
https://www.ncbi.nlm.nih.gov/pubmed/33294763
http://dx.doi.org/10.1210/jendso/bvaa165
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author Scully, Kevin J
Sawicki, Gregory
Kremen, Jessica
Putman, Melissa S
author_facet Scully, Kevin J
Sawicki, Gregory
Kremen, Jessica
Putman, Melissa S
author_sort Scully, Kevin J
collection PubMed
description Cystic fibrosis–related diabetes (CFRD) is associated with worsening pulmonary function, lower body mass index, increased infection frequency, and earlier mortality. While the incidence of CFRD is rising, its development in patients under the age of 10 years is uncommon. We present a 9-year-old girl with cystic fibrosis (CF) who presented with a 5-year history of nonprogressive hyperglycemia, demonstrated by abnormal oral glucose tolerance tests, glycated hemoglobin A1c (HbA1c) levels consistently >6.5%, and negative pancreatic autoantibodies. Subsequent genetic testing revealed a pathogenic heterozygous recessive mutation in the GCK gene at c.667G>A (p.Gly223Ser), consistent with a diagnosis of GCK-MODY. Significant dysglycemia in young children with CF should raise suspicion for alternative etiologies of diabetes and warrants further investigation. The clinical impact of underlying monogenic diabetes in patients with CF is unclear, and close follow-up is warranted. This case also offers unique insight on the impact of hyperglycemia in the absence of insulin deficiency on CF-specific outcomes.
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spelling pubmed-77058712020-12-07 Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature Scully, Kevin J Sawicki, Gregory Kremen, Jessica Putman, Melissa S J Endocr Soc Case Reports Cystic fibrosis–related diabetes (CFRD) is associated with worsening pulmonary function, lower body mass index, increased infection frequency, and earlier mortality. While the incidence of CFRD is rising, its development in patients under the age of 10 years is uncommon. We present a 9-year-old girl with cystic fibrosis (CF) who presented with a 5-year history of nonprogressive hyperglycemia, demonstrated by abnormal oral glucose tolerance tests, glycated hemoglobin A1c (HbA1c) levels consistently >6.5%, and negative pancreatic autoantibodies. Subsequent genetic testing revealed a pathogenic heterozygous recessive mutation in the GCK gene at c.667G>A (p.Gly223Ser), consistent with a diagnosis of GCK-MODY. Significant dysglycemia in young children with CF should raise suspicion for alternative etiologies of diabetes and warrants further investigation. The clinical impact of underlying monogenic diabetes in patients with CF is unclear, and close follow-up is warranted. This case also offers unique insight on the impact of hyperglycemia in the absence of insulin deficiency on CF-specific outcomes. Oxford University Press 2020-11-02 /pmc/articles/PMC7705871/ /pubmed/33294763 http://dx.doi.org/10.1210/jendso/bvaa165 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Reports
Scully, Kevin J
Sawicki, Gregory
Kremen, Jessica
Putman, Melissa S
Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature
title Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature
title_full Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature
title_fullStr Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature
title_full_unstemmed Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature
title_short Monogenic Diabetes in a Child with Cystic Fibrosis: A Case Report and Review of the Literature
title_sort monogenic diabetes in a child with cystic fibrosis: a case report and review of the literature
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705871/
https://www.ncbi.nlm.nih.gov/pubmed/33294763
http://dx.doi.org/10.1210/jendso/bvaa165
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