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Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic

CONTEXT: Congenital hyperinsulinism (HI) is characterized by inappropriate insulin secretion despite low blood glucose. Persistent HI is often monogenic, with the majority of cases diagnosed in infancy. Less is known about the contribution of monogenic forms of disease in those presenting in childho...

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Autores principales: Hopkins, Jasmin J, Childs, Alexandra J, Houghton, Jayne A L, Hewat, Thomas I, Atapattu, Navoda, Johnson, Matthew B, Patel, Kashyap A, Laver, Thomas W, Flanagan, Sarah E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931180/
https://www.ncbi.nlm.nih.gov/pubmed/36239000
http://dx.doi.org/10.1210/clinem/dgac604
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author Hopkins, Jasmin J
Childs, Alexandra J
Houghton, Jayne A L
Hewat, Thomas I
Atapattu, Navoda
Johnson, Matthew B
Patel, Kashyap A
Laver, Thomas W
Flanagan, Sarah E
author_facet Hopkins, Jasmin J
Childs, Alexandra J
Houghton, Jayne A L
Hewat, Thomas I
Atapattu, Navoda
Johnson, Matthew B
Patel, Kashyap A
Laver, Thomas W
Flanagan, Sarah E
author_sort Hopkins, Jasmin J
collection PubMed
description CONTEXT: Congenital hyperinsulinism (HI) is characterized by inappropriate insulin secretion despite low blood glucose. Persistent HI is often monogenic, with the majority of cases diagnosed in infancy. Less is known about the contribution of monogenic forms of disease in those presenting in childhood. OBJECTIVE: We investigated the likelihood of finding a genetic cause in childhood-onset HI and explored potential factors leading to later age at presentation of disease. METHODS: We screened known disease-causing genes in 1848 individuals with HI, referred for genetic testing as part of routine clinical care. Individuals were classified as infancy-onset (diagnosed with HI < 12 months of age) or childhood-onset (diagnosed at age 1-16 years). We assessed clinical characteristics and the genotypes of individuals with monogenic HI diagnosed in childhood to gain insights into the later age at diagnosis of HI in these children. RESULTS: We identified the monogenic cause in 24% (n = 42/173) of the childhood-onset HI cohort; this was significantly lower than the proportion of genetic diagnoses in infancy-onset cases (74.5% [n = 1248/1675], P < 0.00001). Most (75%) individuals with genetically confirmed childhood-onset HI were diagnosed before 2.7 years, suggesting these cases represent the tail end of the normal distribution in age at diagnosis. This is supported by the finding that 81% of the variants identified in the childhood-onset cohort were detected in those diagnosed in infancy. CONCLUSION: We have shown that monogenic HI is an important cause of hyperinsulinism presenting outside of infancy. Genetic testing should be considered in children with persistent hyperinsulinism, regardless of age at diagnosis.
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spelling pubmed-99311802023-02-16 Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic Hopkins, Jasmin J Childs, Alexandra J Houghton, Jayne A L Hewat, Thomas I Atapattu, Navoda Johnson, Matthew B Patel, Kashyap A Laver, Thomas W Flanagan, Sarah E J Clin Endocrinol Metab Clinical Research Article CONTEXT: Congenital hyperinsulinism (HI) is characterized by inappropriate insulin secretion despite low blood glucose. Persistent HI is often monogenic, with the majority of cases diagnosed in infancy. Less is known about the contribution of monogenic forms of disease in those presenting in childhood. OBJECTIVE: We investigated the likelihood of finding a genetic cause in childhood-onset HI and explored potential factors leading to later age at presentation of disease. METHODS: We screened known disease-causing genes in 1848 individuals with HI, referred for genetic testing as part of routine clinical care. Individuals were classified as infancy-onset (diagnosed with HI < 12 months of age) or childhood-onset (diagnosed at age 1-16 years). We assessed clinical characteristics and the genotypes of individuals with monogenic HI diagnosed in childhood to gain insights into the later age at diagnosis of HI in these children. RESULTS: We identified the monogenic cause in 24% (n = 42/173) of the childhood-onset HI cohort; this was significantly lower than the proportion of genetic diagnoses in infancy-onset cases (74.5% [n = 1248/1675], P < 0.00001). Most (75%) individuals with genetically confirmed childhood-onset HI were diagnosed before 2.7 years, suggesting these cases represent the tail end of the normal distribution in age at diagnosis. This is supported by the finding that 81% of the variants identified in the childhood-onset cohort were detected in those diagnosed in infancy. CONCLUSION: We have shown that monogenic HI is an important cause of hyperinsulinism presenting outside of infancy. Genetic testing should be considered in children with persistent hyperinsulinism, regardless of age at diagnosis. Oxford University Press 2022-10-14 /pmc/articles/PMC9931180/ /pubmed/36239000 http://dx.doi.org/10.1210/clinem/dgac604 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Hopkins, Jasmin J
Childs, Alexandra J
Houghton, Jayne A L
Hewat, Thomas I
Atapattu, Navoda
Johnson, Matthew B
Patel, Kashyap A
Laver, Thomas W
Flanagan, Sarah E
Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic
title Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic
title_full Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic
title_fullStr Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic
title_full_unstemmed Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic
title_short Hyperinsulinemic Hypoglycemia Diagnosed in Childhood Can Be Monogenic
title_sort hyperinsulinemic hypoglycemia diagnosed in childhood can be monogenic
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931180/
https://www.ncbi.nlm.nih.gov/pubmed/36239000
http://dx.doi.org/10.1210/clinem/dgac604
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