IDENTIFICATION OF NOVEL GENETIC MUTATIONS IN JAPANESE PATIENTS WITH SEVERE CONGENITAL HYPOTHYROIDISM

概要

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Objective : The prevalence of genetic mutations in congenital hypothyroidism (CH) remains undetermined. The objective of this study was to determine the prevalence of mutations in DUOX2, TSHR, TG, PAX8, and TPO among severe permanent primary CH. Methods : Between April 1999 and March 2011, 114,733 newborns were screened for CH in Akita Prefecture, Japan. Among them, 330 were suspected of having CH and were referred to pediatricians. We recruited 40 patients who were referred to our institute. Among them, we identified 9 permanent primary CH patients who were severely affected with an initial TSH ≥20 mU/l upon newborn screening and performed direct sequencing of the 5 candidate genes. Results : 3 of 9 patients (33%) had mutations in PAX8, TPO, and TSHR. Among the severely affected subjects, 60% had thyroid dysgenesis (TD), while for patients with initial TSH upon screening <20 mU/l only 12% had TD. Conclusions : Despite the high frequency of TD, the detection rate of mutations among severe permanent primary CH was higher than expected.　This study suggests that the genetic analysis of 5 genes, namely, DUOX2, TSHR, TG, PAX8, and TPO, is useful for the diagnosis of CH, and that the actual prevalence of genetic mutations among CH might be higher than as previously estimated.
秋田医学会の論文
2013-11-21