Abstract | CONTEXT: OBJECTIVE: Given that previous screening was carried out by SSCP detection alone and limited to coding regions, we performed an in-depth genetic analysis of HESX1 to establish the true contribution of HESX1 genetic defects to the etiology of hypopituitarism. DESIGN: Nonfamilial patients (724) with either SOD (n = 314) or isolated pituitary dysfunction, optic nerve hypoplasia, or midline neurological abnormalities (n = 410) originally screened by SSCP were rescreened by heteroduplex detection for mutations in the coding and regulatory regions of HESX1. In addition, direct sequencing of HESX1 was performed in 126 patients with familial hypopituitarism from 66 unrelated families and in 11 patients born to consanguineous parents. PATIENTS: RESULTS: Novel sequence changes identified included a functionally significant heterozygous mutation at a highly conserved residue (E149K) in a patient with isolated GH deficiency and digital abnormalities. The overall incidence of coding region mutations within the cohort was less than 1%. CONCLUSIONS: Mutations within HESX1 are a rare cause of SOD and hypopituitarism. However, the large number of familial patients with SOD in whom no mutations were identified is suggestive of an etiological role for other genetic factors. Furthermore, we have found that within our cohort SOD is associated with a reduced maternal age compared with isolated defects of the hypothalamopituitary axis.
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Authors | David E G McNay, James P Turton, Daniel Kelberman, Kathryn S Woods, Raja Brauner, Anastasios Papadimitriou, Eberhard Keller, Alexandra Keller, Nele Haufs, Heiko Krude, Stephen M Shalet, Mehul T Dattani |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 92
Issue 2
Pg. 691-7
(Feb 2007)
ISSN: 0021-972X [Print] United States |
PMID | 17148560
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- HESX1 protein, human
- Homeodomain Proteins
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Topics |
- Adult
- Animals
- Base Sequence
- CHO Cells
- Cricetinae
- Cricetulus
- Female
- Homeodomain Proteins
(genetics)
- Humans
- Hypopituitarism
(genetics, pathology)
- Infant, Newborn
- Male
- Maternal Age
- Molecular Sequence Data
- Optic Nerve
(abnormalities)
- Pedigree
- Phenotype
- Pituitary Gland
(abnormalities)
- Point Mutation
- Polymorphism, Single-Stranded Conformational
- Septo-Optic Dysplasia
(genetics, pathology)
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