Document Detail


Facial appearance in persistent hyperinsulinemic hypoglycemia.
MedLine Citation:
PMID:  12210338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Persistent hyperinsulinism is the most common cause of recurrent hypoglycemia in infancy because of inappropriate oversecretion of insulin by the pancreas. Pancreatic lesions can be either focal or diffuse, and they have distinct molecular bases. We have studied the facial features in 17 unrelated patients presenting with neonatal (n = 8) or infancy-onset (n = 9) hyperinsulinism. Hyperinsulinism was related to focal adenomatous hyperplasia (n = 7), diffuse hyperinsulinism (n = 5), non-operated hyperinsulinism (n = 2), and hyperinsulinism with hyperammonemia (n = 3). SUR1 or Kir6.2 mutations were found in six of seven focal adenomatous hyperplasia and three of five diffuse hyperinsulinism. A loss of the maternal allele from chromosome 11p15 in the lesion was found in all focal adenomatous hyperplasia. GLUD1 mutations were found in all patients with hyperammonemia. Large birth weight (mean > 3,800 g) was consistently observed (11/17) but protruding tongue, exomphalos, or visceromegaly were never noted and Wiedemann-Beckwith syndrome could always be ruled out. All patients presented with high forehead, small nasal tip, and short columella giving the impression that the nose is large and bulbous, smooth philtrum, and thin upper lip. A square appearance to the face was more obvious in younger patients. These specific facial features, observed in patients with hyperinsulinism of various molecular mechanisms, could be the consequence of fetal intoxication by insulin. However, to date, facial anomalies have not been noted in infants of diabetic mothers and inversely, malformations that are commonly reported in infants of diabetic mothers were not present in our hyperinsulinemic patients.
Authors:
Pascale de Lonlay; Valérie Cormier-Daire; Jeanne Amiel; Guy Touati; Alice Goldenberg; Jean-Christophe Fournet; Francis Brunelle; Claire Nihoul-Fékété; Jacques Rahier; Claudine Junien; Jean-Jacques Robert; Jean-Marie Saudubray
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of medical genetics     Volume:  111     ISSN:  0148-7299     ISO Abbreviation:  Am. J. Med. Genet.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-04     Completed Date:  2003-01-31     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7708900     Medline TA:  Am J Med Genet     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-3     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Wiley-Liss, Inc.
Affiliation:
Département de Pédiatrie, INSERM-U383, Hôpital Necker-Enfants Malades, Paris, France. pascale.de-lonlay@necker.fr
Data Bank Information
Bank Name/Acc. No.:
OMIM/600509;  600937
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MeSH Terms
Descriptor/Qualifier:
ATP-Binding Cassette Transporters*
Child, Preschool
Chromosomes, Human, Pair 11 / genetics
Face / abnormalities*
Facial Bones / abnormalities*
GTP Phosphohydrolases / genetics
Glutamate Dehydrogenase / genetics
Humans
Hyperinsulinism / complications*,  genetics
Hypoglycemia / etiology*
Immediate-Early Proteins / genetics
Infant
Monomeric GTP-Binding Proteins / genetics
Multidrug Resistance-Associated Proteins*
Mutation
Potassium Channels, Inwardly Rectifying
Protein-Serine-Threonine Kinases / genetics
Protein-Tyrosine Kinases / genetics
Receptors, Drug
Chemical
Reg. No./Substance:
0/ATP-Binding Cassette Transporters; 0/Immediate-Early Proteins; 0/Multidrug Resistance-Associated Proteins; 0/Potassium Channels, Inwardly Rectifying; 0/Receptors, Drug; 0/sulfonylurea receptor; EC 1.4.1.2/Glutamate Dehydrogenase; EC 2.7.10.1/Protein-Tyrosine Kinases; EC 2.7.11.1/Protein-Serine-Threonine Kinases; EC 3.6.1.-/GTP Phosphohydrolases; EC 3.6.5.2/GEM protein, human; EC 3.6.5.2/Monomeric GTP-Binding Proteins

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