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https://hdl.handle.net/2440/72246
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Type: | Journal article |
Title: | CBG Santiago: a novel CBG mutation |
Author: | Torpy, D. Lundgren, B. Ho, J. Lewis, J. Scott, H. Mericq, V. |
Citation: | Journal of Clinical Endocrinology and Metabolism, 2012; 97(1):E151-E155 |
Publisher: | Endocrine Society |
Issue Date: | 2012 |
ISSN: | 0021-972X 1945-7197 |
Statement of Responsibility: | D.J. Torpy, B. Ardesjö Lundgren, J.T. Ho, J.G. Lewis, H.S. Scott and V. Mericq |
Abstract: | CONTEXT: Corticosteroid-binding globulin (CBG; SERPIN A6) gene mutations are rare; only four mutations have been described, often in association with fatigue and chronic pain, albeit with incomplete penetrance. PATIENT: We report a kindred with a novel SERPINA6 mutation. The proband, a 9-yr-old male, had excessive postexertional fatigue, weakness, and migraine. MAIN OUTCOME MEASURES AND RESULTS: Investigations revealed low morning and ACTH-stimulated peak cortisol levels. SERPIN A6 sequencing detected a novel exon 2 single base deletion (c.13delC) leading to a frameshift generating a stop codon within the signal peptide coding region(p.Leu5CysfsX26) and 50% reduced CBG levels in heterozygotes. The patient’s father and two sisters share the mutation. Symptom expression within the family may have been modified by a polymorphic CBG allele (c.735G>T). Exogenous hydrocortisone had no effect on the fatigue. CONCLUSION: This report documents the fifth CBG gene mutation in humans and the second causing major effects on CBG levels. Individuals with low CBG levels may be misdiagnosed as having secondary hypocortisolism. The association with fatigue and idiopathic pain is again noted and may relate to altered stress system function. Variability of the phenotype may relate to other genetic variations ofthe CBG gene or environmental factors. |
Keywords: | Humans Muscle Weakness Fatigue Transcortin Pedigree DNA Mutational Analysis Amino Acid Sequence Base Sequence Mutation, Missense Polymorphism, Single Nucleotide Child Chile Male Migraine Disorders |
Rights: | Copyright © 2012 by The Endocrine Society |
DOI: | 10.1210/jc.2011-2022 |
Published version: | http://dx.doi.org/10.1210/jc.2011-2022 |
Appears in Collections: | Aurora harvest Medicine publications |
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