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논문KCI 등재

다발성 인슐린종과 부갑상선 기능항진증을 동반한 젊은 남성에서 발견된 MEN1 유전자의 새로운 배선돌연변이

A Novel Germline Mutation of MEN1 Gene in a Young-aged Multiple Insulinoma with Hyperparathyroidism

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초록

Multiple endocrine neoplasia type 1 is an autosomal dominant disease caused by the MEN1germline mutation. A 25-year-old male was admitted for loss of consciousness. Initial laboratory data showed hypoglycemia and hypercalcemia. The image study showed two insulinoma in the pancreas head and body. MIBI scan was positive in the left lower parathyroid gland. After diagnosis of insulinoma and hyperparathyroidism, MEN1 was suspected, but there was no family history of endocrine disease. Enucleation of the insulinoma in the pancreatic head and body was performed. After the operation, the blood sugar level was normalized and no hypoglycemic symptoms were observed. Testing of germline mutations of the MEN1 gene was performed by direct DNA sequence analysis after obtaining informed consent. In the genetic study, a frameshift mutation was found in exon 2 which deleted 16 nucleic acids (c.326_341del16) and resulted in a truncation at codon 113. This mutation was not reported previously. We found a novel and de novo mutation of the MEN1 gene. Genetic study is necessary in case of young-age, multiple endocrine tumors.

Abstract

Multiple endocrine neoplasia type 1 is an autosomal dominant disease caused by the MEN1germline mutation. A 25-year-old male was admitted for loss of consciousness. Initial laboratory data showed hypoglycemia and hypercalcemia. The image study showed two insulinoma in the pancreas head and body. MIBI scan was positive in the left lower parathyroid gland. After diagnosis of insulinoma and hyperparathyroidism, MEN1 was suspected, but there was no family history of endocrine disease. Enucleation of the insulinoma in the pancreatic head and body was performed. After the operation, the blood sugar level was normalized and no hypoglycemic symptoms were observed. Testing of germline mutations of the MEN1 gene was performed by direct DNA sequence analysis after obtaining informed consent. In the genetic study, a frameshift mutation was found in exon 2 which deleted 16 nucleic acids (c.326_341del16) and resulted in a truncation at codon 113. This mutation was not reported previously. We found a novel and de novo mutation of the MEN1 gene. Genetic study is necessary in case of young-age, multiple endocrine tumors.

참고문헌 (7)

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  4. Doherty GM, "Results of a prospective strategy to diagnose, localize, and resect insulinomas", Surgery, 110, pp.989~997 (1991)
  5. Bilezikian JP, "Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop", J Clin Endocrinol Metab, 94, pp.335~339 (2009)
  6. Lemos MC, "Multiple endocrine neoplasia type 1(MEN1): analysis of 1336 mutations reported in the first decade following identification of the gene", Hum Mutat, 29, pp.22~32 (2008)
  7. 이성철, "Characteristics of the Germline MEN1 Mutations in Korea: A Literature Review", The Journal of Endocrine Surgery, 14(1), pp.7~11 (2014), 대한갑상선-내분비외과학회

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