Renal cysts and diabetes syndrome linked to mutations of the hepatocyte nuclear factor-1 beta gene: description of a new family with associated liver involvement.
BACKGROUND
Mutations in the hepatocyte nuclear factor (HNF)-1beta gene (TCF2) are responsible for a syndrome characterized by maturity-onset diabetes of the young, a nondiabetic renal disease, genital malformations, and liver dysfunction.


METHODS
The HNF-1beta gene was screened for mutations in four members of an Italian family with early-onset, nonketotic diabetes or a familiar, nondiabetic renal disease and nonprogressive liver disorder.


RESULTS
The genetic analysis revealed an already described nonsense mutation in codon 177 of HNF-1beta gene (R177X) in the four related subjects. Clinical features included diabetes in three of four patients, monolateral renal hypoplasia with cysts in the controlateral kidney in two patients, and bilaterally small hyperechoic kidneys without cysts in the other two patients. Renal function impairment was severe in one patient, requiring dialysis treatment, and mild in three. Three patients had nonprogressive liver dysfunction, with long-lasting enzyme alterations but no liver insufficiency or jaundice.


CONCLUSIONS
HNF-1beta gene mutations are associated with a wide variability in severity and pattern of clinical symptoms within the same kindred regarding diabetes and renal impairment. Moderate liver dysfunction may be a so far overlooked component of the syndrome.
Montoli
Alberto
A
Renal Unit, Niguarda-Ca' Granda Hospital, Milan, Italy.
Colussi
Giacomo
G
Massa
Ornella
O
Caccia
Roberta
R
Rizzoni
Gianfranco
G
Civati
Giovanni
G
Barbetti
Fabrizio
F
D000328:Adult; D003062:Codon / Q000235:genetics; D004268:DNA-Binding Proteins / Q000235:genetics*; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics*; D005260:Female; D005835:Genitalia / Q000002:abnormalities; D051539:Hepatocyte Nuclear Factor 1-beta; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000235:genetics*; D008107:Liver Diseases / Q000235:genetics* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense / Q000235:genetics; D010375:Pedigree; D013577:Syndrome; D014157:Transcription Factors / Q000235:genetics*
D003062:Codon; D004268:DNA-Binding Proteins; C496495:HNF1B protein, human; D014157:Transcription Factors; D051539:Hepatocyte Nuclear Factor 1-beta