Monozygotic twins with congenital adrenal hyperplasia: long-term endocrine evaluation and gene analysis.
Monozygotic female twins with congenital adrenal hyperplasia due to 21-hydroxylase deficiency are described and evaluated over the first 6 years of life. Despite appropriate steroids, NaCl, and fludrocortisone therapies, there was significant fluctuation in the suppression of adrenal steroid secretion. Advanced bone maturation in both was noted. For the first time, molecular genetic analysis was performed and documented that the twins were compound heterozygotes for two different mutations: the maternal allele carried the 8-bp deletion mutation, whereas the paternal allele carried the 1172N missense mutation. Parental DNA samples confirmed that the mutations were on different alleles.
AvRuskin
Theodore W
TW
Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, The Brookdale University Hospital and Medical Center, State University of New York at Brooklyn, NY 11212-3198, USA. tavruski@brookdale.edu
Witchel
Selma F
SF
Taha
Doris R
DR
Juan
Christina S
CS
D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism*; D000324:Adrenocorticotropic Hormone; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D006801:Humans; D007231:Infant, Newborn; D020125:Mutation, Missense; D013255:Steroid 21-Hydroxylase / Q000235:genetics*; D013256:Steroids / Q000097:blood / Q000627:therapeutic use; D014430:Twins, Monozygotic
D013256:Steroids; D000324:Adrenocorticotropic Hormone; D013255:Steroid 21-Hydroxylase