Mutations in hepatocyte nuclear factor-1beta and their related phenotypes.
BACKGROUND
Hepatocyte nuclear factor-1 beta (HNF-1beta) is a widely distributed transcription factor which plays a critical role in embryonic development of the kidney, pancreas, liver, and Mullerian duct. Thirty HNF-1beta mutations have been reported in patients with renal cysts and other renal developmental disorders, young-onset diabetes, pancreatic atrophy, abnormal liver function tests, and genital tract abnormalities.


METHODS
We sequenced the HNF-1beta gene in 160 unrelated subjects with renal disease, 40% of whom had a personal/family history of diabetes.


RESULTS
Twenty three different heterozygous HNF-1beta mutations were identified in 23/160 subjects (14%), including 10 novel mutations (V61G, V110G, S148L, K156E, Q176X, R276Q, S281fsinsC, R295P, H324fsdelCA, Q470X). Seven (30%) cases were proven to be due to de novo mutations. Renal cysts were found in 19/23 (83%) patients (four with glomerulocystic kidney disease, GCKD) and diabetes in 11/23 (48%, while three other families had a family history of diabetes. Only 26% of families met diagnostic criteria for maturity-onset diabetes of the young (MODY) but 39% had renal cysts and diabetes (RCAD). We found no clear genotype/phenotype relationships.


CONCLUSIONS
We report the largest series to date of HNF-1beta mutations and confirm HNF-1beta mutations as an important cause of renal disease. Despite the original description of HNF-1beta as a MODY gene, a personal/family history of diabetes is often absent and the most common clinical manifestation is renal cysts. Molecular genetic testing for HNF-1beta mutations should be considered in patients with unexplained renal cysts (including GCKD), especially when associated with diabetes, early-onset gout, or uterine abnormalities.
Edghill
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Bingham
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C
Ellard
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Hattersley
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AT
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005091:Exons / Q000235:genetics; D051539:Hepatocyte Nuclear Factor 1-beta / Q000737:chemistry / Q000235:genetics*; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000235:genetics; D009154:Mutation / Q000235:genetics*; D010375:Pedigree; D010641:Phenotype
D051539:Hepatocyte Nuclear Factor 1-beta