Neonatal diabetes mellitus because of pancreatic agenesis with dysmorphic features and recurrent bacterial infections.
Pancreatic agenesis is a rare cause of neonatal diabetes mellitus (NDM). It can be associated with malformations of the heart, the biliary tract, and the cerebellum. We report an infant with NDM because of pancreatic agenesis, intra-uterine growth retardation, dysmorphic features, and recurrent bacterial infections. He was born to healthy consanguineous parents. With adequate replacement of insulin and pancreatic enzymes, his blood glucose levels were controlled and his weight slowly increased. However, he continued to develop recurrent serious bacterial infections and died at the age of 11 months with sepsis and respiratory failure. Analysis of the PTF1A and PDX1 genes, which have been associated with congenital agenesis of the pancreas, did not reveal any mutation. Genetic abnormalities of chromosome 6 associated with transient neonatal diabetes as well as mutations in the KCNJ11 and ABCC8 genes encoding the pancreatic potassium channel were also excluded as a cause of the NDM in this patient. The association of permanent neonatal diabetes because of pancreatic agenesis, dysmorphism, and non-specific immunodeficiency is previously undescribed and may represent a new possibly autosomal recessive syndrome.
Taha
Doris
D
Division of Pediatric Endocrinology, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia. dtaha@kfshrc.edu.sa
Bardise
Jawaher
J
Hegab
Alaa
A
Bonnefond
Amélie
A
Marchand
Marion
M
Drunat
Severine
S
Vaxillaire
Martine
M
Polak
Michel
M
D000015:Abnormalities, Multiple; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001034:Apgar Score; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000188:drug therapy; D005145:Face / Q000002:abnormalities*; D005317:Fetal Growth Retardation; D005532:Foot Deformities, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010179:Pancreas / Q000002:abnormalities*; D012008:Recurrence; D012529:Saudi Arabia
D000900:Anti-Bacterial Agents