title: HNF1A mutation presenting with fetal macrosomia and hypoglycemia in childhood prior to onset of overt diabetes.
abstract: BACKGROUND
  HNF1A-MODY (MODY3) is a common subtype of autosomal dominant diabetes. Unlike HNF4-MODY where fetal macrosomia and early postnatal hyperinsulinemic hypoglycemia have been reported, history of transient insulin overproduction has not yet been recognized in individuals with HNF1A-MODY.
  
  
  METHODS
  Here, we report on a 40-year-old male patient with HNF1A mutation p.Arg272His (c.815G>A) having a history of fetal macrosomia (4750 g, 59 cm), and, at least, one attack of symptomatic hypoglycemia in childhood. Diabetes was subsequently diagnosed at 19 years of age. The proband's daughter who developed diabetes at 16 years carries the same mutation, but her birth weight and length were in the upper normal range, and she never experienced hypoglycemic symptoms.
  
  
  CONCLUSIONS
  The observation of fetal macrosomia and hypoglycemia in childhood is indicative of a biphasic impact of the HNF1A mutation on p-cell function over the lifespan, leading from inappropriate insulin oversecretion to final clinical diabetes.
authors.affiliation: Department of Pediatrics, University Hospital Motol and Second Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Dusatkova
authors.forename: Stepanka
authors.initials: S
authors.lastname: Pruhova
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Sumnik
authors.forename: Stanislava
authors.initials: S
authors.lastname: Kolouskova
authors.forename: Barbora
authors.initials: B
authors.lastname: Obermannova
authors.forename: Ondrej
authors.initials: O
authors.lastname: Cinek
authors.forename: Jan
authors.initials: J
authors.lastname: Lebl
mesh_terms: D000328:Adult; D004252:DNA Mutational Analysis; D005192:Family Health; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000235:genetics*; D051538:Hepatocyte Nuclear Factor 1-alpha / Q000235:genetics*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000235:genetics*; D008297:Male; D009154:Mutation; D010375:Pedigree; D011236:Prediabetic State / Q000175:diagnosis / Q000235:genetics*
chemical_list: C496487:HNF1A protein, human; D051538:Hepatocyte Nuclear Factor 1-alpha