Novel GLIS3 mutations demonstrate an extended multisystem phenotype

Dimitri, P., Warner, J. T., Minton, J. A. L, Patch, A. M., Ellard, S., Hattersley, A. T., Barr, S., Hawkes, D., Wales, J. K. and Gregory, J. W. (2011) Novel GLIS3 mutations demonstrate an extended multisystem phenotype. European Journal of Endocrinology, 164 3: 437-443. doi:10.1530/EJE-10-0893

Author Dimitri, P.
Warner, J. T.
Minton, J. A. L
Patch, A. M.
Ellard, S.
Hattersley, A. T.
Barr, S.
Hawkes, D.
Wales, J. K.
Gregory, J. W.
Title Novel GLIS3 mutations demonstrate an extended multisystem phenotype
Journal name European Journal of Endocrinology   Check publisher's open access policy
ISSN 0804-4643
Publication date 2011-03
Year available 2010
Sub-type Article (original research)
DOI 10.1530/EJE-10-0893
Volume 164
Issue 3
Start page 437
End page 443
Total pages 7
Place of publication Woodlands, Bristol, U.K.
Publisher Wiley - VCH Verlag
Collection year 2012
Language eng
Formatted abstract
Introduction: Mutations in the GLI-similar 3 (GLIS3) gene encoding the transcription factor GLIS3 are a rare cause of neonatal diabetes and congenital hypothyroidism with six affected cases from three families reported to date. Additional features, described previously, include congenital glaucoma, hepatic fibrosis, polycystic kidneys, developmental delay and facial dysmorphism.

We report two new cases from unrelated families with distinct novel homozygous partial GLIS3 deletions. Both patients presented with neonatal diabetes mellitus, severe resistant hypothyroidism in the presence of elevated thyroglobulin and normal thyroid anatomy, degenerative liver disease, cystic renal dysplasia, recurrent infections and facial dysmorphism. These novel mutations have also resulted in osteopenia, bilateral sensorineural deafness and pancreatic exocrine insufficiency, features that have not previously been associated with GLIS3 mutations. Gene dosage analysis showed that the parents were carriers of a deletion encompassing exons 1–2 (case 1) or exons 1–4 (case 2) of the 11 exon gene. Genome-wide SNP analysis did not reveal a common ancestral GLIS3 haplotype in patient 2.

Conclusions: Our results confirm partial gene deletions as the most common type of GLIS3 mutations, accounting for four of five families identified to date. We propose that mutations in GLIS3 lead to a wider clinical phenotype than previously recognised. We also report the first case of a recessive GLIS3 mutation causing neonatal diabetes and congenital hypothyroidism in a child from a nonconsanguineous pedigree, highlighting the importance of molecular genetic testing in any patient with this phenotype.
Keyword Neonatal Diabetes Mellitus
Congenital Hypothyroidism
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
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