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Uniparental disomy leads to a novel cause of MC2R-related familial glucocorticoid deficiency type 1.
Eur. J. Endocrinol. 193, K5-K10 (2025)
Familial Glucocorticoid Deficiency Type 1 (FGD1) is a rare autosomal recessive disease caused by pathogenic variants in the MC2R gene. This case report presents the first documented instance of FGD1 caused by a homozygous 1.421 kb deletion affecting the non-coding promoter region of MC2R. The patient, a 9-year-old girl, presented with severe cortisol insufficiency and hyperpigmentation starting at birth. Genetic testing initially missed the deletion, as standard whole-exome sequencing in 2016 did not include a copy number variation analysis. However, a whole-genome sequencing analysis in 2024 identified the deletion. The variant was inherited through paternal uniparental disomy (UPD), a rare genetic mechanism that caused the homozygous state. This case underscores the value of utilizing current genetic testing approaches, especially in cases where clinical features strongly suggest a genetic etiology despite inconclusive initial genetic testing results. Additionally, it highlights the need to consider non-coding regions and UPD in genetic diagnostics.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Mc2r ; Fgd1 ; Glucocorticoid Deficiency ; Upd 18 ; Non-coding; Acth Receptor; Mutations; Promoter
Language
english
Publication Year
2025
HGF-reported in Year
2025
ISSN (print) / ISBN
0804-4643
e-ISSN
1479-683X
Quellenangaben
Volume: 193,
Issue: 2,
Pages: K5-K10
Publisher
BioScientifica
Publishing Place
Great Clarendon St, Oxford Ox2 6dp, England
Reviewing status
Peer reviewed
Institute(s)
Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
POF-Topic(s)
30201 - Metabolic Health
Research field(s)
Helmholtz Diabetes Center
PSP Element(s)
G-506503-001
Grants
AI-assisted technologies in the writing process
German Research Foundation
German Research Foundation
WOS ID
001548892900001
Scopus ID
105013250987
PubMed ID
40729435
Erfassungsdatum
2025-08-01