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Comparative meta-analysis of Kabuki syndrome with and without hyperinsulinemic hypoglycemia

Hoermann, Henrike (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
El-Rifai, Omar (author)
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. 3 Institute of Clinical Research, University of Southern Denmark Odense, Odense, Denmark
Schebek, Martin (author)
Department of Pediatric Diabetes, Children's Hospital Kassel, Kassel, Germany
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Lodefalk, Maria, 1968- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Pediatrics
Brusgaard, Klaus (author)
Institute of Clinical Research, University of Southern Denmark Odense, Odense, Denmark; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
Bachmann, Nadine (author)
Center for Human Genetics, Bioscientia, Ingelheim, Germany; Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany
Bergmann, Carsten (author)
Center for Human Genetics, Bioscientia, Ingelheim, Germany; Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany
Roeper, Marcia (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
Welters, Alena (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
Salimi Dafsari, Roschan (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
Blankenstein, Oliver (author)
Centre for Chronic Sick Children and Institute for Experimental Pediatric Endocrinology, Charité-Universitätsmedizin Berlin, Berlin, Germany
Mayatepek, Ertan (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
Christesen, Henrik (author)
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark Odense, Odense, Denmark; Odense Pancreas Centre OPAC, Odense University Hospital, Odense, Denmark
Meissner, Thomas (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
Kummer, Sebastian (author)
Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany
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Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Düsseldorf, Germany Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark 3 Institute of Clinical Research, University of Southern Denmark Odense, Odense, Denmark (creator_code:org_t)
2020-07-15
2020
English.
In: Clinical Endocrinology. - : John Wiley & Sons. - 0300-0664 .- 1365-2265. ; 93:3, s. 346-354
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • BACKGROUND AND OBJECTIVE: Kabuki syndrome (KS), caused by pathogenic variants in KMT2D or KDM6A, is associated with hyperinsulinemic hypoglycemia (HH) in 0.3-4% of patients. We characterized the clinical, biochemical and molecular data of children with KS and HH compared to children with KS without HH in a multicenter meta-analysis.METHODS: Data of seven new and 17 already published children with KS and HH were compared to 373 recently published KS patients without HH regarding molecular and clinical characteristics.RESULTS: Seven new patients were identified with seven different pathogenic variants in KDM6A (n=4) or KMT2D (n=3). All presented with HH on the first day of life and were responsive to diazoxide. KS was diagnosed between 9 months and 14 years of age. In the meta-analysis 24 KS patients with HH had a significantly higher frequency of variants in KDM6A compared to 373 KS patients without HH (50% vs. 11.5%, p<0.001), and KDM6A-KS was more likely to be associated with HH than KMT2D-KS (21.8% vs. 3.5%, p<0.001). Sex distribution and other phenotypic features did not differ between KS with and without HH.CONCLUSION: The higher incidence of HH in KDM6A-KS compared to KMT2D-KS indicates that KDM6A loss of function variants predispose more specifically to beta cell dysfunction compared to KMT2D variants. As difficulties to assign syndromic characteristics to KS in early infancy often lead to delayed diagnosis, genetic testing for KS should be considered in children with HH, especially in the presence of other extrapancreatic/syndromic features.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Keyword

KDM6A
KMT2D
Diazoxide
Kabuki syndrome
hyperinsulinism
hypoglycemia
medical genetics

Publication and Content Type

ref (subject category)
art (subject category)

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