A novel mutation in the glutamate dehydrogenase (GLUD1) of a patient with congenital hyperinsulinism-hyperammonemia (HI/HA)

J Pediatr Endocrinol Metab. 2016 Mar;29(3):385-8. doi: 10.1515/jpem-2015-0276.

Abstract

Hyperinsulinism-hyperammonemia (HI/HA) syndrome, often characterized by recurrent symptomatic hypoglycemia and persistent hyperammonemia, is the second most frequent cause of the congenital hyperinsulinism (CHI). Here, we reported a patient with normal birth weight, repeated seizures, untreatable hypoglycemia, and persistent, mild hyperammonemia. The genetic diagnosis revealed that the patient carried a heterozygous, de novo missense mutation (N410I, c.1401A>T) in the glutamate dehydrogenase 1 gene (GLUD1). The patient was treated with diazoxide, which significantly alleviated the hypoglycemia. CT and MRI brain scanning at different developmental stages revealed large-scale brain damage in the front lobe. Severe neurodevelopment deficits were identified in the follow-up.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Sequence
  • Female
  • Glutamate Dehydrogenase / genetics*
  • Humans
  • Hyperinsulinism / congenital*
  • Hyperinsulinism / genetics*
  • Hypoglycemia / congenital*
  • Hypoglycemia / genetics*
  • Infant, Newborn
  • Mutation / genetics*
  • Prognosis
  • Sequence Homology, Amino Acid

Substances

  • Glutamate Dehydrogenase
  • GLUD1 protein, human

Supplementary concepts

  • Hyperinsulinemic hypoglycemia, familial, 6