Hyperinsulinaemic hypoglycaemia diagnosed in childhood can be monogenic
dc.contributor.author | Hopkins, JJ | |
dc.contributor.author | Childs, AJ | |
dc.contributor.author | Houghton, JAL | |
dc.contributor.author | Hewat, TI | |
dc.contributor.author | Atapattu, N | |
dc.contributor.author | Johnson, MB | |
dc.contributor.author | Patel, KA | |
dc.contributor.author | Laver, TW | |
dc.contributor.author | Flanagan, SE | |
dc.date.accessioned | 2022-10-13T14:20:33Z | |
dc.date.issued | 2022-10-14 | |
dc.date.updated | 2022-10-13T13:44:10Z | |
dc.description.abstract | Background Congenital hyperinsulinism (HI) is characterised by inappropriate insulin secretion despite low blood glucose. Persistent HI is often monogenic, with the majority of cases diagnosed in infancy. Less is known about the contribution of monogenic forms of disease in those presenting in childhood. We investigated the likelihood of finding a genetic cause in childhood-onset HI and explored potential factors leading to the later age at presentation of disease. Methods We screened known disease-causing genes in 1848 individuals with HI, referred for genetic testing as part of routine clinical care. Individuals were classified as infancy-onset (when diagnosed with HI <12 months) or childhood-onset (when diagnosed with HI between 1-16 years). We assessed clinical characteristics and the genotypes of individuals with monogenic HI diagnosed in childhood to gain insights into the later age at diagnosis of HI in these children. Results We identified the monogenic cause in 24% (n=42/173) of the childhood-onset HI cohort, this was significantly lower than the proportion of genetic diagnoses in infancy-onset cases (74.5% (n=1248/1675), P<0.00001). 75% of individuals with genetically confirmed childhood-onset HI were diagnosed before 2.7 years suggesting these cases represent the tail-end of the normal distribution in age at diagnosis. This is supported by the finding that 81% of the variants identified in the childhood-onset cohort were detected in those diagnosed in infancy. Conclusion We have shown that monogenic HI is an important cause of hyperinsulinism presenting outside of infancy. Genetic testing should be considered in children with persistent hyperinsulinism, regardless of age at diagnosis. | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | Research England | en_GB |
dc.identifier.citation | Vol. 108 (3), pp. 680 - 687 | en_GB |
dc.identifier.doi | 10.1210/clinem/dgac604 | |
dc.identifier.grantnumber | 223187/Z/21/Z | en_GB |
dc.identifier.grantnumber | 219606/Z/19/Z | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/131256 | |
dc.identifier | ORCID: 0000-0002-5094-9148 (Hopkins, Jasmin) | |
dc.language.iso | en | en_GB |
dc.publisher | Endocrine Society / Oxford University Press | en_GB |
dc.rights | © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. | en_GB |
dc.subject | hyperinsulinism | en_GB |
dc.subject | hypoglycaemia | en_GB |
dc.subject | genetic testing | en_GB |
dc.subject | monogenic disease | en_GB |
dc.subject | childhood | en_GB |
dc.title | Hyperinsulinaemic hypoglycaemia diagnosed in childhood can be monogenic | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2022-10-13T14:20:33Z | |
dc.description | This is the final version. Available on open access from Oxford University Press via the DOI in this record | en_GB |
dc.description | Data Availability Statement: Restrictions apply to the availability of some or all data generated or analyzed during this study to preserve patient confidentiality or because they were used under license. The corresponding author will on request detail the restrictions and any conditions under which access to some data may be provided. | en_GB |
dc.identifier.eissn | 1945-7197 | |
dc.identifier.journal | The Journal of Clinical Endocrinology & Metabolism | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2022-10-12 | |
dcterms.dateSubmitted | 2022-09-06 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2022-10-12 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2022-10-13T13:44:12Z | |
refterms.versionFCD | AM | |
refterms.dateFOA | 2022-11-01T11:41:09Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.