Pendred Syndrome in Two Galician Families: Insights into Clinical Phenotypes Through Cellular, Genetic, and Molecular Studies

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2007 Oct 18

PMID 17940114

Citations 11

Authors

Fernando Palos

Maria E R Garcia-Rendueles

David Araujo-Vilar

Maria Jesus Obregon

Rosa Maria Calvo

Jose Cameselle-Teijeiro

Susana B Bravo

Oscar Perez-Guerra

Lourdes Loidi

Barbara Czarnocka

Paula Alvarez

Samuel Refetoff

Lourdes Dominguez-Gerpe

Clara V Alvarez

Joaquin Lado-Abeal

Affiliations

Soon will be listed here.

Abstract

Context: We studied two families from Galicia (northwest Spain) with Pendred syndrome (PS) and unusual thyroid phenotypes. In family A, the proposita had a large goiter and hypothyroxinemia but normal TSH and free T3 (FT3). In family B, some affected members showed deafness but not goiter.

Objective: Our objective was to identify the mutations causing PS and molecular mechanisms underlying the thyroid phenotypes.

Interventions: Interventions included extraction of DNA and of thyroid tissue.

Patients: Propositi and 10 members of the two families participated in the study.

Main Outcome Measures: Main outcome measures included SLC26A4 gene analysis, deiodinase activities in thyroid tissue, and c.416-1G-->A effects on SLC26A4 splicing. In addition, a primary PS thyrocyte culture, T-PS2, was obtained from propositus B and compared with another culture of normal human thyrocytes, NT, by Western blotting, confocal microscopy, and iodine uptake kinetics.

Results: Proposita A was heterozygous for c.578C-->T and c.279delT, presented with goiter, and had normal TSH and FT3 but low FT4 attributable to high type 1 and type 2 iodothyronine deiodinase activities in the goiter. Propositus B bore c.279delT and a novel mutation c.416-1G-->A; some deaf relatives were homozygous for c.416-1G-->A but did not present goiter. The c.279delT mutation was associated with identical haplotype in the two families. T-PS2 showed truncated pendrin retained intracellularly and high iodine uptake with low efflux leading to iodine retention.

Conclusions: c.279delT is a founder mutation in Galicia. Proposita A adapted to poor organification by increasing deiodinase activities in the goiter, avoiding hypothyroidism. Lack of goiter in subjects homozygous for c.416-1G-->A was due to incomplete penetrance allowing synthesis of some wild-type pendrin. Intracellular iodine retention, as seen in T-PS2, could play a role in thyroid alterations in PS.

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