Pseudohypoparathyroidism type Ia: a novel GNAS mutation in a Brazilian boy presenting with an early primary hypothyroidism

J Pediatr Endocrinol Metab. 2013;26(5-6):557-60. doi: 10.1515/jpem-2012-0301.

Abstract

Pseudohypoparathyroidism type Ia (PHP Ia) is a rare disease characterized by an elevated parathyroid hormone due to the resistance to its action in target tissues. We report a new GNAS mutation causing PHP Ia and an atypical early-onset primary hypothyroidism. A 3-year-old boy was diagnosed with obesity, delayed pyschomotor development, and round face. The laboratory evaluation at the age of 1 year showed primary hypothyroidism, hypocalcemia, hyperphosphatemia, elevated alkaline phosphatase, and parathyroid hormone. These data led to the diagnosis of PHP Ia. Molecular analysis revealed a novel missense mutation in GNAS exon 1 (TCG→CGC, Cys3→Arg) in both the child and his mother. Although previously reported cases described delayed subclinical hypothyroidism as the more common thyroid abnormality, we report a not previously described GNAS mutation associated with an atypical early-onset primary hypothyroidism. These observations broaden the clinical spectrum of PHP Ia and its associated mutations.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Brazil
  • Child, Preschool
  • Chromogranins
  • Family Health
  • Female
  • GTP-Binding Protein alpha Subunits, Gs / genetics*
  • Humans
  • Hypocalcemia / genetics*
  • Hypothyroidism / genetics*
  • Male
  • Mutation, Missense
  • Pseudohypoparathyroidism / genetics*

Substances

  • Chromogranins
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs