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Late-onset familial neurohypophyseal diabetes insipidus due to a novel mutation in the AVP gene
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Endocrine and Diabetes Center, Karlstad Hospital, Karlstad, Sweden.ORCID iD: 0000-0003-1025-1682
Department of Biomedicine, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark .
Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
Research Unit for Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.
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2012 (English)In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 77, no 4, p. 586-592Article in journal (Refereed) Published
Abstract [en]

Objective: Familial neurohypophyseal diabetes insipidus (FNDI) is mainly an autosomal dominant inherited disorder presenting with severe polydipsia and polyuria in early childhood. In this study, we aimed to determine the molecular genetics and clinical characteristics of a large Swedish-Norwegian family presenting with very late-onset autosomal dominant FNDI.

Patients: Six probands with a history of developing polyuria and polydipsia during adolescence were studied.

Measurements: Information on family demography was collected by personal interview with family members. The genetic cause of FNDI was identified by DNA sequencing analysis of the coding regions of the AVP gene. The clinical characteristics were determined by the measurement of basal urine production and osmolality as well as by measurements of concurrent levels of plasma AVP, plasma osmolality, and urine osmolality during fluid deprivation and bolus injection of DDAVP. The integrity of the neurohypophysis was evaluated by magnetic resonance imaging.

Results: The mean age of encountering the first clinical symptoms in the family was 14·8 years (range 3-30 years) (n = 17). All six affected subjects investigated were heterozygous for a novel mutation in the AVP gene (g.1848C>T) predicting a p.Pro84Leu substitution in the AVP precursor protein. We found partial deficiency in evoked AVP secretion during fluid deprivation in one subject and complete deficiency in another. The pituitary bright spot was absent in all six affected subjects studied.

Conclusion: A novel mutation in the AVP gene predicted to cause a neurophysin II dimerization defect is causing surprisingly late onset of FNDI in a large, six generation, Swedish-Norwegian family. The mutation is associated with both complete and partial deficiency in evoked AVP secretion during fluid deprivation in patients who have suffered from FNDI for decades.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2012. Vol. 77, no 4, p. 586-592
National Category
Medical and Health Sciences Endocrinology and Diabetes
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27352DOI: 10.1111/j.1365-2265.2012.04417.xISI: 000308635600015PubMedID: 22524462Scopus ID: 2-s2.0-84867299722OAI: oai:DiVA.org:oru-27352DiVA, id: diva2:603497
Available from: 2013-02-06 Created: 2013-02-06 Last updated: 2017-12-06Bibliographically approved

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