Toshiyuki Yamamoto
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Case report
Language English
Peer review Peer reviewed
Title A Novel PHEX Mutation in Japanese Patients with X-Linked Hypophosphatemic Rickets.
Journal Formal name:Case reports in genetics
Abbreviation:Case Rep Genet
ISSN code:(2090-6544)2090-6552(Linking)
Domestic / ForeginForegin
Volume, Issue, Page 2015,pp.301264
Author and coauthor Kawahara T, Watanabe H, Omae R, Yamamoto T, Inazu T
Publication date 2015
Summary X-linked hypophosphatemic rickets (XLH) is a dominant inherited disorder characterized by renal phosphate wasting, aberrant vitamin D metabolism, and abnormal bone mineralization. Inactivating mutations in the gene encoding phosphate-regulating gene with homologies to endopeptidases on the X chromosome (PHEX) have been found to be associated with XLH. Here, we report a 16-year-old female patient affected by hypophosphatemic rickets. We evaluated her serum fibroblast growth factor 23 (FGF23) levels and conducted sequence analysis of the disease-associated genes of FGF23-related hypophosphatemic rickets: PHEX, FGF23, dentin matrix protein 1, and ectonucleotide pyrophosphatase/phosphodiesterase 1. She was diagnosed with XLH based on her clinical features and family history. Additionally, we observed elevated FGF23 levels and a novel PHEX exon 9 mutation (c.947G>T; p.Gly316Val) inherited from her father. Although bioinformatics showed that the mutation was neutral, Gly316 is perfectly conserved among humans, mice, and rats, and there were no mutations in other FGF23-related rickets genes, suggesting that in silico analysis is limited in determining mutation pathogenicity. In summary, we present a female patient and her father with XLH harboring a novel PHEX mutation that appears to be causative of disease. Measurement of FGF23 for hypophosphatemic patients is therefore useful for the diagnosis of FGF23-dependent hypophosphatemia.
DOI 10.1155/2015/301264
PMID 25861491