KMID : 0191120120270050565
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Journal of Korean Medical Science 2012 Volume.27 No. 5 p.565 ~ p.568
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Two Novel Insulin Receptor Gene Mutations in a Patient with Rabson-Mendenhall Syndrome: The First Korean Case Confirmed by Biochemical, and Molecular Evidence
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Kim Doo-Soo
Cho Sung-Yoon Yeau Sung-Hee Park Sung-Won Sohn Young-Bae Kwon Min-Jung Kim Ji-Yeon Ki Chang-Seok Jin Dong-Kyu
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Abstract
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Rabson-Mendenhall syndrome (RMS) is a rare syndrome manifested by extreme insulin resistance with hyperinsulinemia, acanthosis nigricans, tooth dysplasia and growth retardation. Our patient was first noted at the age of 8 months due to pigmentations on skin-folded areas. Initial laboratory tests showed normal fasting glucose (69 mg/dL). Fasting insulin level was severely elevated, up to 554.6 ¥ìIU/mL, and c-peptide level was increased, up to 13.81 ng/mL. However, hemoglobin A1c was within normal range (4.8%). He is now 11 yr old. His growth development followed the 5-10th percentile and oral hypoglycemic agents are being administered. The last laboratory results showed insulin 364.1 ¥ìIU/mL, C-peptide 4.30 ng/mL, and hemoglobin A1c 7.6%. The boy was a compound heterozygote for the c.90C > A and c.712G > A mutations of the insulin receptor gene, INSR, which are nonsense and missense mutations. In summary, we report the first Korean case of RMS, which was confirmed by two novel mutations of the INSR.
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KEYWORD
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Rabson-Mendenhall Syndrome, Insulin Resistance, Receptor, Insulin, INSR
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