A Unique Genotype of Pseudohypoaldosteronism Type 1b in a Highly Consanguineous Population

• Published in: Journal of the Endocrine Society Vol. 5; no. 8; p. bvab095
• Main Authors: Alzahrani, Ali S, Alswailem, Meshael, Abbas, Bassam Bin, Qasem, Ebtesam, Alsagheir, Afaf, Al Shidhani, Azza, Al Sinani, Aisha, Al Badi, Maryam, Al-Maqbali, Ali, Al Shawi, Manal, Albunyan, Abdulhameed, Bin Nafisah, Abdulghani, Shi, Yufei
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-08-2021
• Subjects: Aldosterone; Clinical s; Corticosteroids; Genes; Genetic aspects; Medical research; Medicine, Experimental; Molecular genetics; Nausea; Saudi Arabia; Oman; pseudohypoaldosteronism; PHA; ENaC; sodium epithelial channel; SCNN1G; SCNN1B; SCNN1A
• ISSN: 2472-1972; 2472-1972
• DOI: 10.1210/jendso/bvab095

Abstract
Context
Pseudohypoaldosteronism (PHA) is a condition in which serum aldosterone level is normal or elevated but its action is deficient.
Objective
This study describes the molecular genetics of PHA 1b in the highly consanguineous population of 2 Arabian Gulf countries, Saudi Arabia and Oman.
Methods
This study enrolled 22 patients from 13 unrelated families (2 families with 5 patients from Oman and 11 families with 17 patients from Saudi Arabia). All of these patients had presented within the first 10 days of life with nausea and vomiting, hyponatremia, hyperkalemia, and hypotension. We isolated DNA from peripheral blood and PCR-sequenced all exons and exon-intron boundaries of SCNN1A and, if negative, SCNN1B and SCNN1G using the Dideoxy Chain termination method.
Results
We found a total of 8 mutations in 13 families as follows: 6 mutations in SCNN1A, 1 in SCNN1B, and 1 in SCNN1G. All of these mutations were novel except one. SCNN1A mutations were: c.1496A>G, p.Q499R (novel) in 1 patient; c.1453C>T, p.Q485X (novel) in 1 patient; c.1322_1322delA, p.N441Tfs*41 (novel) in 2 patients of 1 family; c.876 + 2 delGAGT (novel) in 3 patients of 1 family; c.203_204 delTC, p.I68Tfs*76 (a known mutation) in 8 patients of 5 families; and whole SCNN1A gene deletion (novel) in 2 patients of 2 families. In addition, a nonsense SCNN1B mutation c.1694C>A, p.S565X (novel) was found in 3 siblings from 1 Omani family, and an SCNN1G deletion mutation c.527_528 delCA, p.T176Rfs*9 (novel) in 2 siblings from another Omani family.
Conclusion
We characterized a unique genotype of PHA 1b with several novel gene structure–disrupting mutations in SCNN1A, SCNN1B, and SCNN1G in a highly consanguineous population.