Association of autoimmune thyroiditis and celiac disease with Juvenile Polyposis due to 10q23.1q23.31 deletion: Potential role of PI3K/Akt pathway dysregulation

Eur J Med Genet. 2017 Jul;60(7):380-384. doi: 10.1016/j.ejmg.2017.04.010. Epub 2017 Apr 18.

Abstract

Juvenile Polyposis (JP) is a rare hereditary condition characterized by diffuse hamartomatous gastrointestinal polyposis, associated with a significantly increased risk of neoplastic transformation. Most of the cases are caused by SMAD and BMPR1A mutations, while 10q23 microdeletions, encompassing both PTEN and BMPR1A oncogenes, are extremely rare, typically associated with more aggressive JP, and extraintestinal features overlapping with PTEN Hamartoma Tumor Syndrome. We present the first case of a young female with multiple autoimmune disorders (i.e. thyroiditis and celiac disease), associated with JP, cardiac defects and epilepsy, who carries a de novo heterozygous 10q23.1q23.31 deletion. The dysregulation of the PI3K/Akt pathway is advanced as the putative mechanism connecting autoimmune, malformative and neoplastic disorders. A literature review of clinical manifestation, gene alterations and the treatment of patients with 10q23 deletion is also provided, highlighting the importance of comprehensive, long-term, multi-disciplinary management, aimed at early identification and treatment of both intestinal and extraintestinal disorders.

Keywords: Autoimmune thyroiditis; BMPR1A; Celiac disease; Juvenile Polyposis syndrome; PTEN.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Celiac Disease / diagnosis
  • Celiac Disease / genetics*
  • Child
  • Chromosome Deletion*
  • Chromosomes, Human, Pair 10 / genetics*
  • Female
  • Humans
  • Intestinal Polyposis / congenital*
  • Intestinal Polyposis / diagnosis
  • Intestinal Polyposis / genetics
  • Neoplastic Syndromes, Hereditary / diagnosis
  • Neoplastic Syndromes, Hereditary / genetics*
  • Phosphatidylinositol 3-Kinases / genetics
  • Phosphatidylinositol 3-Kinases / metabolism
  • Proto-Oncogene Proteins c-akt / genetics
  • Proto-Oncogene Proteins c-akt / metabolism
  • Signal Transduction
  • Thyroiditis, Autoimmune / diagnosis
  • Thyroiditis, Autoimmune / genetics*

Substances

  • Phosphatidylinositol 3-Kinases
  • Proto-Oncogene Proteins c-akt

Supplementary concepts

  • Juvenile polyposis syndrome