A New Case of Congenital Malabsorptive Diarrhea and Diabetes Secondary to Mutant Neurogenin-3

Pediatrics. 2017 Aug;140(2):e20162210. doi: 10.1542/peds.2016-2210.

Abstract

Congenital diarrheal disorders are a group of rare enteropathies that often present with life-threatening diarrhea in the first weeks of life. Enteric anendocrinosis, characterized by a lack of intestinal enteroendocrine cells due to recessively inherited mutations in the Neurogenin-3 (NEUROG3) gene, has been described as a cause of congenital malabsorptive diarrhea. Diabetes mellitus also is typically associated with NEUROG3 mutations, be it early onset or a later presentation. Here we report a case of a 16-year-old male patient with severe malabsorptive diarrhea from birth, who was parenteral nutrition dependent and who developed diabetes mellitus at 11 years old. To the best of our knowledge, only 9 cases of recessively inherited NEUROG3 mutations have been reported in the literature to date. Our patient presents with several remarkable differences compared with previously published cases. This report can contribute by deepening our knowledge on new aspects of such an extremely rare disease.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Basic Helix-Loop-Helix Transcription Factors / genetics*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / genetics*
  • Diarrhea, Infantile / congenital*
  • Diarrhea, Infantile / genetics*
  • Diarrhea, Infantile / pathology
  • Diarrhea, Infantile / therapy
  • Genes, Recessive
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Infant, Newborn
  • Insulin / therapeutic use
  • Malabsorption Syndromes / congenital*
  • Malabsorption Syndromes / genetics*
  • Malabsorption Syndromes / pathology
  • Male
  • Mutation*
  • Nerve Tissue Proteins / genetics*
  • Parenteral Nutrition, Home

Substances

  • Basic Helix-Loop-Helix Transcription Factors
  • Hypoglycemic Agents
  • Insulin
  • NEUROG3 protein, human
  • Nerve Tissue Proteins