Diagnosis, treatment and genetic analysis of a case of hypoglycemia caused by glucokinase gene mutation.

Congenital hyperinsulinemia (CHI) is a disease phenotype characterized by persistent or recurrent hypoglycemia due to abnormal secretion of insulin by ß cells of the pancreas. CHI induced by activation mutation of a single allele of glucokinase (GCK) is the rarest type. In this paper, the clinical data of a patient with hypoglycemia of unknown cause were collected without obvious clinical symptoms. And a heterozygous missense mutation (c.295T> C:p.W99R) was detected in exon 3 of the GCK gene. The mutation was found in both the son and daughter of the proband, and the blood glucose level was low, while the others were normal. By summarizing and analyzing the characteristics of this case and the genetic pedigree of the family, the possibility of congenital hyperinsulinemia caused by a single gene mutation should be considered for hypoglycemia whose etiology is difficult to be determined clinically. This case also provides new clinical data for subsequent genetic studies of the disease.

Morphological and functional deterioration of the rat thyroid following chronic exposure to low-dose PCB118.

Polychlorinated biphenyls (PCBs) are persistent environmental pollutants that can severely disrupt the synthesis and secretion of endocrine hormones. To investigate the effects of 2,3',4,4',5-pentachlorobiphenyl (PCB118) on thyroid structure and function, 40 male Wistar rats were divided into 4 equal treatment groups and administered vehicle or one of three doses of PCB118. The experimental groups received intraperitoneal (i.p.) injection of 10, 100, or 1000µg/kg/day PCB118, 5 days per week for 13 weeks, whereas the control group was injected with corn oil (vehicle). Serum concentrations of free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) were measured by radioimmunoassays. Histopathological and ultrastructural changes in the thyroid were observed under light microscopy and transmission electron microscopy (TEM). The mRNA expression levels of the sodium-iodide symporter (NIS) and thyroglobulin (TG) were quantified by real-time PCR. Increasing doses of PCB118 resulted in progressively lower FT3, FT4 and TSH concentrations in serum. Injection of PCB118 at all doses led to histopathological deterioration of the thyroid characterized by follicular hyperplasia and expansion, shedding of epithelial cells and fibrinoid necrosis. Follicle cells exhibited swollen or vacuolated endoplasmic reticula, as revealed by TEM. Exposure to PCB118 also caused significant decreases in NIS and TG mRNA expression levels. Chronic exposure to low-dose PCB118 and other PCB congeners may be a significant risk factor for thyroid diseases.