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GCGR-related hyperglucagonemia(MVAH)

MedGen UID:
1677024
Concept ID:
C4763635
Disease or Syndrome
Synonyms: ALPHA-CELL HYPERPLASIA WITH GLUCAGONEMIA; Mahvash disease
SNOMED CT: Mahvash disease (1228875006); GCGR-related hyperglucagonemia (1228875006); Glucagon receptor-related hyperglucagonemia (1228875006)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): GCGR (17q25.3)
 
Monarch Initiative: MONDO:0018582
OMIM®: 619290
Orphanet: ORPHA438274

Definition

Mahvash disease (MVAH) is an autosomal recessive disorder caused by inactivating mutations in the glucagon receptor, leading to alpha-cell hyperplasia of the pancreas, hyperglucagonemia without glucagonoma syndrome, and occasional hypoglycemia. The disease may lead to glucagonomas and/or primitive neuroectodermal tumors (PNETs). [from OMIM]

Clinical features

From HPO
Abdominal pain
MedGen UID:
7803
Concept ID:
C0000737
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.
Palpitations
MedGen UID:
14579
Concept ID:
C0030252
Finding
A sensation that the heart is pounding or racing, which is a non-specific sign but may be a manifestation of arrhythmia.
Pancreatic alpha-cell hyperplasia
MedGen UID:
1800812
Concept ID:
C5558401
Finding
A diffuse and specific increase in the number of alpha-cells.
Vertigo
MedGen UID:
53006
Concept ID:
C0042571
Sign or Symptom
An abnormal sensation of spinning while the body is actually stationary.
Recurrent pancreatitis
MedGen UID:
1639431
Concept ID:
C4551632
Disease or Syndrome
A recurrent form of pancreatitis.
Type 2 diabetes mellitus
MedGen UID:
41523
Concept ID:
C0011860
Disease or Syndrome
Type 2 diabetes mellitus is distinct from maturity-onset diabetes of the young (see 606391) in that it is polygenic, characterized by gene-gene and gene-environment interactions with onset in adulthood, usually at age 40 to 60 but occasionally in adolescence if a person is obese. The pedigrees are rarely multigenerational. The penetrance is variable, possibly 10 to 40% (Fajans et al., 2001). Persons with type 2 diabetes usually have an obese body habitus and manifestations of the so-called metabolic syndrome (see 605552), which is characterized by diabetes, insulin resistance, hypertension, and hypertriglyceridemia. Genetic Heterogeneity of Susceptibility to Type 2 Diabetes Susceptibility to T2D1 (601283) is conferred by variation in the calpain-10 gene (CAPN10; 605286) on chromosome 2q37. The T2D2 locus (601407) on chromosome 12q was found in a Finnish population. The T2D3 locus (603694) maps to chromosome 20. The T2D4 locus (608036) maps to chromosome 5q34-q35. Susceptibility to T2D5 (616087) is conferred by variation in the TBC1D4 gene (612465) on chromosome 13q22. A mutation has been observed in hepatocyte nuclear factor-4-alpha (HNF4A; 600281.0004) in a French family with NIDDM of late onset. Mutations in the NEUROD1 gene (601724) on chromosome 2q32 were found to cause type 2 diabetes mellitus in 2 families. Mutation in the GLUT2 glucose transporter was associated with NIDDM in 1 patient (138160.0001). Mutation in the MAPK8IP1 gene, which encodes the islet-brain-1 protein, was found in a family with type 2 diabetes in individuals in 4 successive generations (604641.0001). Polymorphism in the KCNJ11 gene (600937.0014) confers susceptibility. In French white families, Vionnet et al. (2000) found evidence for a susceptibility locus for type 2 diabetes on 3q27-qter. They confirmed the diabetes susceptibility locus on 1q21-q24 reported by Elbein et al. (1999) in whites and by Hanson et al. (1998) in Pima Indians. A mutation in the GPD2 gene (138430.0001) on chromosome 2q24.1, encoding mitochondrial glycerophosphate dehydrogenase, was found in a patient with type 2 diabetes mellitus and in his glucose-intolerant half sister. Mutations in the PAX4 gene (167413) have been identified in patients with type 2 diabetes. Triggs-Raine et al. (2002) stated that in the Oji-Cree, a gly319-to-ser change in HNF1-alpha (142410.0008) behaves as a susceptibility allele for type 2 diabetes. Mutation in the HNF1B gene (189907.0007) was found in 2 Japanese patients with typical late-onset type 2 diabetes. Mutations in the IRS1 gene (147545) have been found in patients with type 2 diabetes. A missense mutation in the AKT2 gene (164731.0001) caused autosomal dominant type 2 diabetes in 1 family. A (single-nucleotide polymorphism) SNP in the 3-prime untranslated region of the resistin gene (605565.0001) was associated with susceptibility to diabetes and to insulin resistance-related hypertension in Chinese subjects. Susceptibility to insulin resistance has been associated with polymorphism in the TCF1 (142410.0011), PPP1R3A (600917.0001), PTPN1 (176885.0001), ENPP1 (173335.0006), IRS1 (147545.0002), and EPHX2 (132811.0001) genes. The K121Q polymorphism of ENPP1 (173335.0006) is associated with susceptibility to type 2 diabetes; a haplotype defined by 3 SNPs of this gene, including K121Q, is associated with obesity, glucose intolerance, and type 2 diabetes. A SNP in the promoter region of the hepatic lipase gene (151670.0004) predicts conversion from impaired glucose tolerance to type 2 diabetes. Variants of transcription factor 7-like-2 (TCF7L2; 602228.0001), located on 10q, have also been found to confer risk of type 2 diabetes. A common sequence variant, rs10811661, on chromosome 9p21 near the CDKN2A (600160) and CDKN2B (600431) genes has been associated with risk of type 2 diabetes. Variation in the PPARG gene (601487) has been associated with risk of type 2 diabetes. A promoter polymorphism in the IL6 gene (147620) is associated with susceptibility to NIDDM. Variation in the KCNJ15 gene (602106) has been associated with T2DM in lean Asians. Variation in the SLC30A8 gene (611145) has been associated with susceptibility to T2D. Variation in the HMGA1 gene (600701.0001) is associated with an increased risk of type 2 diabetes. Mutation in the MTNR1B gene (600804) is associated with susceptibility to type 2 diabetes. Protection Against Type 2 Diabetes Mellitus Protein-truncating variants in the SLC30A8 (611145) have been associated with a reduced risk for T2D.
Increased glucagon level
MedGen UID:
717776
Concept ID:
C1295677
Finding
An elevated concentration of glucagon in the blood circulation.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVGCGR-related hyperglucagonemia

Professional guidelines

PubMed

Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB
Diabetes Care 2015 Sep;38(9):1687-93. Epub 2015 Jun 15 doi: 10.2337/dc15-0843. PMID: 26078479Free PMC Article
Rafacho A, Ortsäter H, Nadal A, Quesada I
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Deane AM, Horowitz M
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Recent clinical studies

Etiology

Maruszczak K, Radzikowski K, Schütz S, Mangge H, Bergsten P, Forslund A, Manell H, Pixner T, Ahlström H, Kullberg J, Mörwald K, Weghuber D
Front Endocrinol (Lausanne) 2022;13:1004128. Epub 2022 Sep 5 doi: 10.3389/fendo.2022.1004128. PMID: 36133310Free PMC Article
Koshy RM, Fernandez CJ, Jacob K
Curr Drug Saf 2021;16(2):129-141. doi: 10.2174/1574886315999201105153852. PMID: 33153424
Perry RJ, Shulman GI
J Biol Chem 2020 Oct 16;295(42):14379-14390. Epub 2020 Aug 12 doi: 10.1074/jbc.REV120.008387. PMID: 32796035Free PMC Article
Valaiyapathi B, Gower B, Ashraf AP
Curr Diabetes Rev 2020;16(3):220-229. doi: 10.2174/1573399814666180608074510. PMID: 29879890Free PMC Article
Ghasemi A, Norouzirad R
Crit Rev Oncog 2019;24(3):213-222. doi: 10.1615/CritRevOncog.2019030976. PMID: 32422019

Diagnosis

Chen W, Cui W, Wu J, Zheng W, Sun X, Zhang J, Shang H, Yuan Y, Li X, Wang J, Hu X, Chen L, Zeng F, Xiao RP, Zhang X
Metabolism 2023 Sep;146:155641. Epub 2023 Jun 26 doi: 10.1016/j.metabol.2023.155641. PMID: 37380017
Valaiyapathi B, Gower B, Ashraf AP
Curr Diabetes Rev 2020;16(3):220-229. doi: 10.2174/1573399814666180608074510. PMID: 29879890Free PMC Article
Ghasemi A, Norouzirad R
Crit Rev Oncog 2019;24(3):213-222. doi: 10.1615/CritRevOncog.2019030976. PMID: 32422019
Wewer Albrechtsen NJ, Pedersen J, Galsgaard KD, Winther-Sørensen M, Suppli MP, Janah L, Gromada J, Vilstrup H, Knop FK, Holst JJ
Endocr Rev 2019 Oct 1;40(5):1353-1366. doi: 10.1210/er.2018-00251. PMID: 30920583
Wewer Albrechtsen NJ, Kuhre RE, Pedersen J, Knop FK, Holst JJ
Biomark Med 2016 Nov;10(11):1141-1151. Epub 2016 Sep 9 doi: 10.2217/bmm-2016-0090. PMID: 27611762

Therapy

Grandt J, Jensen AH, Werge MP, Rashu EB, Møller A, Junker AE, Hobolth L, Mortensen C, Johansen CD, Vyberg M, Serizawa RR, Møller S, Gluud LL, Wewer Albrechtsen NJ
Physiol Rep 2023 Apr;11(8):e15653. doi: 10.14814/phy2.15653. PMID: 37078380Free PMC Article
Caruso I, Marrano N, Biondi G, Genchi VA, D'Oria R, Sorice GP, Perrini S, Cignarelli A, Natalicchio A, Laviola L, Giorgino F
Diabetes Metab Res Rev 2023 Mar;39(3):e3609. Epub 2023 Jan 30 doi: 10.1002/dmrr.3609. PMID: 36637256
Wewer Albrechtsen NJ
Peptides 2018 Feb;100:42-47. doi: 10.1016/j.peptides.2017.11.016. PMID: 29412830
Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB
Diabetes Care 2015 Sep;38(9):1687-93. Epub 2015 Jun 15 doi: 10.2337/dc15-0843. PMID: 26078479Free PMC Article
Raskin P, Unger RH
Med Clin North Am 1978 Jul;62(4):713-22. doi: 10.1016/s0025-7125(16)31767-9. PMID: 355737

Prognosis

Maruszczak K, Radzikowski K, Schütz S, Mangge H, Bergsten P, Forslund A, Manell H, Pixner T, Ahlström H, Kullberg J, Mörwald K, Weghuber D
Front Endocrinol (Lausanne) 2022;13:1004128. Epub 2022 Sep 5 doi: 10.3389/fendo.2022.1004128. PMID: 36133310Free PMC Article
Bellis A, Mauro C, Barbato E, Ceriello A, Cittadini A, Morisco C
Int J Mol Sci 2021 Jan 14;22(2) doi: 10.3390/ijms22020775. PMID: 33466656Free PMC Article
Jorsal T, Wewer Albrechtsen NJ, Christensen MM, Mortensen B, Wandall E, Langholz E, Friis S, Worm D, Ørskov C, Støving RK, Andries A, Juhl CB, Sørensen F, Forman JL, Falkenhahn M, Musholt PB, Theis S, Larsen PJ, Holst JJ, Vrang N, Jelsing J, Vilsbøll T, Knop FK
J Clin Endocrinol Metab 2019 Dec 1;104(12):6403-6416. doi: 10.1210/jc.2019-00062. PMID: 31276156
Chastain MA
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Kopple JD
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Clinical prediction guides

Wewer Albrechtsen NJ, Holst JJ, Cherrington AD, Finan B, Gluud LL, Dean ED, Campbell JE, Bloom SR, Tan TM, Knop FK, Müller TD
Diabetologia 2023 Aug;66(8):1378-1394. Epub 2023 Jun 27 doi: 10.1007/s00125-023-05947-y. PMID: 37367959
Dean ED
Diabetes 2020 Apr;69(4):542-549. Epub 2019 Oct 25 doi: 10.2337/dbi19-0021. PMID: 31653720Free PMC Article
Knop FK
Eur J Endocrinol 2018 Jun;178(6):R267-R280. Epub 2018 Apr 20 doi: 10.1530/EJE-18-0197. PMID: 29678923
Wewer Albrechtsen NJ, Kuhre RE, Pedersen J, Knop FK, Holst JJ
Biomark Med 2016 Nov;10(11):1141-1151. Epub 2016 Sep 9 doi: 10.2217/bmm-2016-0090. PMID: 27611762
Giugliano D, Torella R, D'Onofrio F
Prostaglandins Med 1981 Mar;6(3):283-97. doi: 10.1016/0161-4630(81)90152-x. PMID: 7012876

Recent systematic reviews

Chai S, Zhang R, Zhang Y, Carr RD, Zheng Y, Rajpathak S, Ji L
Front Endocrinol (Lausanne) 2022;13:994944. Epub 2022 Oct 12 doi: 10.3389/fendo.2022.994944. PMID: 36313782Free PMC Article
Valaiyapathi B, Gower B, Ashraf AP
Curr Diabetes Rev 2020;16(3):220-229. doi: 10.2174/1573399814666180608074510. PMID: 29879890Free PMC Article

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