Clinical and genetic characterization of congenital lipoid adrenal hyperplasia

Clin Dysmorphol. 2020 Oct;29(4):173-176. doi: 10.1097/MCD.0000000000000340.

Abstract

Disorders of steroid synthesis are a group of anomalies caused by defects in any step of conversion of cholesterol into steroid hormones. The disorders are characterized by defects leading to abnormalities of salt-water balance and/or sexual differentiation. Congenital lipoid adrenal hyperplasia (CLAH) is the most severe form of steroid synthesis disorder caused by the accumulation of cholesterol in the outer mitochondrial membrane due to steroidogenic acute regulatory protein (StAR) deficiency. Pathogenic sequence variants in the gene STAR encoding StAR protein leads to CLAH. In the present study, a Pakistani family was clinically diagnosed with the LAH phenotype. Sanger sequencing of STAR in the family revealed a novel homozygous nonsense mutation [c.295G>T, p.(Glu99*)] in the living affected individual. The study was designed to assist in carrier testing and prenatal diagnosis within the affected family. In addition, searching for common variants in the STAR gene would help in designing low-cost targeted variation testing in other patients.

MeSH terms

  • Adrenal Hyperplasia, Congenital / diagnosis*
  • Adrenal Hyperplasia, Congenital / genetics*
  • Biomarkers
  • Chromosome Banding
  • Consanguinity
  • Disorder of Sex Development, 46,XY / diagnosis*
  • Disorder of Sex Development, 46,XY / genetics*
  • Female
  • Genetic Association Studies* / methods
  • Genetic Predisposition to Disease*
  • Homozygote
  • Humans
  • Inheritance Patterns
  • Karyotype
  • Membrane Transport Proteins / genetics
  • Mutation
  • Pedigree
  • Phenotype*

Substances

  • Biomarkers
  • Membrane Transport Proteins

Supplementary concepts

  • Lipoid congenital adrenal hyperplasia