Sulfonylurea improves CNS function in a case of intermediate DEND syndrome caused by a mutation in KCNJ11

Wojciech Mlynarski, Andrei I. Tarasov, Agnieszka Gach, Christophe A. Girard, Iwona Pietrzak, Lejla Zubcevic, Jacek Kusmierek, Tomasz Klupa, Maciej T. Malecki, Frances M. Ashcroft

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Background: A 12-week-old female presented with neonatal diabetes. Insulin therapy alleviated the diabetes, but the patient showed marked motor and mental developmental delay. The patient underwent genetic evaluation at the age of 6 years, prompted by reports that mutations in the KCNJ11 gene caused neonatal diabetes. Investigations: Genomic sequencing of the ATP-sensitive potassium (KATP) channel gene KCNJ11 and in vitro functional analysis of the channel defect, and single-photon emission CT imaging before and after glibenclamide therapy. Diagnosis: Genetic evaluation revealed a missense mutation (His46Leu) in KCNJ11, which encodes the Kir6.2 subunit of the KATP channel, conferring reduced ATP sensitivity. Functional studies demonstrated that the mutant channels were strongly inhibited by the sulfonylurea tolbutamide. Management: Sulfonylurea (glibenclamide) treatment led to both improved glucose homeostasis and an increase in mental and motor function.

Original languageEnglish
Pages (from-to)640-645
Number of pages6
JournalNature Clinical Practice Neurology
Volume3
Issue number11
DOIs
Publication statusPublished - 1 Nov 2007

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