Familial hyperaldosteronism type III a novel case and review of literature.

Autores de IIS La Fe

• Francisca Moreno Macián

  Autor

• Sara León Cariñena

  Autor

• Maria Carmen De Mingo Alemany

  Autor

• Ángel Zúñiga Cabrera

  Autor

Participantes ajenos a IIS La Fe

• Pons Fernández N
• Morata J
• Moriano A
• Calvo F

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

• Investigación Traslacional en Genética

  

  Leader

  Francisco Martínez Castellano

Abstract

Less than 15% of hypertension cases in children are secondary to a primary hyperaldosteronism. This is idiopathic in 60% of the cases, secondary to a unilateral adenoma in 30% and 10% remaining by primary adrenal hyperplasia, familial hyperaldosteronism, ectopic aldosterone production or adrenocortical carcinoma.To date, four types of familial hyperaldosteronism (FH I to FH IV) have been reported. FH III is caused by germline mutations in KCNJ5, encoding the potassium channel Kir3.4. The mutations cause the channel to lose its selectivity for potassium, allowing large quantities of sodium to enter the cell. As a consequence, the membrane depolarizes, voltage-gated calcium channels open, calcium enters the cell, initiating the cascade that leads to aldosterone synthesis. Somatic mutations in KCNJ5 has also been described in aldosterone-producing adenomas. The most frequent presentation of FH III is with severe hyperaldosteronism symptoms and resistance to pharmacological therapy which leads to bilateral adrenalectomy. We will review current literature and describe a child with FH III due to a novel de novo deletion in KCNJ5 with wild phenotype as a sign of clinical variability of this disease.

Keywords

• Hypertension, KCNJ5, Kir3.4, Mineralocorticoid receptor, Primary hyperaldosteronism