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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2011-5-18
pubmed:abstractText
Digital clubbing is the most prominent feature in primary (PHO) and secondary (pulmonary) hypertrophic osteoarthropathy (HO). Homozygous and compound heterozygous germline mutations in the 15-hydroxyprostaglandin dehydrogenase (HPGD) gene encoding the major prostaglandin PGE2 catabolizing enzyme have been recently described in familial PHO cases. Elevated prostaglandin levels in affected individuals with cytokine-mediated tissue remodelling and vascular stimulation may underlie PHO and associated features as hyperhidrosis, acroosteolysis, pachyderma, periostosis and arthritis. We present clinical and biochemical data of three unrelated PHO families with HPGD mutations. The truncating mutation c.175_176del was found in two of our families and in one of the recently described pedigrees, all of European origin. We present evidence that c.175_176del is a recurrent mutation rather than an ancient founder allele. Two novel heterozygous HPGD mutations, the nonsense mutation c.118G>T (p.Glu40X) and the missense mutation c.563C>T (p.Thr188Ile), could be identified in a third family. We postulate that all HPGD mutations constitute loss-of-function alleles due to protein truncation or missense changes that affect hydrogen bonds lining the 15-PGDH enzyme reaction cavity. Elevated prostaglandin levels may give rise to use of non-steroidal anti-inflammatory drugs; however, therapeutic strategies have not been reported to date. Naproxen treatment in one of our mutation-positive patients resulted in alleviation of pain caused by periostosis and arthritis as well as reduction in substantially elevated prostaglandin levels, while no significant effects on digital clubbing, hyperhidrosis and pachyderma were observed. Further experience with nonsteroidal anti-inflammatory drugs in PHO is awaited.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1600-0625
pubmed:author
pubmed:copyrightInfo
© 2011 John Wiley & Sons A/S.
pubmed:issnType
Electronic
pubmed:volume
20
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
531-3
pubmed:meshHeading
pubmed-meshheading:21426412-Adolescent, pubmed-meshheading:21426412-Aged, pubmed-meshheading:21426412-Amino Acid Sequence, pubmed-meshheading:21426412-Base Sequence, pubmed-meshheading:21426412-Codon, Nonsense, pubmed-meshheading:21426412-DNA Mutational Analysis, pubmed-meshheading:21426412-Female, pubmed-meshheading:21426412-Humans, pubmed-meshheading:21426412-Hydroxyprostaglandin Dehydrogenases, pubmed-meshheading:21426412-Hyperhidrosis, pubmed-meshheading:21426412-Male, pubmed-meshheading:21426412-Molecular Sequence Data, pubmed-meshheading:21426412-Mutation, pubmed-meshheading:21426412-Mutation, Missense, pubmed-meshheading:21426412-Osteoarthropathy, Primary Hypertrophic, pubmed-meshheading:21426412-Osteoarthropathy, Secondary Hypertrophic, pubmed-meshheading:21426412-Pedigree, pubmed-meshheading:21426412-Sequence Deletion, pubmed-meshheading:21426412-Sequence Homology, Amino Acid
pubmed:year
2011
pubmed:articleTitle
Primary hypertrophic osteoarthropathy with digital clubbing and palmoplantar hyperhidrosis caused by 15-PGHD/HPGD loss-of-function mutations.
pubmed:publicationType
Letter, Case Reports