Phenotypic Heterogeneity in Five Japanese Patients with an Identical Point Mutation in the Vitamin D Receptor Gene

    January 1992 in “ Clinical Pediatric Endocrinology
    Takahiko Saijo, Eiji Takeda, Michinori Ito, Etsuo Naito, Ichiro Yokota, Junko Matsuda, Yasuhiro Kuroka
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    Studysummary This study observed wide clinical diversity among five patients with the same VDR gene mutation causing vitamin D-dependent rickets type II, suggesting involvement of a nuclear accessory factor and a nongenomic action of the vitamin.
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    The study examined 5 Japanese patients with vitamin D-dependent rickets type II (VDDR II) who shared an identical point mutation in the vitamin D receptor (VDR) gene. Despite having the same genetic mutation, the patients exhibited significant phenotypic heterogeneity, particularly in the severity of alopecia, rickets, and vitamin D resistance. The study found that the clinical severity correlated with the rate of nuclear uptake of [3H] 1, 25-dihydroxyvitamin D3 in skin fibroblasts and serum alkaline phosphatase activity. The researchers concluded that the variability in clinical manifestations might be due to a nuclear accessory factor and a nongenomic action of 1, 25-dihydroxyvitamin D.
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