25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations
Vitamin D deficiency remains a major cause of rickets worldwide. Nutritional factors are the major cause and less commonly, inheritance causes. Rece ntly, CYP2R1 has been reported as a major factor for 25-hydroxylation contributing to the inherited forms of vitamin D deficiency. We conducted a pr...
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doaj-59ab0c0cbda948019b693dfe448cc62a2021-07-24T05:48:54ZengBioscientificaEndocrine Connections2049-36142049-36142021-07-01107767775https://doi.org/10.1530/EC-21-010225-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutationsSarah Bakhamis0Faiqa Imtiaz1Khushnooda Ramzan2Edward De Vol3Osamah Al-Sagheir4Abdulrahman Al-Rajhi5Abdullah Alashwal6Bassam Bin Abbas7Nadia Sakati8Afaf Al-Sagheir9Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaCentre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaCentre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Biostatistics, Epidemiology & Scientific Computing, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Orthopedics, King Saud University Medical City, Riyadh, Saudi ArabiaDepartment of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaVitamin D deficiency remains a major cause of rickets worldwide. Nutritional factors are the major cause and less commonly, inheritance causes. Rece ntly, CYP2R1 has been reported as a major factor for 25-hydroxylation contributing to the inherited forms of vitamin D deficiency. We conducted a prospective cohort study at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, to review cas es with 25-hydroxylase deficiency and describe their clinical, biochemical, and molecul ar genetic features. We analyzed 27 patients from nine different families who presented with low 25-OH vitamin D and not responding to usual treatment. Genetic testing identi fied two mutations: c.367+1G>A (12/27 patients) and c.768dupT (15/27 patients), whe re 18 patients were homozygous for their identified mutation and 9 patients were het erozygous. Both groups had similar clinical manifestations ranging in severity, but no ne of the patients with the heterozygous mutation had hypocalcemic manifestations. Thirteen out of 18 homozygous patients and all the heterozygous patients responded to high doses of vitamin D treatment, but they regressed after decreasing the dose, requiring lifelon g therapy. Five out of 18 homozygous patients required calcitriol to improve their bioche mical data, whereas none of the heterozygous patients and patients who carried the c.367 +1G>A mutation required calcitriol treatment. To date, this is the largest cohort serie s analyzing CYP2R1-related 25-hydroxylase deficiency worldwide, supporting its major role i n 25-hydroxylation of vitamin D. It is suggested that a higher percentage of CYP2R1 mutations might be found in the Saudi population. We believe that our study will help in th e diagnosis, treatment, and prevention of similar cases in the future.https://ec.bioscientifica.com/view/journals/ec/10/7/EC-21-0102.xmlvitamin dcyp2r1 mutation25-hydroxylase deficiencyricketssaudi arabia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sarah Bakhamis Faiqa Imtiaz Khushnooda Ramzan Edward De Vol Osamah Al-Sagheir Abdulrahman Al-Rajhi Abdullah Alashwal Bassam Bin Abbas Nadia Sakati Afaf Al-Sagheir |
spellingShingle |
Sarah Bakhamis Faiqa Imtiaz Khushnooda Ramzan Edward De Vol Osamah Al-Sagheir Abdulrahman Al-Rajhi Abdullah Alashwal Bassam Bin Abbas Nadia Sakati Afaf Al-Sagheir 25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations Endocrine Connections vitamin d cyp2r1 mutation 25-hydroxylase deficiency rickets saudi arabia |
author_facet |
Sarah Bakhamis Faiqa Imtiaz Khushnooda Ramzan Edward De Vol Osamah Al-Sagheir Abdulrahman Al-Rajhi Abdullah Alashwal Bassam Bin Abbas Nadia Sakati Afaf Al-Sagheir |
author_sort |
Sarah Bakhamis |
title |
25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations |
title_short |
25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations |
title_full |
25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations |
title_fullStr |
25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations |
title_full_unstemmed |
25-Hydroxylase vitamin D deficiency in 27 Saudi Arabian subjects: a clinical and molecular report on CYP2R1 mutations |
title_sort |
25-hydroxylase vitamin d deficiency in 27 saudi arabian subjects: a clinical and molecular report on cyp2r1 mutations |
publisher |
Bioscientifica |
series |
Endocrine Connections |
issn |
2049-3614 2049-3614 |
publishDate |
2021-07-01 |
description |
Vitamin D deficiency remains a major cause of rickets worldwide. Nutritional factors
are the major cause and less commonly, inheritance causes. Rece ntly, CYP2R1 has been
reported as a major factor for 25-hydroxylation contributing to the inherited forms of
vitamin D deficiency. We conducted a prospective cohort study at King Faisal Specialist
Hospital & Research Centre, Riyadh, Saudi Arabia, to review cas es with 25-hydroxylase
deficiency and describe their clinical, biochemical, and molecul ar genetic features. We
analyzed 27 patients from nine different families who presented with low 25-OH vitamin
D and not responding to usual treatment. Genetic testing identi fied two mutations:
c.367+1G>A (12/27 patients) and c.768dupT (15/27 patients), whe re 18 patients were
homozygous for their identified mutation and 9 patients were het erozygous. Both groups
had similar clinical manifestations ranging in severity, but no ne of the patients with the
heterozygous mutation had hypocalcemic manifestations. Thirteen out of 18 homozygous
patients and all the heterozygous patients responded to high doses of vitamin D treatment,
but they regressed after decreasing the dose, requiring lifelon g therapy. Five out of 18
homozygous patients required calcitriol to improve their bioche mical data, whereas none
of the heterozygous patients and patients who carried the c.367 +1G>A mutation required
calcitriol treatment. To date, this is the largest cohort serie s analyzing CYP2R1-related
25-hydroxylase deficiency worldwide, supporting its major role i n 25-hydroxylation of
vitamin D. It is suggested that a higher percentage of CYP2R1 mutations might be found in
the Saudi population. We believe that our study will help in th e diagnosis, treatment, and
prevention of similar cases in the future. |
topic |
vitamin d cyp2r1 mutation 25-hydroxylase deficiency rickets saudi arabia |
url |
https://ec.bioscientifica.com/view/journals/ec/10/7/EC-21-0102.xml |
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