A multicenter experience on the prevalence of ARMC5 mutations in patients with primary bilateral macronodular adrenal hyperplasia: from genetic characterization to clinical phenotype

N M Albiger, D. Regazzo, B. Rubin, A M Ferrara, S Rizzati, E Taschin, Fabio Ceccato, G. Arnaldi, F Pecori Giraldi, Antonio Stigliano, Lidia Cerquetti, F. Grimaldi, Ernesto De Menis, M. Boscaro, Maurizio Iacobone, Guya Occhi, C. Scaroni

Research output: Contribution to journalArticlepeer-review

Abstract

ARMC5 mutations have recently been identified as a common genetic cause of primary bilateral macronodular adrenal hyperplasia (PBMAH). We aimed to assess the prevalence of ARMC5 germline mutations and correlate genotype with phenotype in a large cohort of PBMAH patients. A multicenter study was performed, collecting patients from different endocrinology units in Italy. Seventy-one PBMAH patients were screened for small mutations and large rearrangements in the ARMC5 gene: 53 were cortisol-secreting (two with a family history of adrenal hyperplasia) and 18 were non-secreting cases of PBMAH. Non-mutated and mutated patients' clinical phenotypes were compared and related to the type of mutation. A likely causative germline ARMC5 mutation was only identified in cortisol-secreting PBMAH patients (one with a family history of adrenal hyperplasia and ten apparently sporadic cases). Screening in eight first-degree relatives of three index cases revealed four carriers of an ARMC5 mutation. Evidence of a second hit at somatic level was identified in five nodules. Mutated patients had higher cortisol levels (p = 0.062), and more severe hypertension and diabetes (p < 0.05). Adrenal glands were significantly larger, with a multinodular phenotype, in the mutant group (p < 0.01). No correlation emerged between type of mutation and clinical parameters. ARMC5 mutations are frequent in cortisol-secreting PBMAH and seem to be associated with a particular pattern of the adrenal masses. Their identification may have implications for the clinical care of PBMAH cases and their relatives.

Original languageEnglish
Pages (from-to)959-968
Number of pages10
JournalEndocrine
Volume55
Issue number3
Early online dateApr 19 2016
DOIs
Publication statusPublished - Mar 2017

Keywords

  • Journal Article

Fingerprint

Dive into the research topics of 'A multicenter experience on the prevalence of ARMC5 mutations in patients with primary bilateral macronodular adrenal hyperplasia: from genetic characterization to clinical phenotype'. Together they form a unique fingerprint.

Cite this