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Alstrom syndrome in two siblings.

Y J Hung1, C Jeng, D Pei

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 8, Sec. 3, Ting-Chow Road, Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|March 27, 2001
PubMed
Summary

Alstrom syndrome, a rare genetic disorder, causes obesity, vision loss, hearing impairment, and diabetes. This report details two siblings with Alstrom syndrome, highlighting their severe insulin resistance and endocrine dysfunction.

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Area of Science:

  • Genetics
  • Endocrinology
  • Ophthalmology

Background:

  • Alstrom syndrome is an extremely rare autosomal recessive inherited disorder, with only 50 cases reported since 1959.
  • It is characterized by a complex phenotype including obesity, insulin resistance, retinal degeneration, neurosensory deafness, hepatic dysfunction, and endocrine disorders.

Observation:

  • A 12-year-old girl presented with progressive vision loss since age 6, diagnosed with diabetes mellitus and acanthosis nigricans at age 12.
  • Her 10-year-old brother exhibited similar symptoms.
  • Both siblings showed retinal degeneration and moderate sensorineural hearing loss via electroretinography and audiometry.

Findings:

  • Biochemical tests and oral glucose tolerance tests revealed diabetes mellitus, dyslipidemia, and hepatic dysfunction in the index case.

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  • Elevated insulin, C-peptide, and leptin concentrations were observed in both siblings.
  • The modified insulin suppression test confirmed significant insulin resistance in both siblings.
  • Implications:

    • This case report underscores the severe metabolic and endocrine complications associated with Alstrom syndrome, particularly profound insulin resistance.
    • Early diagnosis and comprehensive management are crucial for patients with Alstrom syndrome to address multi-systemic involvement.
    • Further research into the pathophysiology of insulin resistance in Alstrom syndrome may offer insights into broader metabolic disease mechanisms.