De Novo GUCY2C and PRR12 Mutations in a Patient With Chronic Diarrhea, Small Bowel Obstructions, and Developmental
Feruza Abraamyan1, Luke Pecha2, Valentina Medici2
1Department of Internal Medicine, Sutter Roseville Medical Center, Roseville, CA.
Insights
A novel GUCY2C mutation causes congenital diarrhea and bowel obstructions. A PRR12 mutation explains developmental delay, resolving a long-standing diagnostic mystery and enabling personalized patient care.
Area of Science:
- Genetics
- Gastroenterology
- Developmental Biology
Background:
- Congenital secretory diarrhea and recurrent small bowel obstructions present significant diagnostic challenges.
- Neurodevelopmental delay can be associated with complex genetic disorders.
Abstract:
We present the case of a 30-year-old man with a history of neurodevelopmental delay and congenital secretory diarrhea since childhood complicated by recurrent small bowel obstructions requiring multiple surgeries. Genetic testing identified a de novo gain-of-function GUCY2C c.2309T>C (p.Leu770Pro) mutation, causing congenital diarrhea through persistent chloride and water secretion in a mechanism similar of enterotoxigenic E. coli. For less clear reasons, the mutation is also associated with small bowel obstructions and Crohn's disease-like phenotype. A co-occurring de novo PRR12 c.768del (p.Ala257Leufs*58) frameshift mutation explained his developmental delay. Together, these findings resolved a decades-long diagnostic challenge and enabled a personalized care plan for the patient.
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