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Analysis of the thyroid phenotype in 42 patients with Pendred syndrome and nonsyndromic enlargement of the vestibular aqueduct.
[pendred syndrome]
Pendred
syndrome
(
PS
)
,
a
recessive
disorder
caused
by
mutations
in
the
SLC
26
A
4
(
PDS
)
gene
,
is
associated
with
deafness
and
goiter
.
SLC
26
A
4
mutations
have
also
been
identified
in
patients
exhibiting
isolated
sensorineural
hearing
loss
without
apparent
thyroid
abnormality
(
nonsyndromic
enlargement
of
the
vestibular
aqueduct
;
nonsyndromic
EVA
)
.
Our
aim
was
to
describe
systematically
the
thyroidal
phenotypes
and
the
SLC
26
A
4
genotypes
of
patients
presenting
with
PS
or
nonsyndromic
EVA
.
Nineteen
patients
with
PS
and
23
patients
with
nonsyndromic
EVA
,
aged
5
-
53
years
,
were
included
.
They
underwent
thyroid
evaluation
(
physical
examination
,
biological
thyroid
function
tests
,
measurement
of
thyroglobulin
level
,
thyroid
ultrasonography
,
and
thyroid
(
123
)
I
scintigraphy
with
perchlorate
discharge
test
)
,
otological
evaluation
,
and
SLC
26
A
4
mutation
screening
.
In
19
patients
with
PS
,
goiter
was
identified
in
15
(
79
%
)
and
hypothyroidism
in
15
(
79
%
)
;
hypothyroidism
was
subclinical
in
four
patients
and
congenital
in
six
patients
.
The
perchlorate
discharge
test
(
PDT
)
was
positive
in
10
/
16
(
63
%
)
.
Morphological
evaluation
of
the
inner
ear
using
MRI
and
/
or
CT
showed
bilateral
EVA
in
15
/
15
PS
patients
.
Mutation
screening
revealed
two
SLC
26
A
4
mutant
alleles
in
all
19
PS
patients
that
were
homozygous
in
two
families
and
compound
heterozygous
in
12
families
.
In
the
23
patients
with
nonsyndromic
EVA
,
systematic
thyroid
evaluation
found
no
abnormalities
except
for
slightly
increased
thyroglobulin
levels
in
two
patients
.
SLC
26
A
4
mutations
were
identified
in
9
/
23
(
39
%
)
.
Mutations
were
biallelic
in
two
(
compound
heterozygous
)
and
monoallelic
in
seven
patients
.
The
thyroid
phenotype
is
widely
variable
in
PS
.
SLC
26
A
4
mutation
screening
is
needed
in
patients
exhibiting
PS
or
nonsyndromic
EVA
.
PS
is
associated
with
biallelic
SLC
26
A
4
mutations
and
nonsyndromic
EVA
with
no
,
monoallelic
,
or
biallelic
SLC
26
A
4
mutations
.
Systematic
thyroid
evaluation
is
recommended
in
patients
with
nonsyndromic
EVA
associated
with
one
or
two
SLC
26
A
4
mutations
.
We
propose
using
a
combination
of
three
parameters
to
define
and
diagnose
PS
:
(
i
)
sensorineural
deafness
with
bilateral
EVA
;
(
ii
)
thyroid
abnormality
comprising
goiter
and
/
or
hypothyroidism
and
/
or
a
positive
PDT
;
(
iii
)
biallelic
SLC
26
A
4
mutations
.
Diseases
Validation
Diseases presenting
"hypothyroidism"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
adrenomyeloneuropathy
alpha-thalassemia
aromatase deficiency
congenital adrenal hyperplasia
cowden syndrome
cushing syndrome
familial mediterranean fever
gm1 gangliosidosis
harlequin ichthyosis
hirschsprung disease
inclusion body myositis
kallmann syndrome
pendred syndrome
proteus syndrome
pyruvate dehydrogenase deficiency
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated