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2018 ; 2018
(ä): 9412676
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English Wikipedia
Wolfram Syndrome: A Case Report and Review of Clinical Manifestations, Genetics
Pathophysiology, and Potential Therapies
#MMPMID29850290
Toppings NB
; McMillan JM
; Au PYB
; Suchowersky O
; Donovan LE
Case Rep Endocrinol
2018[]; 2018
(ä): 9412676
PMID29850290
show ga
BACKGROUND: Classical Wolfram syndrome (WS) is a rare autosomal recessive
disorder caused by mutations in WFS1, a gene implicated in endoplasmic reticulum
(ER) and mitochondrial function. WS is characterized by insulin-requiring
diabetes mellitus and optic atrophy. A constellation of other features
contributes to the acronym DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic
Atrophy, and Deafness). This review seeks to raise awareness of this rare form of
diabetes so that individuals with WS are identified and provided with appropriate
care. CASE: We describe a woman without risk factors for gestational or type 2
diabetes who presented with gestational diabetes (GDM) at the age of 39 years
during her first and only pregnancy. Although she had optic atrophy since the age
of 10 years, WS was not considered as her diagnosis until she presented with GDM.
Biallelic mutations in WFS1 were identified, supporting a diagnosis of classical
WS. CONCLUSIONS: The distinct natural history, complications, and differences in
management reinforce the importance of distinguishing WS from other forms of
diabetes. Recent advances in the genetics and pathophysiology of WS have led to
promising new therapeutic considerations that may preserve ?-cell function and
slow progressive neurological decline. Insight into the pathophysiology of WS may
also inform strategies for ?-cell preservation for individuals with type 1 and 2
diabetes.