A patient with congenital hypothyroidism due to a PAX8 frameshift variant accompanying a urogenital malformation

Kanako Tanase-Nakao, Koji Muroya, Masanori Adachi, Kiyomi Abe, Tomonobu Hasegawa, Satoshi Narumi

Research output: Contribution to journalArticlepeer-review


PAX8 is a transcription factor that is expressed in the thyroid gland and kidneys. Monoallelic loss-of-function PAX8 variants cause congenital hypothyroidism (CH), and urogenital malformations are infrequent complications seen in less than 10% of PAX8 variant carriers. Herein, we report the case of a 3-yr-old female patient with CH who was diagnosed during newborn screening. She was treated with levothyroxine, and she showed normal growth and development at a minimal dose (0.7 µg/kg/d of levothyroxine at 3 yr of age). At 5 mo of age, she visited an emergency department for fever and was incidentally found to have differently sized kidneys by ultrasonography, which was subsequently diagnosed as unilateral multicystic dysplastic kidney. Her serum creatinine and cystatin C levels were normal. Next-generation sequencing-based genetic analysis revealed that the patient was heterozygous for a PAX8 frameshift variant (p.Thr320ProfsTer106) and a DUOX2 missense variant (p.Arg885Gln). Our patient is the first truncating PAX8 variant carrier to have a urogenital malformation with CH. Genetic analysis for PAX8 should be considered in patients with CH and urogenital malformations.

Original languageEnglish
Pages (from-to)250-255
Number of pages6
Journalclinical pediatric endocrinology
Issue number4
Publication statusPublished - 2022 Oct


  • PAX8
  • congenital hypothyroidism
  • frameshift mutation
  • urogenital abnormality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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