Mitchell-Riley Syndrome: A rare genetic disorder, case report

Mitchell-Riley Syndrome (MRS), is a rare autosomal recessive genetic disorder due to recessive mutations of the RFX6 gene. It has a distinct clinical phenotype marked by neonatal diabetes and chronic diarrhoea, accompanied by various anomalies within the digestive system such as intestinal atresia/m...

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Main Authors: Shria Sadhu, Nibal Albitar, Mai AlKhouly, Aqeel Farooque
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Rare
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950008724000255
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author Shria Sadhu
Nibal Albitar
Mai AlKhouly
Aqeel Farooque
author_facet Shria Sadhu
Nibal Albitar
Mai AlKhouly
Aqeel Farooque
author_sort Shria Sadhu
collection DOAJ
description Mitchell-Riley Syndrome (MRS), is a rare autosomal recessive genetic disorder due to recessive mutations of the RFX6 gene. It has a distinct clinical phenotype marked by neonatal diabetes and chronic diarrhoea, accompanied by various anomalies within the digestive system such as intestinal atresia/malrotation, pancreatic hypoplasia, biliary atresia, and gallbladder aplasia or hypoplasia, with or without cholestasis. Early identification will prompt the physician toward a genetic diagnosis, aggressive clinical management, and family counselling. We report a case of a male infant with neonatal diabetes and intestinal obstruction, with genetically confirmed RFX6 missense homozygous variant. Though our infant ultimately succumbed to gram positive (Staphylococcus epidermidis) septicaemia originating from an infected central venous catheter, multidisciplinary and intensive disease management overall improves the clinical outcome in patients with Mitchell-Riley Syndrome. This includes tailored parenteral/oral nutrition and the use of advanced diabetes technologies. This rare syndrome is usually fatal, with death within the first year of life in the majority of reported cases. Clinicians should consider the possibility of this rarely reported syndrome in the diagnosis of a newborn that presents with hyperglycaemia along with intestinal atresia and/or progressive cholestasis. A better understanding of RFX6 function among both intestine and pancreas cells is essential for the identification of using new drugs that could modulate the enteroendocrine system. Level of clinical evidence: 4
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spelling doaj-art-aa42eaa0e05e4a9ea6b2d71fc66770c92025-08-20T02:37:02ZengElsevierRare2950-00872024-01-01210004210.1016/j.rare.2024.100042Mitchell-Riley Syndrome: A rare genetic disorder, case reportShria Sadhu0Nibal Albitar1Mai AlKhouly2Aqeel Farooque3Corresponding authors.; Al Qassimi Women’s and Children’s Hospital, Sharjah, UAEAl Qassimi Women’s and Children’s Hospital, Sharjah, UAEAl Qassimi Women’s and Children’s Hospital, Sharjah, UAECorresponding authors.; Al Qassimi Women’s and Children’s Hospital, Sharjah, UAEMitchell-Riley Syndrome (MRS), is a rare autosomal recessive genetic disorder due to recessive mutations of the RFX6 gene. It has a distinct clinical phenotype marked by neonatal diabetes and chronic diarrhoea, accompanied by various anomalies within the digestive system such as intestinal atresia/malrotation, pancreatic hypoplasia, biliary atresia, and gallbladder aplasia or hypoplasia, with or without cholestasis. Early identification will prompt the physician toward a genetic diagnosis, aggressive clinical management, and family counselling. We report a case of a male infant with neonatal diabetes and intestinal obstruction, with genetically confirmed RFX6 missense homozygous variant. Though our infant ultimately succumbed to gram positive (Staphylococcus epidermidis) septicaemia originating from an infected central venous catheter, multidisciplinary and intensive disease management overall improves the clinical outcome in patients with Mitchell-Riley Syndrome. This includes tailored parenteral/oral nutrition and the use of advanced diabetes technologies. This rare syndrome is usually fatal, with death within the first year of life in the majority of reported cases. Clinicians should consider the possibility of this rarely reported syndrome in the diagnosis of a newborn that presents with hyperglycaemia along with intestinal atresia and/or progressive cholestasis. A better understanding of RFX6 function among both intestine and pancreas cells is essential for the identification of using new drugs that could modulate the enteroendocrine system. Level of clinical evidence: 4http://www.sciencedirect.com/science/article/pii/S2950008724000255CholestasisIntestinal atresiaMitchell–Riley SyndromeNeonatal hyperglycaemiaPancreatic hypoplasiaRFX6 gene
spellingShingle Shria Sadhu
Nibal Albitar
Mai AlKhouly
Aqeel Farooque
Mitchell-Riley Syndrome: A rare genetic disorder, case report
Rare
Cholestasis
Intestinal atresia
Mitchell–Riley Syndrome
Neonatal hyperglycaemia
Pancreatic hypoplasia
RFX6 gene
title Mitchell-Riley Syndrome: A rare genetic disorder, case report
title_full Mitchell-Riley Syndrome: A rare genetic disorder, case report
title_fullStr Mitchell-Riley Syndrome: A rare genetic disorder, case report
title_full_unstemmed Mitchell-Riley Syndrome: A rare genetic disorder, case report
title_short Mitchell-Riley Syndrome: A rare genetic disorder, case report
title_sort mitchell riley syndrome a rare genetic disorder case report
topic Cholestasis
Intestinal atresia
Mitchell–Riley Syndrome
Neonatal hyperglycaemia
Pancreatic hypoplasia
RFX6 gene
url http://www.sciencedirect.com/science/article/pii/S2950008724000255
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AT nibalalbitar mitchellrileysyndromeararegeneticdisordercasereport
AT maialkhouly mitchellrileysyndromeararegeneticdisordercasereport
AT aqeelfarooque mitchellrileysyndromeararegeneticdisordercasereport