Primary glucocorticoid resistance (OMIM 615962) is a rare endocrinologic condition caused by resistance of the human glucocorticoid receptor (hGR) to glucocorticoids (GR) and characterised by general or partial insensitivity of target organs to GK. Compensatory activation of hypothalamic-pituitary-andrenal axis results in development of a various pathological conditions caused by overstimulation of adrenal glands. Clinical spectrum may range from asymptomatic cases to severe cases of mineralocorticoid and/or androgen excess. At present time, primary generalized glucocorticoid resistance has been exclusively associated with defects in the NR3C1 gene. Here, we present a case report of an adolescent patient with clinical presentation of glucocorticoid resistance confirmed by detailed endocrinologic evaluation but no confirmed mutations in the NR3C1 gene.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10926243PMC
http://dx.doi.org/10.14341/probl13321DOI Listing

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Article Synopsis
  • Primary generalized glucocorticoid resistance syndrome (GGRS) is a rare condition linked to a mutation in the NR3C1 gene, specifically a missense variant affecting the Glucocorticoid Receptor's DNA Binding Domain.
  • A case study detailed a 59-year-old man with high cortisol levels and a misdiagnosis of Cushing disease, ultimately leading to a correct diagnosis of GGRS at age 68.
  • Functional tests on the identified gene variant indicated it had significantly reduced transcriptional activity, emphasizing the need for increased awareness of GGRS to prevent misdiagnosis and harmful treatments.
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