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Journal of the Endocrine Society · 2026

Recurring and isolated intronic FGFR1 variants as an underdiagnosed cause of congenital hypogonadotropic hypogonadism.

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Yacobi-Bach Michal, Hagin Rona, Levy Lando Bar, Délot Emmanuèle, Vilain Eric, Kępczyński Łukasz, Botvinik Adi, Mory Adi, Amir Yam, Kałużewski Tadeusz, Gach Agnieszka, Łupińska Anna, Zygmunt Arkadiusz, Johnson Jodie, Rutter Meilan M, Lebenthal Yael, Shaklai Sigal, Greenman Yona, Baris Feldman Hagit, Kurolap Alina

Аннотация

BACKGROUND: Congenital hypogonadotropic hypogonadism (CHH) is a genetically heterogeneous disorder characterized by absent or delayed puberty and infertility due to gonadotropin-releasing hormone deficiency. While loss-of-function variants in FGFR1 are the most commonly known genetic cause of CHH, diagnostic screening typically focuses on coding exons, potentially overlooking pathogenic variants in noncoding regions.

METHODS: We investigated 4 unrelated families with CHH. Family 1 included a mother and 3 daughters presenting with variable reproductive phenotypes and incomplete penetrance of anosmia; Family 3 consisted of a girl with CHH and anosmia; and Families 2 and 4 consisted of male patients who presented with CHH and anosmia. Genetic investigations were done using either exome or genome sequencing. Experimental characterization of the identified intronic variants was conducted using RNA extracted from peripheral blood mononuclear cells. Exome or genome sequencing-based haplotyping was performed for the recurring variant.

RESULTS: In Families 1 to 3, we identified a recurring heterozygous intronic variant in FGFR1: c.92-19G > A. RNA analysis confirmed that this variant generates a cryptic splice acceptor site, leading to the inclusion of 17 intronic nucleotides, resulting in a premature stop codon. Haplotype analysis revealed the variant occurred independently in each family. In Family 4, a distinct heterozygous intronic variant was identified in FGFR1, which was shown to cause intron 15 retention with premature termination.

CONCLUSION: Our findings demonstrate that intronic variants in FGFR1 are a possible cause of CHH and can lead to diverse clinical phenotypes ranging from normosmic CHH to severe Kallmann syndrome, including significant presentation in female patients.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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