DNA hypomethylation, transient neonatal diabetes, and prune belly sequence in one of two identical twins

Eur J Pediatr. 2010 Feb;169(2):207-13. doi: 10.1007/s00431-009-1008-y. Epub 2009 Jun 13.


One known genetic mechanism for transient neonatal diabetes is loss of methylation at 6q24. The etiology of prune belly sequence is unknown but a genetic defect, affecting the mesoderm from which the triad abdominal muscle hypoplasia, urinary tract abnormalities, and cryptorchidism develop, has been suggested. We investigated a family, including one twin, with transient neonatal diabetes and prune belly sequence. Autoantibody tests excluded type 1 diabetes. Microsatellite marker analysis confirmed the twins being monozygotic. We identified no mutations in ZFP57, KCNJ11, ABCC8, GCK, HNF1A, HNF1B, HNF3B, IPF1, PAX4, or ZIC3. The proband had loss of methylation at the 6q24 locus TNDM and also at the loci IGF2R, DIRAS3, and PEG1, while the other family members, including the healthy monozygotic twin, had normal findings. The loss of methylation on chromosome 6q24 and elsewhere may indicate a generalized maternal hypomethylation syndrome, which accounts for both transient neonatal diabetes and prune belly sequence.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Twin Study

MeSH terms

  • Chromosomes, Human, Pair 6
  • DNA / genetics*
  • DNA Methylation
  • DNA Mutational Analysis
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / genetics*
  • Diseases in Twins / genetics*
  • Genetic Markers / genetics*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / genetics*
  • Male
  • Mutation*
  • Pedigree
  • Polymerase Chain Reaction
  • Twins, Monozygotic*


  • Genetic Markers
  • DNA