Introduction: Variants affecting a microsatellite on the noncoding region of chromosome 15q26.1 are associated with familial non-autoimmune thyroid abnormalities characterized by mild congenital hypothyroidism (CH) with elevated thyroglobulin (Tg) levels. Some individuals who carry these variants may develop multinodular goiter if left untreated. Although these variants have been recognized as genetic etiologies of CH, nongoitrous, 3 (CHNG3), the associated severity of CH remains unclear. Method: A cohort of 63 participants diagnosed with CH at Tohoku University underwent screening for genetic variants on 15q26.1. We then analyzed the clinical phenotypes of the variant-carrying participants. Results: We identified five 15q26.1 variant carriers from four families among the cohort. Family histories of thyroid abnormalities were documented in three of these 5 cases. The variant carriers had mild CH phenotypes, with two discontinuing levothyroxine treatment and the others requiring relatively low doses (1.33–1.89 µg/kg/day) at their final visit. During levothyroxine treatment, serum Tg and thyroid-stimulating hormone (TSH) levels were within the reference ranges at the majority of the evaluation points. Three of the five participants continued treatment into adulthood, whereas the other two discontinued it and maintained serum TSH levels within the reference range. All five participants exhibited normal intellectual development and stature. Conclusion: These findings provide further evidence supporting the role of 15q26.1 variants as a common genetic etiology of CH, with clinical phenotypes including transient CH. Early genetic evaluation may facilitate the identification of 15q26.1 variant carriers among patients who are diagnosed with CH.

1.
Narumi
S
,
Nagasaki
K
,
Kiriya
M
,
Uehara
E
,
Akiba
K
,
Tanase-Nakao
K
, et al
.
Functional variants in a TTTG microsatellite on 15q26.1 cause familial nonautoimmune thyroid abnormalities
.
Nat Genet
.
2024
;
56
(
5
):
869
76
.
2.
Grasberger
H
,
Dumitrescu
AM
,
Liao
XH
,
Swanson
EG
,
Weiss
RE
,
Srichomkwun
P
, et al
.
STR mutations on chromosome 15q cause thyrotropin resistance by activating a primate-specific enhancer of MIR7-2/MIR1179
.
Nat Genet
.
2024
;
56
(
5
):
877
88
.
3.
Narumi
S
.
Deciphering the mystery of CHNG3
.
Ann Pediatr Endocrinol Metab
.
2024
;
29
(
5
):
279
83
.
4.
Grasberger
H
,
Vaxillaire
M
,
Pannain
S
,
Beck
JC
,
Mimouni-Bloch
A
,
Vatin
V
, et al
.
Identification of a locus for nongoitrous congenital hypothyroidism on chromosome 15q25.3-26.1
.
Hum Genet
.
2005
;
118
(
3–4
):
348
55
.
5.
van Trotsenburg
P
,
Stoupa
A
,
Léger
J
,
Rohrer
T
,
Peters
C
,
Fugazzola
L
, et al
.
Congenital hypothyroidism: a 2020–2021 consensus guidelines update-an ENDO-European reference network initiative endorsed by the European society for pediatric endocrinology and the European Society for Endocrinology
.
Thyroid
.
2021
;
31
(
3
):
387
419
.
6.
Nagasaki
K
,
Minamitani
K
,
Nakamura
A
,
Kobayashi
H
,
Numakura
C
,
Itoh
M
, et al
.
Guidelines for newborn screening of congenital hypothyroidism; (2021 Revision)
.
Clin Pediatr Endocrinol
.
2023
;
32
(
1
):
26
51
.
7.
Grosse
SD
,
Van Vliet
G
.
Prevention of intellectual disability through screening for congenital hypothyroidism: how much and at what level
.
Arch Dis Child
.
2011
;
96
(
4
):
374
9
.
8.
Delvecchio
M
,
Salerno
M
,
Vigone
MC
,
Wasniewska
M
,
Popolo
PP
,
Lapolla
R
, et al
.
Levothyroxine requirement in congenital hypothyroidism: a 12-year longitudinal study
.
Endocrine
.
2015
;
50
(
3
):
674
80
.
9.
Dussault
JH
,
Coulombe
P
,
Laberge
C
,
Letarte
J
,
Guyda
H
,
Khoury
K
.
Preliminary report on a mass screening program for neonatal hypothyroidism
.
J Pediatr
.
1975
;
86
(
5
):
670
4
.
10.
Peters
C
,
Schoenmakers
N
.
Mechanisms in endocrinology: the pathophysiology of transient congenital hypothyroidism
.
Eur J Endocrinol
.
2022
;
187
(
2
):
R1
6
.
11.
Shima
H
,
Ishii
A
,
Wada
Y
,
Kizawa
J
,
Yokoi
T
,
Azuma
N
, et al
.
SOX2 nonsense mutation in a patient clinically diagnosed with non-syndromic hypogonadotropic hypogonadism
.
Endocr J
.
2017
;
64
(
8
):
813
7
.
12.
Morris
TG
,
Layley
J
,
Geevarghese
R
,
Steele
L
,
Ssali
J
,
Mirzazadeh
M
.
Adult and neonate TSH blood spot reference intervals
.
Ann Clin Biochem
.
2022
;
59
(
5
):
363
72
.
13.
Liu
S
,
Wang
X
,
Zou
H
,
Ge
Y
,
Wang
F
,
Wang
Y
, et al
.
Identification and characterization of novel PAX8 mutations in Congenital Hypothyroidism (CH) in a Chinese population
.
Oncotarget
.
2017
;
8
(
5
):
8707
16
.
14.
Abe
K
,
Narumi
S
,
Suwanai
AS
,
Adachi
M
,
Muroya
K
,
Asakura
Y
, et al
.
Association between monoallelic TSHR mutations and congenital hypothyroidism: a statistical approach
.
Eur J Endocrinol
.
2018
;
178
(
2
):
137
44
.
15.
Da
DZ
,
Wang
Y
,
Wang
M
,
Long
Z
,
Wang
Q
,
Liu
J
.
Congenital hypothyroidism patients with thyroid hormone receptor variants are not rare: a systematic review
.
Inquiry
.
2021
;
58
:
469580211067943
.
16.
de Filippis
T
,
Gelmini
G
,
Paraboschi
E
,
Vigone
MC
,
Di Frenna
M
,
Marelli
F
, et al
.
A frequent oligogenic involvement in congenital hypothyroidism
.
Hum Mol Genet
.
2017
;
26
(
13
):
2507
14
.
17.
Oliver-Petit
I
,
Edouard
T
,
Jacques
V
,
Bournez
M
,
Cartault
A
,
Grunenwald
S
, et al
.
Next-generation sequencing analysis reveals frequent familial origin and oligogenism in congenital hypothyroidism with dyshormonogenesis
.
Front Endocrinol
.
2021
;
12
:
657913
.
18.
Citterio
CE
,
Targovnik
HM
,
Arvan
P
.
The role of thyroglobulin in thyroid hormonogenesis
.
Nat Rev Endocrinol
.
2019
;
15
(
6
):
323
38
.
You do not currently have access to this content.