Liddle syndrome (OMIM #177200) is an autosomal dominant disorder caused by gain-of-function pathogenic variants in the genes encoding epithelial sodium channel subunits, including α (SCNN1A), β (SCNN1B), and γ (SCNN1G). The majority of the reported cases carry SCNN1B variants (∼90%), and SCNN1A/G variants are relatively infrequent. Here, we report a 24-year-old Chinese male patient diagnosed with early-onset hypertension. Laboratory tests revealed hypokalemia with a low level of plasma renin activity. Liddle syndrome was confirmed by high-throughput sequencing, which identified a novel nonsense variant Q591X in the SCNN1G gene, resulting in the PY motif’s deletion. The patient’s father has the same mutation, and his mother and sister are normal. All eleven variants in the SCNN1G gene were summarized. Liddle syndrome usually presents with early onset of hypertension with hypokalemia and low-renin activity, but it can be clinically heterogeneous. It is necessary to utilize next-generation sequencing to clarify the diagnosis to identify Liddle syndrome in young patients with hypertension and to perform early treatment and prevent a series of adverse outcomes caused by hypertension.

1.
Yang
KQ
,
Xiao
Y
,
Tian
T
,
Gao
LG
,
Zhou
XL
.
Molecular genetics of Liddle’s syndrome
.
Clin Chim Acta
.
2014
;
436
:
202
6
. .
2.
Hanukoglu
I
,
Hanukoglu
A
.
Epithelial sodium channel (ENaC) family: phylogeny, structure-function, tissue distribution, and associated inherited diseases
.
Gene
.
2016
;
579
(
2
):
95
132
. .
3.
Yang
KQ
,
Lu
CX
,
Fan
P
,
Zhang
Y
,
Meng
X
,
Dong
XQ
,
Genetic screening of SCNN1B and SCNN1G genes in early-onset hypertensive patients helps to identify Liddle syndrome
.
Clin Exp Hypertens
.
2018
;
40
(
2
):
107
11
.
4.
Polfus
LM
,
Boerwinkle
E
,
Gibbs
RA
,
Metcalf
G
,
Muzny
D
,
Veeraraghavan
N
,
Whole-exome sequencing reveals an inherited R566X mutation of the epithelial sodium channel β-subunit in a case of early-onset phenotype of Liddle syndrome
.
Cold Spring Harbor Mol Case Stud
.
2016
;
2
(
6
):
a001255
.
5.
Canessa
CM
,
Schild
L
,
Buell
G
,
Thorens
B
,
Gautschi
I
,
Horisberger
JD
,
Amiloride-sensitive epithelial Na+ channel is made of three homologous subunits
.
Nature
.
1994
;
367
(
6462
):
463
7
.
6.
Zhou
R
,
Patel
SV
,
Snyder
PM
.
Nedd4-2 catalyzes ubiquitination and degradation of cell surface ENaC
.
J Biol Chem
.
2007
;
282
(
28
):
20207
12
. .
7.
Pagani
L
,
Diekmann
Y
,
Sazzini
M
,
De Fanti
S
,
Rondinelli
M
,
Farnetti
E
,
Three reportedly unrelated families with Liddle syndrome inherited from a common ancestor
.
Hypertension
.
2018
;
71
(
2
):
273
9
.
8.
Wang
LP
,
Yang
KQ
,
Jiang
XJ
,
Wu
HY
,
Zhang
HM
,
Zou
YB
,
Prevalence of Liddle syndrome among young hypertension patients of undetermined cause in a Chinese population
.
J Clin Hypertens
.
2015
;
17
(
11
):
902
7
.
9.
Liu
K
,
Qin
F
,
Sun
X
,
Zhang
Y
,
Wang
J
,
Wu
Y
,
Analysis of the genes involved in Mendelian forms of low-renin hypertension in Chinese early-onset hypertensive patients
.
J Hypertens
.
2018
;
36
(
3
):
502
9
.
10.
Schild
L
,
Lu
Y
,
Gautschi
I
,
Schneeberger
E
,
Lifton
RP
,
Rossier
BC
.
Identification of a PY motif in the epithelial Na channel subunits as a target sequence for mutations causing channel activation found in Liddle syndrome
.
EMBO J
.
1996
;
15
(
10
):
2381
7
. .
11.
Hiltunen
TP
,
Hannila-Handelberg
T
,
Petajaniemi
N
,
Kantola
I
,
Tikkanen
I
,
Virtamo
J
,
Liddle’s syndrome associated with a point mutation in the extracellular domain of the epithelial sodium channel gamma subunit
.
J Hypertens
.
2002
;
20
(
12
):
2383
90
.
12.
Shi
JY
,
Chen
X
,
Ren
Y
,
Long
Y
,
Tian
HM
.
Liddle’s syndrome caused by a novel mutation of the gamma-subunit of epithelial sodium channel gene SCNN1G in Chinese
.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi
.
2010
;
27
(
2
):
132
5
. .
13.
Wang
YX
,
Lu
CY
,
Gu
XM
.
Liddle syndrome caused by SCNN1G mutation: a case report and literature review
.
Chinese J Pract Inter Med
.
2021
;
41
(
11
):
998
1000
.
14.
Hansson
JH
,
Nelson-Williams
C
,
Suzuki
H
,
Schild
L
,
Shimkets
R
,
Lu
Y
,
Hypertension caused by a truncated epithelial sodium channel gamma subunit: genetic heterogeneity of Liddle syndrome
.
Nat Genet
.
1995
;
11
(
1
):
76
82
.
15.
Yamashita
Y
,
Koga
M
,
Takeda
Y
,
Enomoto
N
,
Uchida
S
,
Hashimoto
K
,
Two sporadic cases of Liddle’s syndrome caused by De novo ENaC mutations
.
Am J Kidney Dis
.
2001
;
37
(
3
):
499
504
.
16.
Yang
KQ
,
Lu
CX
,
Xiao
Y
,
Liu
YX
,
Jiang
XJ
,
Zhang
X
,
A novel frameshift mutation of epithelial sodium channel beta-subunit leads to Liddle syndrome in an isolated case
.
Clin Endocrinol
.
2015
;
82
(
4
):
611
4
.
17.
Fan
P
,
Zhao
YM
,
Zhang
D
,
Liao
Y
,
Yang
KQ
,
Tian
T
,
A novel frameshift mutation of SCNN1G causing Liddle syndrome with normokalemia
.
Am J Hypertens
.
2019
;
32
(
8
):
752
8
.
18.
Kozina
AA
,
Trofimova
TA
,
Okuneva
EG
,
Baryshnikova
NV
,
Obuhova
VA
,
Krasnenko
AY
,
Liddle syndrome due to a novel mutation in the gamma subunit of the epithelial sodium channel (ENaC) in family from Russia: a case report
.
BMC Nephrol
.
2019
;
20
(
1
):
389
.
19.
Lata
S
,
Marasa
M
,
Li
Y
,
Fasel
DA
,
Groopman
E
,
Jobanputra
V
,
Whole-exome sequencing in adults with chronic kidney disease: a pilot study
.
Ann Intern Med
.
2018
;
168
(
2
):
100
9
.
20.
Fan
P
,
Pan
XC
,
Zhang
D
,
Yang
KQ
,
Zhang
Y
,
Tian
T
,
Pediatric Liddle syndrome caused by a novel SCNN1G variant in a Chinese family and characterized by early-onset hypertension
.
Am J Hypertens
.
2020
;
33
(
7
):
670
5
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.