Common and recurrent HPGD mutations in Caucasian individuals with primary hypertrophic osteoarthropathy

Christine P. Diggle, Ian M. Carr, Emanuel Zitt, Katie Wusik, Robert J. Hopkin, Carlos E. Prada, Olga Calabrese, Olaf Rittinger, Marilynn G. Punaro, Alexander F. Markham, David T. Bonthron

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Objective. Homozygous recessive germline mutations of the 15-hydroxyprostaglandin dehydrogenase (HPGD) gene, encoding 15-hydroxyprostaglandin dehydrogenase, result in persistent elevation of circulating PGE2 levels, causing the syndrome of primary hypertrophic osteoarthropathy (PHO). Homozygous HPGD mutations have so far been reported in 10 families, all but one displaying parental consanguinity. Only two of these families were of European origin. We wished to determine the role of HPGD in causing PHO in non-consanguineous European families. Methods. Five previously unreported families of Caucasian European origin, with one or more individuals affected with typical PHO, were characterized clinically and by complete sequencing of the HPGD coding exons. Results. Biallelic HPGD mutations were identified in affected individuals in all the five families, confirming a very specific association of this phenotype with HPGD mutations. The previously described c.175_176delCT frameshift mutation was observed in association with two different alleles of an adjacent single nucleotide polymorphism. Conclusions. Biallelic HPGD mutations are found in the majority of patients with typical PHO, and sequencing of the HPGD gene is a highly specific first-line investigation for patients presenting in this way, particularly during childhood. The c.175_176delCT frameshift mutation appears to be recurrent and to be the commonest HPGD mutation in Caucasian families.

Original languageEnglish (US)
Article numberkeq048
Pages (from-to)1056-1062
Number of pages7
Issue number6
StatePublished - Mar 18 2010


  • 15-hydroxyprostaglandin dehydrogenase
  • Clubbing
  • Primary hypertrophic osteoarthropathy
  • Prostaglandin

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)


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