Vitamin D-Binding Protein Deficiency and Homozygous Deletion of the GC Gene.

Clark M Henderson, Susan L Fink, Hanan Bassyouni,Bob Argiropoulos, Lindsay Brown,Thomas J Laha, Konner J Jackson, Raymond Lewkonia, Patrick Ferreira,Andrew N Hoofnagle,Julien L Marcadier

The New England journal of medicine(2019)

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Abstract
A 58-year-old woman with debilitating ankylosing spondylitis who was born to consanguineous parents was found to have an apparent severe vitamin D deficiency that did not respond to supplementation. Liquid chromatography-tandem mass spectrometry showed the absence of circulating vitamin D-binding protein, and chromosomal microarray confirmed a homozygous deletion of the group-specific component (GC) gene that encodes the protein. Congenital absence of vitamin D-binding protein resulted in normocalcemia and a relatively mild disruption of bone metabolism, in this case complicated by severe autoimmune disease. (Funded by the National Institutes of Health and the University of Washington.).
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