• Di Zhang, Congli Chen, Wenli Yang, Yurong Piao, Li Ren, and Yanmei Sang.
• Department of Pediatric Endocrinology, Capital Institute of Pediatrics, Beijing, China.
• Medicine (Baltimore). 2022 Dec 23; 101 (51): e32461e32461.

RationaleMaturity-onset diabetes of the young (MODY) is a group of autosomal dominant monogenic diabetes mellitus with a wide range of clinical manifestations that require distinct treatment strategies. MODY9 (OMIM # 612225) is a rare type of MODY, caused by a mutation in the Paired box gene 4 (PAX4).Patient ConcernA 19-months boy was admitted to the department of endocrinology at Beijing Children's Hospital due to excessive water drinking, polyuria for over half a month, and wheezing for 3 days.DiagnoseThe whole-exon sequencing analysis demonstrated that the child carried the heterozygous missense mutation of c.487>T in the 7th exon region of PAX4 gene and diagnosed MODY9.InterventionThe patient was treated with fluid therapy, ketosis correction, insulin, and anti-infection treatment.OutcomesAfter 17 days in the hospital, the blood glucose levels remained stable and the patient was discharged.LessonsIn Chinese children, the heterozygous mutation of c.487C>T in the PAX4 gene can lead to the occurrence of MODY9.Gene sequencing analysis is of great significance in the diagnosis and classification of MODY.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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