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A novel FLNA variant in a fetus with skeletal dysplasia. Hum Genome Var 2022; 9:45. [PMID: 36509760 PMCID: PMC9744731 DOI: 10.1038/s41439-022-00224-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 12/14/2022] Open
Abstract
Otopalatodigital spectrum disorder (OPDSD) is characterized by variable phenotypes, including skeletal dysplasia, and is caused by pathogenic variants in filamin A-encoding FLNA. FLNA variants associated with lethal OPDSD primarily alter the CH2 subdomain of the ABD of FLNA. Herein, we report a novel FLNA mutation in a fetus with severe skeletal dysplasia in a pregnant multigravida female with a history of repeated miscarriages and terminations.
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Otopalatodigital Syndrome Type I: Novel Characteristics and Prenatal Manifestations in two Siblings. Balkan J Med Genet 2019; 22:83-88. [PMID: 31942422 PMCID: PMC6956634 DOI: 10.2478/bjmg-2019-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Otopalatodigital spectrum disorder (OPDSD) is rare group of X-linked disorders caused by mutations in the filamin A (FLNA) gene. It is characterized by skeletal dysplasia of variable severity and different extra skeletal manifestations. Its presentation in the fetal period is quite unspecific, so diagnosis is usually made after birth. We present prenatal ultrasonography and postmortem findings that led us to a diagnosis of the mildest form of OPDSD (OPD type I) in two consecutive pregnancies. This is the first report on prenatal diagnosis (PND) of OPD type I. Affected fetuses showed facial dysmorphy (hypertelorism, micrognathia, cleft palate) and digital anomalies, features typical of OPD type I. In addition, microphtalmia and early neonatal death due to severe respiratory distress syndrome are described as a novel characteristics of the disorder. Clinical exome sequencing revealed a hemizygous missense pathogenic variant in the FLNA gene (NM_ 001110556.1: c.620C>T). We suggest that the presence of hypertelorism, micrognathia, digital anomalies on prenatal ultrasound examination should alert suspicion to OPDSD. Detailed clinical examination of mother and other female relatives is of great importance in establishing definitive diagnosis of OPD type I.
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Fernández-Marmiesse A, Pérez-Poyato MS, Fontalba A, Marco de Lucas E, Martínez MT, Cabero Pérez MJ, Couce ML. Septo-optic dysplasia caused by a novel FLNA splice site mutation: a case report. BMC MEDICAL GENETICS 2019; 20:112. [PMID: 31234783 PMCID: PMC6591933 DOI: 10.1186/s12881-019-0844-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 06/05/2019] [Indexed: 12/22/2022]
Abstract
Background Septo-optic dysplasia (SOD), also known as de-Morsier syndrome, is a rare disorder characterized by any combination of optic nerve hypoplasia, pituitary gland hypoplasia, and midline abnormalities of the brain including absence of the septum pellucidum and corpus callosum dysgenesis. The variable presentation of SOD includes visual, neurologic, and/or hypothalamic-pituitary endocrine defects. The unclear aetiology of a large proportion of SOD cases underscores the importance of identifying novel SOD-associated genes. Case presentation To identify the disease-causing gene in a male infant with neonatal hypoglycaemia, dysmorphic features, and hypoplasia of the optic nerve and corpus callosum, we designed a targeted next-generation sequencing panel for brain morphogenesis defects. We identified a novel hemizygous deletion, c.6355 + 4_6355 + 5delAG, in intron 38 of the FLNA gene that the patient had inherited from his mother. cDNA studies showed that this variant results in the production of 3 aberrant FLNA transcripts, the most abundant of which results in retention of intron 38 of FLNA. Conclusions We report for the first time a case of early-onset SOD associated with a mutation in the FLNA gene. This finding broadens the spectrum of genetic causes of this rare disorder and expands the phenotypic spectrum of the FLNA gene.
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Affiliation(s)
- A Fernández-Marmiesse
- Unit for the Diagnosis and Treatment of Congenital Metabolic Diseases, Clinical University Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | - M S Pérez-Poyato
- Pediatric Neurology Unit, Department of Pediatrics, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - A Fontalba
- Department of Genetics, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - E Marco de Lucas
- Department of Radiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - M T Martínez
- Department of Genetics, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - M J Cabero Pérez
- Pediatric Neurology Unit, Department of Pediatrics, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - M L Couce
- Unit for the Diagnosis and Treatment of Congenital Metabolic Diseases, Clinical University Hospital of Santiago de Compostela, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
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Naudion S, Moutton S, Coupry I, Sole G, Deforges J, Guerineau E, Hubert C, Deves S, Pilliod J, Rooryck C, Abel C, Le Breton F, Collardeau-Frachon S, Cordier M, Delezoide A, Goldenberg A, Loget P, Melki J, Odent S, Patrier S, Verloes A, Viot G, Blesson S, Bessières B, Lacombe D, Arveiler B, Goizet C, Fergelot P. Fetal phenotypes in otopalatodigital spectrum disorders. Clin Genet 2015; 89:371-7. [DOI: 10.1111/cge.12679] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/12/2015] [Accepted: 09/21/2015] [Indexed: 11/27/2022]
Affiliation(s)
- S. Naudion
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
| | - S. Moutton
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - I. Coupry
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - G. Sole
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
- CHU Bordeaux; Fédération des Neurosciences Cliniques; Bordeaux France
| | - J. Deforges
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
| | - E. Guerineau
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - C. Hubert
- Plateforme Génome Transcriptome; Centre de Génomique Fonctionnelle de Bordeaux, Université de Bordeaux; Bordeaux France
| | - S. Deves
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
| | - J. Pilliod
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - C. Rooryck
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - C. Abel
- CHU Lyon, Service de Génétique; Hôpital Femme Mère Enfant, Hospices Civils de Lyon; Lyon France
| | - F. Le Breton
- CHU Lyon, Service de Pathologie du Nord; Hôpital de la Croix-Rousse; Lyon France
| | | | - M.P. Cordier
- CHU Lyon, Service de Génétique Médicale; Hôpital Mère Enfant; Lyon France
| | - A.L. Delezoide
- APHP, Service de Biologie du Développement; Hôpital Robert Debré; Paris France
| | - A. Goldenberg
- CHU Rouen; Service de Génétique Médicale; Rouen France
| | - P. Loget
- CHU Rennes; Service d'Anatomie Cytologie Pathologique; Rennes France
| | - J. Melki
- INSERM U78, Laboratoire de Neurogénétique Moléculaire; Université de Paris XI; Paris France
| | - S. Odent
- CHU de Rennes, Service de Génétique Clinique; Centre de Référence Anomalies du Développement CLAD-Ouest, Hôpital Sud; Rennes France
| | - S. Patrier
- CHU Rouen; Service d'Anatomie Pathologique; Rouen France
| | - A. Verloes
- Département de Génétique, APHP-Hôpital universitaire Robert Debré; Université Sorbonne Paris-Cité, Faculté de Médecine Denis Diderot-Paris 7, and INSERM UMR 1141; Paris France
| | - G. Viot
- APHP, Service de Génétique Médicale; Maternité Port-Royal; Paris France
| | - S. Blesson
- CHRU Tours, Service de Génétique; Hôpital Bretonneau; Tours France
| | - B. Bessières
- APHP, Service Histo-Embryologie et Cytogénétique; Hôpital Necker; Paris France
| | - D. Lacombe
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - B. Arveiler
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - C. Goizet
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
| | - P. Fergelot
- CHU Bordeaux, Centre de Référence des Anomalies du Développement Embryonnaire; Service de Génétique Médicale; Bordeaux France
- University Bordeaux, Laboratoire Maladies Rares; Génétique et Métabolisme (MRGM); Bordeaux France
- Plateforme Génome Transcriptome; Centre de Génomique Fonctionnelle de Bordeaux, Université de Bordeaux; Bordeaux France
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Basart H, van de Kar A, Adès L, Cho TJ, Carter E, Maas SM, Wilson LC, van der Horst CMAM, Wade EM, Robertson SP, Hennekam RC. Frontometaphyseal dysplasia and keloid formation without FLNA mutations. Am J Med Genet A 2015; 167:1215-22. [PMID: 25899317 DOI: 10.1002/ajmg.a.37044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 02/16/2015] [Indexed: 11/11/2022]
Abstract
Frontometaphyseal dysplasia (FMD) is a distinctive sclerosing skeletal dysplasia associated with a number of non-skeletal manifestations including hearing loss, cardiac malformations, and stenosis, particularly of the upper airway and urinary tract. Some, but not all, patients have mutations in FLNA causing the condition. Consonant with the X chromosomal location of FLNA males are generally more severely affected than females. FLNA mutations can be detected in 82% of affected males. We describe seven patients (one male, six females) all of whom have the major clinical and radiological features of FMD, but without detectable mutations in FLNA. The females in our cohort are affected to a similar degree as is usually found in males. In addition, all patients have marked keloid formation at various body sites, including the eye, from an early age. Other features that may indicate a different etiology in these patients are the increased frequency of cleft palate, Robin sequence, tracheal stenosis, and mild intellectual disability, which all occur in three of more patients in the present group. All patients are isolated. We hypothesize that the presently reported patients represent further evidence that phenotypes strongly resembling FMD exist that are not accounted for by mutations in FLNA. Since the frequency of several of the manifestations, their sporadic presentations, and the presence of keloid formation differ from the X-linked form of this condition we propose de novo autosomal dominant acting mutations in a gene functionally related to FLNA, underpin this disorder.
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Affiliation(s)
- Hanneke Basart
- Department of Pediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Plastic and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Annekatrien van de Kar
- Department of Plastic and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lesley Adès
- Discipline of Pediatrics and Child Health, Department of Clinical Genetics, University of Sydney, The Children's Hospital, Westmead, Sydney, Australia
| | - Tae-Joon Cho
- Division of Pediatric Orthopedics, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Erin Carter
- Kathryn O. and Alan C. Greenberg Center for Skeletal Dysplasias, Hospital for Special Surgery, New York, New York
| | - Saskia M Maas
- Department of Pediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Louise C Wilson
- Clinical Genetics Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Chantal M A M van der Horst
- Department of Plastic and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Emma M Wade
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Stephen P Robertson
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Raoul C Hennekam
- Department of Pediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Genetics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Terminal osseous dysplasia is caused by a single recurrent mutation in the FLNA gene. Am J Hum Genet 2010; 87:146-53. [PMID: 20598277 DOI: 10.1016/j.ajhg.2010.06.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 05/31/2010] [Accepted: 06/11/2010] [Indexed: 12/29/2022] Open
Abstract
Terminal osseous dysplasia (TOD) is an X-linked dominant male-lethal disease characterized by skeletal dysplasia of the limbs, pigmentary defects of the skin, and recurrent digital fibroma with onset in female infancy. After performing X-exome capture and sequencing, we identified a mutation at the last nucleotide of exon 31 of the FLNA gene as the most likely cause of the disease. The variant c.5217G>A was found in six unrelated cases (three families and three sporadic cases) and was not found in 400 control X chromosomes, pilot data from the 1000 Genomes Project, or the FLNA gene variant database. In the families, the variant segregated with the disease, and it was transmitted four times from a mildly affected mother to a more seriously affected daughter. We show that, because of nonrandom X chromosome inactivation, the mutant allele was not expressed in patient fibroblasts. RNA expression of the mutant allele was detected only in cultured fibroma cells obtained from 15-year-old surgically removed material. The variant activates a cryptic splice site, removing the last 48 nucleotides from exon 31. At the protein level, this results in a loss of 16 amino acids (p.Val1724_Thr1739del), predicted to remove a sequence at the surface of filamin repeat 15. Our data show that TOD is caused by this single recurrent mutation in the FLNA gene.
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