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Muurinen M, Taylan F, Tournis S, Eisfeldt J, Balanika A, Vastardis H, Ala‐Mello S, Mäkitie O, Costantini A. Mosaic deletions of known genes explain skeletal dysplasias with high and low bone mass. JBMR Plus 2022; 6:e10660. [PMID: 35991531 PMCID: PMC9382864 DOI: 10.1002/jbm4.10660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/19/2022] [Accepted: 06/03/2022] [Indexed: 11/27/2022] Open
Abstract
Mosaicism, a state in which an individual has two or more genetically distinct populations of cells in the body, can be difficult to detect because of either mild or atypical clinical presentation and limitations in the commonly used detection methods. Knowledge of the role of mosaicism is limited in many skeletal disorders, including osteopathia striata with cranial sclerosis (OSCS) and cleidocranial dysplasia (CCD). We used whole‐genome sequencing (WGS) with coverage >40× to identify the genetic causes of disease in two clinically diagnosed patients. In a female patient with OSCS, we identified a mosaic 7‐nucleotide frameshift deletion in exon 2 of AMER1, NM_152424.4:c.855_861del:p.(His285Glnfs*7), affecting 8.3% of the WGS reads. In a male patient with CCD, approximately 34% of the WGS reads harbored a 3710‐basepair mosaic deletion, NC_000006.11:g.45514471_45518181del, starting in intron 8 of RUNX2 and terminating in the 3′ untranslated region. Droplet digital polymerase chain reaction was used to validate these deletions and quantify the absolute level of mosaicism in each patient. Although constitutional variants in AMER1 and RUNX2 are a known cause of OSCS and CCD, respectively, the mosaic changes here reported have not been described previously. Our study indicates that mosaicism should be considered in unsolved cases of skeletal dysplasia and should be investigated with comprehensive and sensitive detection methods. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Mari Muurinen
- Research Program for Clinical and Molecular Metabolism University of Helsinki Helsinki Finland
- Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
- Folkhälsan Research Center Helsinki Finland
| | - Fulya Taylan
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden
- Department of Clinical Genetics Karolinska University Hospital Stockholm Sweden
| | - Symeon Tournis
- Laboratory for the Research of Musculoskeletal System "Th. Garofalidis," Medical School National and Kapodistrian University of Athens, KAT Hospital Greece
| | - Jesper Eisfeldt
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden
- Department of Clinical Genetics Karolinska University Hospital Stockholm Sweden
| | - Alexia Balanika
- Department of Computed Tomography Asklepeion Voulas Hospital Athens Greece
| | - Heleni Vastardis
- Department of Orthodontics School of Dentistry, National and Kapodistrian University of Athens Athens Greece
| | - Sirpa Ala‐Mello
- Department of Clinical Genetics Helsinki University Hospital Helsinki Finland
| | - Outi Mäkitie
- Research Program for Clinical and Molecular Metabolism University of Helsinki Helsinki Finland
- Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland
- Folkhälsan Research Center Helsinki Finland
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden
- Department of Clinical Genetics Karolinska University Hospital Stockholm Sweden
| | - Alice Costantini
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden
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Heikoop D, Brick L, Chitayat D, Colaiacovo S, Dupuis L, Faghfoury H, Goobie S, Mendoza R, Napier M, Nowaczyk M, Oh R, Silver J, Prasad C, Saleh M. The phenotypic spectrum of AMER1-related osteopathia striata with cranial sclerosis: The first Canadian cohort. Am J Med Genet A 2021; 185:3793-3803. [PMID: 34414661 DOI: 10.1002/ajmg.a.62452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/10/2022]
Abstract
Osteopathia striata with cranial sclerosis (OSCS; OMIM# 300373) is a rare X-linked disorder caused by mutations of the AMER1 gene. OSCS is traditionally considered a skeletal dysplasia, characterized by cranial sclerosis and longitudinal striations in the long bone metaphyses. However, OSCS affects many body systems and varies significantly in phenotypic severity between individuals. This case series focuses on the phenotypic presentation and development of individuals with OSCS. We provide an account of 12 patients with OSCS, ranging from 5 months to 38 years of age. These patients were diagnosed with OSCS after genetic testing confirmed pathogenic mutations in AMER1. Patient consent was obtained for photos and participation. Data were collected regarding perinatal history, dysmorphic features, and review of systems. This case series documents common facial dysmorphology, as well as rare extraskeletal features of OSCS, including two patients with intestinal malrotation and two patients with pyloric stenosis. We share four apparently nonmosaic males with OSCS (one de novo and three maternal variants). We also provide a clinical update on a patient who was previously published by Chénier et al. (2012). American Journal of Medical Genetics Part A, 158, 2946-2952. More research is needed to investigate the links between genotype and phenotype and assess the long-term comorbidities and overall quality of life of individuals with OSCS.
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Affiliation(s)
- David Heikoop
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Lauren Brick
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - David Chitayat
- Division of Clinical and Metabolic Genetics, Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada.,The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Samantha Colaiacovo
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Lucie Dupuis
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Hanna Faghfoury
- Division of Clinical and Metabolic Genetics, Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Sharan Goobie
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, IWK Hospital, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Roberto Mendoza
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Napier
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Margaret Nowaczyk
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Rachel Oh
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Josh Silver
- Division of Clinical and Metabolic Genetics, Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Chitra Prasad
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Maha Saleh
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada
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Hague J, Delon I, Brugger K, Martin H, Sparnon L, Simonic I, Abbs S, Park SM. Male child with somatic mosaic Osteopathia Striata with Cranial Sclerosis caused by a novel pathogenic AMER1 frameshift mutation. Am J Med Genet A 2017; 173:1931-1935. [PMID: 28497491 DOI: 10.1002/ajmg.a.38261] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/06/2017] [Accepted: 03/27/2017] [Indexed: 11/08/2022]
Abstract
Osteopathia striata with cranial sclerosis (OSCS; OMIM #300373) is a rare X-linked dominant condition caused by mutations in the AMER1 gene (also known as WTX or FAM123B). It is a condition which usually affects females in whom the clinical phenotype can be extremely variable. Conversely affected males typically die in utero or during the neonatal period [Perdu et al. (); Clinical Genetics 80: 383-388; Vasiljevic et al. (); Prenatal Diagnosis 35: 302-304]. There have been a small number of reported cases of surviving males, including three patients who are somatic mosaic for the condition [Chénier, Noor, Dupuis, Stavropoulos, & Mendoza-Londono, (); American Journal of Medical Genetics Part A 158A: 2946-2952; Holman et al. (); American Journal of Medical Genetics Part A 155A: 2397-2408; Joseph, Shoji, & Econs, (); The Journal of Clinical Endocrinology and Metabolism 95: 1506-1507]. We report a case of a male child who has proven somatic mosaicism for OSCS associated with a novel pathogenic frameshift mutation, c.607_611delAGGCC (p.Arg203 fs) in AMER1. We describe the multisystemic clinical features which include macrocephaly with ventriculomegaly and requirement for ventriculoperitoneal shunt, cleft palate, and respiratory difficulties after birth requiring tracheostomy insertion, persistent patent ductus arteriosus, failure to thrive and gastrostomy insertion, growth retardation, ophthalmoplegia, kidney malformation, cryptorchidism, and developmental delay. The use of new technologies with next generation sequencing (NGS) may improve the detection rate of mosaicism in rare conditions.
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Affiliation(s)
- Jennifer Hague
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Isabelle Delon
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kim Brugger
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Howard Martin
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Leanne Sparnon
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ingrid Simonic
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Stephen Abbs
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Soo-Mi Park
- Department of Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Sclerosteosis (craniotubular hyperostosis-syndactyly) with complex hyperphalangy of the index finger. Pediatr Radiol 2015; 45:1239-43. [PMID: 25835322 DOI: 10.1007/s00247-015-3292-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/16/2014] [Accepted: 01/21/2015] [Indexed: 10/23/2022]
Abstract
We report a 4-year-old boy with sclerosteosis associated with severe digital dysostosis. The initial medical consultation was prompted by bilateral, asymmetrical syndactyly of the index and middle fingers. The left index finger had complicated phalangeal anomalies: hyperphalangy (supernumerary phalanx distal to the middle phalanx) and hypoplasia with bracket epiphyses of the proximal and middle phalanges. Development of facial nerve palsy, hearing impairment and generalized osteosclerosis had occurred between 3 years and 4 years of age, with the subsequent identification of a homozygous SOST mutation. Bilateral second and third fingers syndactyly associated with abnormal patterning of the same fingers should be considered prodromal signs of sclerosteosis.
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Cattaneo E, Ciceri S, Liberati N, Radice P, Tarani L, Selicorni A, Perotti D. Osteopathia striata with cranial sclerosis, Wilms’ tumor and the WTX gene. World J Med Genet 2014; 4:34-38. [DOI: 10.5496/wjmg.v4.i2.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 02/10/2014] [Accepted: 02/18/2014] [Indexed: 02/06/2023] Open
Abstract
Osteopathia striata with cranial sclerosis (OSCS, OMIM#300373) is an X-linked dominant sclerosing bone dysplasia that shows a distinct phenotype in females and males. In 2009, Zandra Jenkins et al found that germline mutations in the FAM123B/WTX/AMER1 gene, mapped to chromosome Xq11.2, cause both the familial and sporadic forms of OSCS. Intriguingly, the WTX gene was already known as a putative tumor suppressor gene, since in 2007 Rivera et al had reported inactivating WTX mutations in Wilms’ tumor (WT), the most frequent renal tumor of childhood. Here we review the heterogeneous clinical presentation of OSCS patients and the involvement of WTX anomalies in OSCS and in WT.
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Waterval JJ, Borra VM, Van Hul W, Stokroos RJ, Manni JJ. Sclerosing bone dysplasias with involvement of the craniofacial skeleton. Bone 2014; 60:48-67. [PMID: 24325978 DOI: 10.1016/j.bone.2013.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 11/25/2013] [Accepted: 12/02/2013] [Indexed: 01/13/2023]
Abstract
In this review we provide a complete overview of the existing sclerosing bone dysplasias with craniofacial involvement. Clinical presentation, disease course, the craniofacial symptoms, genetic transmission pattern and pathophysiology are discussed. There is an emphasis on radiologic features with a large collection of CT and MRI images. In previous reviews the craniofacial area of the sclerosing bone dysplasias was underexposed. However, craniofacial symptoms are often the first symptoms to address a physician. The embryology of the skull and skull base is explained and illustrated for a better understanding of the affected areas.
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Affiliation(s)
- J J Waterval
- Department of Otorhinolaryngology-Head & Neck Surgery, Maastricht University Medical Center, P.O. 5800, 6202AZ Maastricht, The Netherlands.
| | - V M Borra
- Department of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, B-2650 Edegem, Belgium.
| | - W Van Hul
- Department of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, B-2650 Edegem, Belgium.
| | - R J Stokroos
- Department of Otorhinolaryngology-Head & Neck Surgery, Maastricht University Medical Center, P.O. 5800, 6202AZ Maastricht, The Netherlands.
| | - J J Manni
- Department of Otorhinolaryngology-Head & Neck Surgery, Maastricht University Medical Center, P.O. 5800, 6202AZ Maastricht, The Netherlands.
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