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Ryan MV, Alvarez R, Elias ER, Ihekweazu C, Wilkinson CC. Management of Pediatric Patient with Multiple Cranial, Intracranial, and Spinal Manifestations of Penttinen Syndrome: A Case Report. Pediatr Neurosurg 2024:1-8. [PMID: 39134002 DOI: 10.1159/000540756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024]
Abstract
INTRODUCTION Penttinen premature aging syndrome is caused by mutations in the PDGFRB gene. We describe the case of a 10-year-old girl with a de novo c.1994T>C variant in PDGFRB who developed multiple cranial, intracranial, and spinal manifestations, including macrocephaly, enlarged convexity subarachnoid spaces crossed by numerous vascularized arachnoid trabecule, hydrocephalus, spinal epidural lipomatosis, a low conus medullaris, calvarial thinning with large anterior fontanelle, and a skull fracture with bilateral epidural hematomas. Vascularized arachnoid granulations, spinal epidural lipomatosis, and low conus medullaris have not been previously described in Penttinen syndrome. CASE PRESENTATION A female with Penttinen syndrome diagnosed at 9 years of age initially presented as an infant with cutaneous hemangiomas and macrocephaly; imaging showed enlarged convexity subarachnoid spaces. Her convexity subarachnoid spaces continued to expand, leading to subdural shunt placement. At surgery, her enlarged subarachnoid spaces were found to contain numerous abnormally thick, vascularized arachnoid trabecule. Eventually, her subdural shunt failed and her ventricles enlarged, leading to ventricular shunt placement. A large, sunken anterior fontanelle which did not diminish in size led to cranioplasty with a custom implant. She later developed chronic back pain and imaging revealed spinal epidural lipomatosis, a low conus medullaris, and mild scoliosis. At 10 years of age, a fall from a chair resulted in a depressed skull fracture and bilateral parietal epidural hematomas. Emergency left parietal craniotomy was performed for evacuation of the left hematoma, and the patient recovered without complications. Intraoperatively, it was noted that her skull was extremely thin. CONCLUSION This case report highlights the clinical presentation and multifaceted neurosurgical management of a patient with Penttinen syndrome. The patient exhibited characteristic features including hypertrophic skin lesions, macrocephaly, and skeletal abnormalities. Our patient's vascularized arachnoid trabecule, spinal epidural lipomatosis, and low conus medullaris have not previously been reported in Penttinen syndrome. Her thin skull potentially contributed to the extent of her depressed skull fracture after her backwards fall and predisposed her toward developing epidural hematomas. Patients with Penttinen syndrome can have multiple cranial, intracranial, and spinal manifestations which may need the attention of a neurosurgeon.
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Affiliation(s)
- Megan V Ryan
- Division of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado, USA
- College of Osteopathic Medicine, Rocky Vista University, Parker, Colorado, USA
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Reinier Alvarez
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ellen R Elias
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Chinonye Ihekweazu
- Division of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - C Corbett Wilkinson
- Division of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Ben H, Liu X, Zhang P, Hong J. Progressive conjunctival invasion of cornea in a child with Warburg-Cinotti Syndrome: a case report. BMC Ophthalmol 2024; 24:322. [PMID: 39095787 PMCID: PMC11295642 DOI: 10.1186/s12886-024-03596-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Warburg-Cinotti syndrome is a rare syndrome caused by de novo or inherited variants in discoding domain receptor tyrosine kinase 2 (DDR2). Only six cases have been reported worldwide and our knowledge of this disease remained sparse especially from an ophthalmological perspective, since previous literature mostly focused on systemic malformations or genetics. CASE PRESENTATION A seven-year-old boy developed a gelatinous vascularized conjunctiva-like mass secondary to trauma. The mass enlarged and gradually invaded the cornea. With each surgical intervention, the mass recurred and grew even larger rapidly. The patient ended up with the mass covering the entire cornea along with symblepharon formation. Whole exome sequencing revealed a hemizygous variant in the DDR2 gene, which is consistent with Warburg-Cinotti syndrome. CONCLUSIONS Considering Warburg-Cinotti syndrome, we should be vigilant of patients exhibiting progressive conjunctival invasion of the cornea, even those without systemic manifestations or a positive family history.
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Affiliation(s)
- Hanzhi Ben
- Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, China
| | - Xiaozhen Liu
- Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, China
| | - Pei Zhang
- Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, China
| | - Jing Hong
- Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, China.
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3
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Howaldt A, Lenglez S, Velmans C, Schultheis AM, Clahsen T, Matthaei M, Kohlhase J, Vokuhl C, Büttner R, Netzer C, Demoulin JB, Cursiefen C. Corneal Infantile Myofibromatosis Caused by Novel Activating Imatinib-Responsive Variants in PDGFRB. OPHTHALMOLOGY SCIENCE 2024; 4:100444. [PMID: 38374928 PMCID: PMC10875226 DOI: 10.1016/j.xops.2023.100444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 02/21/2024]
Abstract
Purpose To investigate the genetic cause, clinical characteristics, and potential therapeutic targets of infantile corneal myofibromatosis. Design Case series with genetic and functional in vitro analyses. Participants Four individuals from 2 unrelated families with clinical signs of corneal myofibromatosis were investigated. Methods Exome-based panel sequencing for platelet-derived growth factor receptor beta gene (PDGFRB) and notch homolog protein 3 gene (NOTCH3) was performed in the respective index patients. One clinically affected member of each family was tested for the pathogenic variant detected in the respective index by Sanger sequencing. Immunohistochemical staining on excised corneal tissue was conducted. Functional analysis of the individual PDGFRB variants was performed in vitro by luciferase reporter assays on transfected porcine aortic endothelial cells using tyrosine kinase inhibitors. Protein expression analysis of mutated PDGFRB was analyzed by Western blot. Main Outcome Measures Sequencing data, immunohistochemical stainings, functional analysis of PDGFRB variants, and protein expression analysis. Results We identified 2 novel, heterozygous gain-of-function variants in PDGFRB in 4 individuals from 2 unrelated families with corneal myofibromatosis. Immunohistochemistry demonstrated positivity for alpha-smooth muscle actin and β-catenin, a low proliferation rate in Ki-67 (< 5%), marginal positivity for Desmin, and negative staining for Caldesmon and CD34. In all patients, recurrence of disease occurred after corneal surgery. When transfected in cultured cells, the PDGFRB variants conferred a constitutive activity to the receptor in the absence of its ligand and were sensitive to the tyrosine kinase inhibitor imatinib. The variants can both be classified as likely pathogenic regarding the American College of Medical Genetics and Genomics classification criteria. Conclusions We describe 4 cases of corneal myofibromatosis caused by novel PDGFRB variants with autosomal dominant transmission. Imatinib sensitivity in vitro suggests perspectives for targeted therapy preventing recurrences in the future. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Antonia Howaldt
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | | | - Clara Velmans
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Thomas Clahsen
- Department of Ophthalmology, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mario Matthaei
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Jürgen Kohlhase
- Center for Human Genetics, SYNLAB MVZ Humangenetik Freiburg GmbH, Freiburg, Germany
| | | | | | - Christian Netzer
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Claus Cursiefen
- Department of Ophthalmology, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Worm C, Schambye MER, Mkrtchyan GV, Veviorskiy A, Shneyderman A, Ozerov IV, Zhavoronkov A, Bakula D, Scheibye-Knudsen M. Defining the progeria phenome. Aging (Albany NY) 2024; 16:2026-2046. [PMID: 38345566 PMCID: PMC10911340 DOI: 10.18632/aging.205537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/17/2023] [Indexed: 02/22/2024]
Abstract
Progeroid disorders are a heterogenous group of rare and complex hereditary syndromes presenting with pleiotropic phenotypes associated with normal aging. Due to the large variation in clinical presentation the diseases pose a diagnostic challenge for clinicians which consequently restricts medical research. To accommodate the challenge, we compiled a list of known progeroid syndromes and calculated the mean prevalence of their associated phenotypes, defining what we term the 'progeria phenome'. The data were used to train a support vector machine that is available at https://www.mitodb.com and able to classify progerias based on phenotypes. Furthermore, this allowed us to investigate the correlation of progeroid syndromes and syndromes with various pathogenesis using hierarchical clustering algorithms and disease networks. We detected that ataxia-telangiectasia like disorder 2, spastic paraplegia 49 and Meier-Gorlin syndrome display strong association to progeroid syndromes, thereby implying that the syndromes are previously unrecognized progerias. In conclusion, our study has provided tools to evaluate the likelihood of a syndrome or patient being progeroid. This is a considerable step forward in our understanding of what constitutes a premature aging disorder and how to diagnose them.
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Affiliation(s)
- Cecilie Worm
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Denmark
| | | | - Garik V. Mkrtchyan
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Denmark
| | - Alexander Veviorskiy
- Insilico Medicine AI Limited, Level 6, Unit 08, Block A, IRENA HQ Building, Masdar City, Abu Dhabi, UAE
| | | | - Ivan V. Ozerov
- Insilico Medicine Hong Kong Limited, Science Park West Avenue, Hong Kong, China
| | - Alex Zhavoronkov
- Insilico Medicine AI Limited, Level 6, Unit 08, Block A, IRENA HQ Building, Masdar City, Abu Dhabi, UAE
- Insilico Medicine Hong Kong Limited, Science Park West Avenue, Hong Kong, China
| | - Daniela Bakula
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Denmark
| | - Morten Scheibye-Knudsen
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Denmark
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Iznardo H, Bredrup C, Bernal S, Gladkauskas T, Mascaró JM, Roé E, Baselga E. Clinical and molecular response to dasatinib in an adult patient with Penttinen syndrome. Am J Med Genet A 2021; 188:1233-1238. [PMID: 34894066 DOI: 10.1002/ajmg.a.62603] [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: 07/16/2021] [Revised: 10/08/2021] [Accepted: 11/28/2021] [Indexed: 11/12/2022]
Abstract
Penttinen type of premature aging syndrome is an autosomal-dominant disorder that can be caused by the c.1994T>A pVal665Ala pathogenic variant in platelet-derived growth factor receptor-B (PDGFRB). Imatinib, a receptor tyrosine kinase (RTK) inhibitor, has been used in Penttinen syndrome (PS) patients with good results. A 21-year-old male presented shortly after birth with a prematurely aged appearance with distinctive facial features and cutaneous atrophy with hypertrophic scar-like lesions. Generalized brachydactyly with acro-osteolysis was observed. Flexion contractures limited his daily activities. Cognitive impairment was not present. Genetic testing found a heterozygous variant c.1994T>A pVal665Ala in exon 14 of PDGFRB. A diagnosis of PS was made and imatinib treatment was started with partial response. After lack of further improvement, in vitro molecular studies with imatinib and dasatinib showed that the Val665Ala variant had greater sensitivity to dasatinib than imatinib. This was seen examining levels of P-PDGFRB directly and on downstream ligands P-AKT and P-STAT. Improved clinical response was observed after treatment with dasatinib. We report a new case of PS with clinical and molecular response to dasatinib after incomplete response to imatinib. Our work provides further molecular and clinical evidence of RTK inhibitors' efficacy in this rare disorder.
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Affiliation(s)
- Helena Iznardo
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cecilie Bredrup
- Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Sara Bernal
- Genetics Department and Sant Pau Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705). IICS-Madrid, Spain
| | - Titas Gladkauskas
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - José-Manuel Mascaró
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Esther Roé
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eulalia Baselga
- Department of Dermatology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
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Aggarwal B, Correa ARE, Gupta N, Jana M, Kabra M. First case report of Penttinen syndrome from India. Am J Med Genet A 2021; 188:683-687. [PMID: 34799960 DOI: 10.1002/ajmg.a.62558] [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: 05/30/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 11/09/2022]
Abstract
Penttinen type of premature aging syndrome is an extremely rare progeroid disorder, caused by activating variants in the receptor tyrosine kinase domain of the PDGFRB gene. Only eight individuals have been previously reported worldwide, with a consistent phenotype of prematurely aged appearance, lipoatrophy, hypertrophic skin lesions, proptosis, malar hypoplasia, and marked acro-osteolysis. We report the first patient of Penttinen syndrome from India, with novel radiographic findings of terminal phalangeal tufting, thereby expanding the phenotypic spectrum of Penttinen syndrome.
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Affiliation(s)
- Bhawana Aggarwal
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Alec R E Correa
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Madhulika Kabra
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Limenis E, Stimec J, Kannu P, Laxer RM. Lost bones: differential diagnosis of acro-osteolysis seen by the pediatric rheumatologist. Pediatr Rheumatol Online J 2021; 19:113. [PMID: 34261502 PMCID: PMC8278612 DOI: 10.1186/s12969-021-00596-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Acro-osteolysis is a radiographic finding which refers to bone resorption of the distal phalanges. Acro-osteolysis is associated with various conditions and its presence should prompt the clinician to search for the underlying etiology. The aim of this review is to discuss disorders with which acro-osteolysis is associated and their distinguishing features, with a focus on the pediatric population. METHODS A targeted literature review was performed using the term "acro-osteolysis" in combination with other key terms. The primary search results were supplemented using reference citations. Articles published prior to the year 2000 were included if they described additional associations not encountered in the more recent literature. RESULTS Genetic disorders (particularly primary hypertrophic osteoarthropathy and skeletal dysplasias) and rheumatic diseases (particularly psoriatic arthritis and systemic sclerosis) are the most frequently encountered conditions associated with acro-osteolysis in children. Hyperparathyroidism, neuropathy, local trauma and thermal injury, and spinal dysraphism should also be included in the differential diagnosis. CONCLUSION Although acro-osteolysis is uncommon, its presence should prompt the clinician to consider a differential diagnosis based on clinical and radiographic features.
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Affiliation(s)
- Elizaveta Limenis
- Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
| | - Jennifer Stimec
- grid.42327.300000 0004 0473 9646Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Peter Kannu
- grid.42327.300000 0004 0473 9646Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Ronald M. Laxer
- grid.42327.300000 0004 0473 9646Division of Rheumatology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
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Guérit E, Arts F, Dachy G, Boulouadnine B, Demoulin JB. PDGF receptor mutations in human diseases. Cell Mol Life Sci 2021; 78:3867-3881. [PMID: 33449152 PMCID: PMC11072557 DOI: 10.1007/s00018-020-03753-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
PDGFRA and PDGFRB are classical proto-oncogenes that encode receptor tyrosine kinases responding to platelet-derived growth factor (PDGF). PDGFRA mutations are found in gastrointestinal stromal tumors (GISTs), inflammatory fibroid polyps and gliomas, and PDGFRB mutations drive myofibroma development. In addition, chromosomal rearrangement of either gene causes myeloid neoplasms associated with hypereosinophilia. Recently, mutations in PDGFRB were linked to several noncancerous diseases. Germline heterozygous variants that reduce receptor activity have been identified in primary familial brain calcification, whereas gain-of-function mutants are present in patients with fusiform aneurysms, Kosaki overgrowth syndrome or Penttinen premature aging syndrome. Functional analysis of these variants has led to the preclinical validation of tyrosine kinase inhibitors targeting PDGF receptors, such as imatinib, as a treatment for some of these conditions. This review summarizes the rapidly expanding knowledge in this field.
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Affiliation(s)
- Emilie Guérit
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Florence Arts
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Guillaume Dachy
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Boutaina Boulouadnine
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Jean-Baptiste Demoulin
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium.
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Chenbhanich J, Hu Y, Hetts S, Cooke D, Dowd C, Devine P, Russell B, Kang SHL, Chang VY, Abla AA, Cornett P, Yeh I, Lee H, Martinez-Agosto JA, Frieden IJ, Shieh JT. Segmental overgrowth and aneurysms due to mosaic PDGFRB p.(Tyr562Cys). Am J Med Genet A 2021; 185:1430-1436. [PMID: 33683022 DOI: 10.1002/ajmg.a.62126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/18/2020] [Accepted: 01/14/2021] [Indexed: 01/19/2023]
Abstract
Activating variants in the platelet-derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome. A recently described phenotype with fusiform aneurysm has been associated with mosaic PDGFRB c.1685A > G p.(Tyr562Cys) variant. Few reports however have examined the vascular phenotypes and mosaic effects of PDGFRB variants. We describe clinical characteristics of two patients with a recurrent mosaic PDGFRB p.(Tyr562Cys) variant identified via next-generation sequencing-based genetic testing. We observed intracranial fusiform aneurysm in one patient and found an additional eight patients with aneurysms and phenotypes associated with PDGFRB-activating variants through literature search. The conditions caused by PDGFRB-activating variants share overlapping features including overgrowth, premature aged skin, and vascular malformations including aneurysms. Aneurysms are progressive and can result in morbidities and mortalities in the absence of successful intervention. Germline and/or somatic testing for PDGFRB gene should be obtained when PDGFRB activating variant-related phenotypes are present. Whole-body imaging of the arterial tree and echocardiography are recommended after diagnosis. Repeating the imaging study within a 6- to 12-month period after detection is reasonable. Finally, further evaluation for the effectiveness and safety profile of kinase inhibitors in this patient population is warranted.
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Affiliation(s)
- Jirat Chenbhanich
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Yan Hu
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Steven Hetts
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Daniel Cooke
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Christopher Dowd
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Patrick Devine
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, California, USA.,Institute of Human Genetics, University of California, San Francisco, California, USA
| | | | - Bianca Russell
- Department of Pediatrics, Division of Medical Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Sung Hae L Kang
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Vivian Y Chang
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University of California Los Angeles, Los Angeles, California, USA
| | - Adib A Abla
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Patricia Cornett
- Department of Hematology and Oncology, University of California, San Francisco, California, USA
| | - Iwei Yeh
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, California, USA.,Department of Dermatology, University of California, San Francisco, California, USA
| | - Hane Lee
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Human Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Julian A Martinez-Agosto
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Human Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Ilona J Frieden
- Department of Dermatology, University of California, San Francisco, California, USA
| | - Joseph T Shieh
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, California, USA.,Institute of Human Genetics, University of California, San Francisco, California, USA
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Takenouchi T, Kodo K, Yamazaki F, Nakatomi H, Kosaki K. Progressive cerebral and coronary aneurysms in the original two patients with Kosaki overgrowth syndrome. Am J Med Genet A 2020; 185:999-1003. [PMID: 33382209 DOI: 10.1002/ajmg.a.62027] [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: 08/01/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 11/06/2022]
Abstract
Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet-derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592). Emerging evidence suggests a role of PDGFRB in the genesis of cerebral aneurysms. The delineation of the range and progression of the vascular phenotype of Kosaki overgrowth syndrome is urgently needed. Herein, we conducted subsequent analyses of serial neurovascular imaging studies of two original patients with a de novo heterozygous mutation in PDGFRB, that is, p.Pro584Arg. The analysis showed the progressive dilation of basilar and vertebral arteries and coronary arteries commencing during the teenage years and early 20s. The radiographic appearance of the basilar vertebral aneurysms showed signs of arterial wall dilation, compatible with the known vascular pathology of vascular-type Ehlers-Danlos syndrome and Loeys-Dietz syndrome. The dolichoectasia in cerebrovascular arteries can lead to fatal complications, even with neurosurgical interventions. To prevent the progression of artery dilation, preventative and therapeutic medical measures using tyrosine kinase inhibitors may be necessary in addition to optimal control of the systemic blood pressure. Kosaki overgrowth syndrome is a clinically recognizable syndrome that can exhibit progressive dilatory and tortuous vascular changes in basilar/vertebral and coronary arteries as early as in the teenage years. We recommend careful counseling regarding the risk of future vascular complications, optimal blood pressure control, and regular systemic vascular screening during follow-up examinations.
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Affiliation(s)
- Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kazuki Kodo
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Fumito Yamazaki
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hirofumi Nakatomi
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
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11
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Schnabel F, Kornak U, Wollnik B. Premature aging disorders: A clinical and genetic compendium. Clin Genet 2020; 99:3-28. [PMID: 32860237 DOI: 10.1111/cge.13837] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/22/2022]
Abstract
Progeroid disorders make up a heterogeneous group of very rare hereditary diseases characterized by clinical signs that often mimic physiological aging in a premature manner. Apart from Hutchinson-Gilford progeria syndrome, one of the best-investigated progeroid disorders, a wide spectrum of other premature aging phenotypes exist, which differ significantly in their clinical presentation and molecular pathogenesis. Next-generation sequencing (NGS)-based approaches have made it feasible to determine the molecular diagnosis in the early stages of a disease. Nevertheless, a broad clinical knowledge on these disorders and their associated symptoms is still fundamental for a comprehensive patient management and for the interpretation of variants of unknown significance from NGS data sets. This review provides a detailed overview on characteristic clinical features and underlying molecular genetics of well-known as well as only recently identified premature aging disorders and also highlights novel findings towards future therapeutic options.
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Affiliation(s)
- Franziska Schnabel
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Uwe Kornak
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Bernd Wollnik
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany.,Cluster of Excellence "Multiscale Bioimaging: From Molecular Machines to Networks of Excitable cells" (MBExC), University of Göttingen, Göttingen, Germany
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12
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Wenger TL, Bly RA, Wu N, Albert CM, Park J, Shieh J, Chenbhanich J, Heike CL, Adam MP, Chang I, Sun A, Miller DE, Beck AE, Gupta D, Boos MD, Zackai EH, Everman D, Ganapathi S, Wilson M, Christodoulou J, Zarate YA, Curry C, Li D, Guimier A, Amiel J, Hakonarson H, Webster R, Bhoj EJ, Perkins JA, Dahl JP, Dobyns WB. Activating variants in PDGFRB result in a spectrum of disorders responsive to imatinib monotherapy. Am J Med Genet A 2020; 182:1576-1591. [PMID: 32500973 DOI: 10.1002/ajmg.a.61615] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/25/2020] [Accepted: 04/20/2020] [Indexed: 11/09/2022]
Abstract
More than 50 individuals with activating variants in the receptor tyrosine kinase PDGFRB have been reported, separated based on clinical features into solitary myofibromas, infantile myofibromatosis, Penttinen syndrome with premature aging and osteopenia, Kosaki overgrowth syndrome, and fusiform aneurysms. Despite their descriptions as distinct clinical entities, review of previous reports demonstrates substantial phenotypic overlap. We present a case series of 12 patients with activating variants in PDGFRB and review of the literature. We describe five patients with PDGFRB activating variants whose clinical features overlap multiple diagnostic entities. Seven additional patients from a large family had variable expressivity and late-onset disease, including adult onset features and two individuals with sudden death. Three patients were treated with imatinib and had robust and rapid response, including the first two reported infants with multicentric myofibromas treated with imatinib monotherapy and one with a recurrent p.Val665Ala (Penttinen) variant. Along with previously reported individuals, our cohort suggests infants and young children had few abnormal features, while older individuals had multiple additional features, several of which appeared to worsen with advancing age. Our analysis supports a diagnostic entity of a spectrum disorders due to activating variants in PDGFRB. Differences in reported phenotypes can be dramatic and correlate with advancing age, genotype, and to mosaicism in some individuals.
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Affiliation(s)
- Tara L Wenger
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
| | - Randall A Bly
- Department of Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Natalie Wu
- Division of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Catherine M Albert
- Division of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Julie Park
- Division of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Joseph Shieh
- Division of Medical Genetics, Benioff Children's Hospital and Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA
| | - Jirat Chenbhanich
- Division of Medical Genetics, Benioff Children's Hospital and Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA
| | - Carrie L Heike
- Division of Craniofacial Medicine, Seattle Children's Hospital, Seattle, Washington, USA
| | - Margaret P Adam
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
| | - Irene Chang
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
| | - Angela Sun
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
| | - Danny E Miller
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
| | - Anita E Beck
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
| | - Deepti Gupta
- Division of Dermatology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Markus D Boos
- Division of Dermatology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Elaine H Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - David Everman
- Greenwood Genetics Center, Greenville, South Carolina, USA
| | - Shireen Ganapathi
- Division of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Meredith Wilson
- Department of Clinical Genetics, Sydney Children's Hospitals Network-Westmead, University of Sydney, Sydney, New South Wales, Australia.,Division of Genetic Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - John Christodoulou
- Murdoch Children's Research Institute, Parkville, Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Yuri A Zarate
- Section of Genetics and Metabolism, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Cynthia Curry
- Division of Medical Genetics, Benioff Children's Hospital and Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA
| | - Dong Li
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Anne Guimier
- Département de Génétique, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Jeanne Amiel
- Département de Génétique, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Richard Webster
- Department of Neurology, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Elizabeth J Bhoj
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jonathan A Perkins
- Department of Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA
| | - John P Dahl
- Department of Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA
| | - William B Dobyns
- Division of Genetic Medicine, University of Washington, Seattle, Washington, USA
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13
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Foster A, Chalot B, Antoniadi T, Schaefer E, Keelagher R, Ryan G, Thomas Q, Philippe C, Bruel A, Sorlin A, Thauvin‐Robinet C, Bardou M, Luu M, Quenardelle V, Wolff V, Woodley J, Vabres P, Lim D, Igbokwe R, Joseph A, Walker H, Jester A, Ellenbogen J, Johnson D, Rooke B, Moss C, Cole T, Faivre L. Kosaki overgrowth syndrome: A novel pathogenic variant in
PDGFRB
and expansion of the phenotype including cerebrovascular complications. Clin Genet 2020; 98:19-31. [DOI: 10.1111/cge.13752] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Alison Foster
- Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK
- West Midlands Regional Genetics Service and Birmingham Health Partners Birmingham Women's and Children's Hospitals NHS Foundation Trust Birmingham UK
| | - Basile Chalot
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d’Enfants Centre Hospitalier Universitaire de Dijon Dijon France
- Laboratoire de Génétique chromosomique et moléculaire, UF Innovation en diagnostic génomique des maladies rares Centre Hospitalier Universitaire de Dijon Dijon France
- UMR‐Inserm 1231 GAD team, Génétique des Anomalies du développement Université de Bourgogne Franche‐Comté Dijon France
| | - Thalia Antoniadi
- West Midlands Regional Genetics Laboratory Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Elise Schaefer
- Service de génétique médicale ‐ Hôpitaux Universitaires de Strasbourg Institut de Génétique Médicale d'Alsace Strasbourg France
| | - Rebecca Keelagher
- West Midlands Regional Genetics Laboratory Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Gavin Ryan
- West Midlands Regional Genetics Laboratory Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Quentin Thomas
- Service de Neurologie Centre Hospitalier Universitaire de Dijon Dijon France
| | - Christophe Philippe
- Laboratoire de Génétique chromosomique et moléculaire, UF Innovation en diagnostic génomique des maladies rares Centre Hospitalier Universitaire de Dijon Dijon France
- UMR‐Inserm 1231 GAD team, Génétique des Anomalies du développement Université de Bourgogne Franche‐Comté Dijon France
| | - Ange‐Line Bruel
- Laboratoire de Génétique chromosomique et moléculaire, UF Innovation en diagnostic génomique des maladies rares Centre Hospitalier Universitaire de Dijon Dijon France
- UMR‐Inserm 1231 GAD team, Génétique des Anomalies du développement Université de Bourgogne Franche‐Comté Dijon France
| | - Arthur Sorlin
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d’Enfants Centre Hospitalier Universitaire de Dijon Dijon France
- Laboratoire de Génétique chromosomique et moléculaire, UF Innovation en diagnostic génomique des maladies rares Centre Hospitalier Universitaire de Dijon Dijon France
- UMR‐Inserm 1231 GAD team, Génétique des Anomalies du développement Université de Bourgogne Franche‐Comté Dijon France
| | - Christel Thauvin‐Robinet
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d’Enfants Centre Hospitalier Universitaire de Dijon Dijon France
- Laboratoire de Génétique chromosomique et moléculaire, UF Innovation en diagnostic génomique des maladies rares Centre Hospitalier Universitaire de Dijon Dijon France
- UMR‐Inserm 1231 GAD team, Génétique des Anomalies du développement Université de Bourgogne Franche‐Comté Dijon France
| | - Marc Bardou
- Service de Pharmacologie et Centre d'Investigation Clinique Centre Hospitalier Universitaire de Dijon Dijon France
- INSERM CIC 1432 Université de Bourgogne Franche‐Comté Dijon France
| | - Maxime Luu
- Service de Pharmacologie et Centre d'Investigation Clinique Centre Hospitalier Universitaire de Dijon Dijon France
- INSERM CIC 1432 Université de Bourgogne Franche‐Comté Dijon France
| | | | - Valerie Wolff
- Stroke Unit University Hospital Strasbourg France
- Federation of Translational Medicine of Strasbourg University of Strasbourg Strasbourg France
| | - Jessica Woodley
- West Midlands Regional Genetics Laboratory Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Pierre Vabres
- Service de Dermatologie CHU de Dijon, Université de Bourgogne France
| | - Derek Lim
- West Midlands Regional Genetics Service and Birmingham Health Partners Birmingham Women's and Children's Hospitals NHS Foundation Trust Birmingham UK
| | - Rebecca Igbokwe
- West Midlands Regional Genetics Service and Birmingham Health Partners Birmingham Women's and Children's Hospitals NHS Foundation Trust Birmingham UK
| | - Annie Joseph
- Ophthalmology Department Royal Stoke University Hospital Stoke‐on‐Trent UK
| | - Harriet Walker
- Hand and Upper Limb Service, Plastic and Reconstructive Surgery Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Andrea Jester
- Hand and Upper Limb Service, Plastic and Reconstructive Surgery Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Jonathan Ellenbogen
- Paediatric Neurosurgery Alder Hey Children's NHS Foundation Trust Liverpool UK
| | - Diana Johnson
- Sheffield Clinical Genetics Service Sheffield Children's NHS Foundation Trust Sheffield UK
| | - Bethanie Rooke
- Department of Dermatology Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Celia Moss
- Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK
- Department of Dermatology Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - Trevor Cole
- West Midlands Regional Genetics Service and Birmingham Health Partners Birmingham Women's and Children's Hospitals NHS Foundation Trust Birmingham UK
| | - Laurence Faivre
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d’Enfants Centre Hospitalier Universitaire de Dijon Dijon France
- UMR‐Inserm 1231 GAD team, Génétique des Anomalies du développement Université de Bourgogne Franche‐Comté Dijon France
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14
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Guimier A, Gordon CT, Hully M, Blauwblomme T, Minard-Colin V, Bole-Feysot C, Nitschké P, Oufadem M, Boddaert N, Sarnacki S, Amiel J. A novel de novo PDGFRB variant in a child with severe cerebral malformations, intracerebral calcifications, and infantile myofibromatosis. Am J Med Genet A 2019; 179:1304-1309. [PMID: 31004414 DOI: 10.1002/ajmg.a.61151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 12/17/2022]
Abstract
The spectrum of clinical consequences of variants in the Platelet derived growth factor receptor beta (PDGFRB) gene is wide. Missense variants leading to variable loss of signal transduction in vitro have been reported in the idiopathic basal ganglia calcification (IBGC) syndrome Type 4. In contrast, gain-of-function variants have been reported in infantile myofibromatosis, Penttinen syndrome, and Kosaki overgrowth syndrome. Here, we report a patient harboring a novel postzygotic variant in PDGFRB (c.1682_1684del, p.[Arg561_Tyr562delinsHis]) and presenting severe cerebral malformations, intracerebral calcifications, and infantile myofibromatosis. This observation expands the phenotype associated with PDGFRB variants and illustrates the wide clinical spectrum linked to dysregulation of PDGFRB.
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Affiliation(s)
- Anne Guimier
- Laboratory of embryology and genetics of malformations, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Institut Imagine, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France.,Département de Génétique, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Christopher T Gordon
- Laboratory of embryology and genetics of malformations, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Institut Imagine, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Marie Hully
- Service de Neuropédiatrie, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Thomas Blauwblomme
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France.,Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | | | - Christine Bole-Feysot
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France.,Genomics Platform, INSERM UMR 1163, Institut Imagine, Paris, France
| | - Patrick Nitschké
- Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France.,Bioinformatics Platform, INSERM UMR 1163, Institut Imagine, Paris, France
| | - Myriam Oufadem
- Laboratory of embryology and genetics of malformations, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Institut Imagine, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Nathalie Boddaert
- Service de Radiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, INSERM U1000 and INSERM UMR 1163, Institut Imagine, Paris, France
| | - Sabine Sarnacki
- Sevice de Chirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Jeanne Amiel
- Laboratory of embryology and genetics of malformations, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Institut Imagine, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Paris, France.,Département de Génétique, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
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15
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Bredrup C, Stokowy T, McGaughran J, Lee S, Sapkota D, Cristea I, Xu L, Tveit KS, Høvding G, Steen VM, Rødahl E, Bruland O, Houge G. A tyrosine kinase-activating variant Asn666Ser in PDGFRB causes a progeria-like condition in the severe end of Penttinen syndrome. Eur J Hum Genet 2018; 27:574-581. [PMID: 30573803 DOI: 10.1038/s41431-018-0323-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 01/08/2023] Open
Abstract
Missense variants located to the "molecular brake" in the tyrosine kinase hinge region of platelet-derived growth factor receptor-β, encoded by PFGFRB, can cause Penttinen-type (Val665Ala) and Penttinen-like (Asn666His) premature ageing syndromes, as well as infantile myofibromatosis (Asn666Lys and Pro660Thr). We have found the same de novo PDGFRB c.1997A>G p.(Asn666Ser) variants in two patients with lipodystrophy, acro-osteolysis and severely reduced vision due to corneal neovascularisation, reminiscent of a severe form of Penttinen syndrome with more pronounced connective tissue destruction. In line with this phenotype, patient skin fibroblasts were prone to apoptosis. Both in patient fibroblasts and stably transduced HeLa and HEK293 cells, autophosphorylation of PDGFRβ was observed, as well as increased phosphorylation of downstream signalling proteins such as STAT1, PLCγ1, PTPN11/SHP2-Tyr580 and AKT. Phosphorylation of MAPK3 (ERK1) and PTPN11/SHP2-Tyr542 appeared unaffected. This suggests that this missense change not only weakens tyrosine kinase autoinhibition, but also influences substrate binding, as both PTPN11 tyrosines (Tyr542 and Tyr580) usually are phosphorylated upon PDGFR activation. Imatinib was a strong inhibitor of phosphorylation of all these targets, suggesting an option for precision medicine based treatment.
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Affiliation(s)
- Cecilie Bredrup
- Department of Medical Genetics, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Ophthalmology, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway
| | - Tomasz Stokowy
- Department of Medical Genetics, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Clinical Science, University of Bergen, 5020, Bergen, Norway
| | - Julie McGaughran
- Genetic Health QLD, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Samuel Lee
- Genetic Health QLD, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Dipak Sapkota
- Department of Oncology and Medical Physics, Haukeland University Hospital, 5021, Bergen, Norway.,Institute of Oral Biology, University of Oslo, 0315, Oslo, Norway
| | - Ileana Cristea
- Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway
| | - Linda Xu
- Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway
| | - Kåre Steinar Tveit
- Department of Dermatology, Haukeland University Hospital, 5021, Bergen, Norway
| | - Gunnar Høvding
- Department of Ophthalmology, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway
| | - Vidar Martin Steen
- Department of Medical Genetics, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Clinical Science, University of Bergen, 5020, Bergen, Norway
| | - Eyvind Rødahl
- Department of Ophthalmology, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, 5020, Bergen, Norway
| | - Ove Bruland
- Department of Medical Genetics, Haukeland University Hospital, 5021, Bergen, Norway
| | - Gunnar Houge
- Department of Medical Genetics, Haukeland University Hospital, 5021, Bergen, Norway.
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16
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Abstract
Acro-osteolysis is an osteolysis of the distal phalanges of the hands and feet and can affect the terminal tuft or the shaft of the distal phalanx (transverse or band acro-osteolysis). It is often associated with distal digital ischemia, digital calcinosis, or severe sensory neuropathy. Acro-osteolysis has been associated with a heterogeneous group of disorders, including occupational activities, infections, rheumatic disorders (systemic sclerosis, psoriatic arthritis), endocrinopathies, genetic disorders, and lysosomal storage disorders. Plain radiography is the gold standard for the detection of acro-osteolysis.
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17
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Aminkeng F. PDGFRBmutation causes autosomal-dominant Penttinen syndrome. Clin Genet 2015; 88:531. [DOI: 10.1111/cge.12680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 11/29/2022]
Affiliation(s)
- F. Aminkeng
- Department of Medical Genetics, Center for Molecular Medicine and Therapeutics; Canadian Pharmacogenomic Network for Drug Safety; Vancouver Canada
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18
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Johnston J, Sanchez-Contreras M, Keppler-Noreuil K, Sapp J, Crenshaw M, Finch N, Cormier-Daire V, Rademakers R, Sybert V, Biesecker L. A Point Mutation in PDGFRB Causes Autosomal-Dominant Penttinen Syndrome. Am J Hum Genet 2015; 97:465-74. [PMID: 26279204 DOI: 10.1016/j.ajhg.2015.07.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/21/2015] [Indexed: 01/30/2023] Open
Abstract
Penttinen syndrome is a distinctive disorder characterized by a prematurely aged appearance with lipoatrophy, epidermal and dermal atrophy along with hypertrophic lesions that resemble scars, thin hair, proptosis, underdeveloped cheekbones, and marked acro-osteolysis. All individuals have been simplex cases. Exome sequencing of an affected individual identified a de novo c.1994T>C p.Val665Ala variant in PDGFRB, which encodes the platelet-derived growth factor receptor β. Three additional unrelated individuals with this condition were shown to have the identical variant in PDGFRB. Distinct mutations in PDGFRB have been shown to cause infantile myofibromatosis, idiopathic basal ganglia calcification, and an overgrowth disorder with dysmorphic facies and psychosis, none of which overlaps with the clinical findings in Penttinen syndrome. We evaluated the functional consequence of this causative variant on the PDGFRB signaling pathway by transfecting mutant and wild-type cDNA into HeLa cells, and transfection showed ligand-independent constitutive signaling through STAT3 and PLCγ. Penttinen syndrome is a clinically distinct genetic condition caused by a PDGFRB gain-of-function mutation that is associated with a specific and unusual perturbation of receptor function.
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