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Cuk M, Unal B, Bevanda A, Hayes CP, Walker M, Abraamyan F, Beluzic R, Gornik KC, Ozretic D, Prutki M, Nie Q, Reddi HV, Ghazani AA. Diagnosis of Two Unrelated Syndromes of Prader-Willi and Calpainopathy: Insight from Trio Whole Genome Analysis and Isodisomy Mapping. Genes (Basel) 2024; 15:946. [PMID: 39062725 PMCID: PMC11276144 DOI: 10.3390/genes15070946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
PURPOSE An investigation for the co-occurrence of two unrelated genetic disorders of muscular dystrophy and Prader-Willi syndrome (PWS) (OMIM#176270) using joint whole genome sequencing (WGS). METHODS Trio WGS joint analysis was performed to investigate the genetic etiology in a proband with PWS, prolonged muscular hypotonia associated hyperCKemia, and early-onset obesity. The parents were unaffected. RESULTS Results showed maternal isodisomy uniparental disomy (UPD) in chromosome 15, expanding from 15q11.2 to 15q22.2, including PWS regions at 15q11.2-15q13. Maternal heterodisomy was detected from 15q22.2 to 15q26.3. A pathogenic variant, NM_000070.3(CAPN3):c.550del (p.Thr184fs), was identified at 15q15.1 in a heterozygous state in the mother that was homozygous in the proband due to maternal isodisomy. CONCLUSION This is the first study of the concurrent molecular etiology of PWS and calpainopathy (OMIM#253600) in the same patient. This report highlights the utility of joint analysis and the need for the assessment of autosomal recessive disease in regions of isodisomy in patients with complex and unexplained phenotypes.
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Affiliation(s)
- Mario Cuk
- Department of Pediatrics, School of Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Busra Unal
- Division of Genetics, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.U.); (C.P.H.); (M.W.); (F.A.)
| | | | - Connor P. Hayes
- Division of Genetics, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.U.); (C.P.H.); (M.W.); (F.A.)
| | - McKenzie Walker
- Division of Genetics, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.U.); (C.P.H.); (M.W.); (F.A.)
| | - Feruza Abraamyan
- Division of Genetics, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.U.); (C.P.H.); (M.W.); (F.A.)
| | - Robert Beluzic
- Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia;
| | - Kristina Crkvenac Gornik
- Department of Laboratory Diagnostics, Division of Cytogenetics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - David Ozretic
- Department for Diagnostic and Interventional Neuroradiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Maja Prutki
- Department of Radiology, School of Medicine, University Hospital Center Zagreb, 10000 Zagreb, Croatia;
| | - Qian Nie
- Precision Medicine Laboratory, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Q.N.); (H.V.R.)
| | - Honey V. Reddi
- Precision Medicine Laboratory, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Q.N.); (H.V.R.)
| | - Arezou A. Ghazani
- Division of Genetics, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.U.); (C.P.H.); (M.W.); (F.A.)
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
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Butler MG, Hossain WA, Cowen N, Bhatnagar A. Chromosomal Microarray Study in Prader-Willi Syndrome. Int J Mol Sci 2023; 24:ijms24021220. [PMID: 36674736 PMCID: PMC9863005 DOI: 10.3390/ijms24021220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
A high-resolution chromosome microarray analysis was performed on 154 consecutive individuals enrolled in the DESTINY PWS clinical trial for Prader-Willi syndrome (PWS). Of these 154 PWS individuals, 87 (56.5%) showed the typical 15q11-q13 deletion subtypes, 62 (40.3%) showed non-deletion maternal disomy 15 and five individuals (3.2%) had separate unexpected microarray findings. For example, one PWS male had Klinefelter syndrome with segmental isodisomy identified in both chromosomes 15 and X. Thirty-five (40.2%) of 87 individuals showed typical larger 15q11-q13 Type I deletion and 52 individuals (59.8%) showed typical smaller Type II deletion. Twenty-four (38.7%) of 62 PWS individuals showed microarray patterns indicating either maternal heterodisomy 15 subclass or a rare non-deletion (epimutation) imprinting center defect. Segmental isodisomy 15 was seen in 34 PWS subjects (54.8%) with 15q26.3, 15q14 and 15q26.1 bands most commonly involved and total isodisomy 15 seen in four individuals (6.5%). In summary, we report on PWS participants consecutively enrolled internationally in a single clinical trial with high-resolution chromosome microarray analysis to determine and describe an unbiased estimate of the frequencies and types of genetic defects and address potential at-risk genetic disorders in those with maternal disomy 15 subclasses in the largest PWS cohort studied to date.
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Affiliation(s)
- Merlin G. Butler
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 4015, Kansas City, KS 66160, USA
- Correspondence:
| | - Waheeda A. Hossain
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 4015, Kansas City, KS 66160, USA
| | - Neil Cowen
- Soleno Therapeutics, Inc., Redwood City, CA 94065, USA
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Kunta AR, Jueng J, Jordan C, Kojic J, Mo A, Ebrahimi-Fakhari D. Blended Phenotype of Prader-Willi Syndrome and HSP- SPG11 Caused by Maternal Uniparental Isodisomy. Neurol Genet 2022; 8:e200041. [PMID: 36524102 PMCID: PMC9747140 DOI: 10.1212/nxg.0000000000200041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/19/2022] [Indexed: 11/26/2022]
Abstract
Objective Uniparental isodisomy can lead to blended phenotypes of imprinting disorders and autosomal recessive diseases. To determine whether a presentation of Prader-Willi syndrome (PWS) and progressive neurologic symptoms was caused by uniparental isodisomy, a detailed clinical and molecular characterization was performed. Methods A combination of clinical, molecular, and imaging data was included in this study. Results We present the case of a 12-year-old boy with a blended phenotype of PWS and hereditary spastic paraplegia type 11 (HSP-SPG11) caused by maternal uniparental isodisomy of chromosome 15 (UPiD(15)mat) covering a loss-of-function variant in SPG11 (NM_025137.4: c.733_734del; p.Met245ValfsTer2). Although symptoms in early childhood including hypotonia, global developmental delay, hyperphagia, obesity, and seizures were consistent with PWS, additional features of progressive spastic paraparesis, parkinsonism, and cognitive decline in later childhood were atypical. Brain MR imaging showed thinning of the corpus callosum and signal abnormalities of the forceps minor, consistent with a "ears of the lynx" sign. Exome sequencing confirmed a frameshift variant in SPG11 located in the PWS imprinting region on chromosome 15. Discussion This case highlights that atypical clinical features in patients with well-described imprinting disorders should lead to investigations for recessive conditions caused by variants in genes that localize to the region of homozygosity, including autosomal recessive forms of HSP.
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Affiliation(s)
- Avaneesh R Kunta
- University of Central Florida - College of Medicine (A.R.K., J.J., J.K.), Orlando; Movement Disorders Program (C.J., A.M., D.E.-F.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; The Manton Center for Orphan Disease Research (D.E.-F.), Boston Children's Hospital; and Intellectual and Developmental Disabilities Research Center (D.E.-F.), Boston Children's Hospital, MA
| | - Jeremy Jueng
- University of Central Florida - College of Medicine (A.R.K., J.J., J.K.), Orlando; Movement Disorders Program (C.J., A.M., D.E.-F.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; The Manton Center for Orphan Disease Research (D.E.-F.), Boston Children's Hospital; and Intellectual and Developmental Disabilities Research Center (D.E.-F.), Boston Children's Hospital, MA
| | - Catherine Jordan
- University of Central Florida - College of Medicine (A.R.K., J.J., J.K.), Orlando; Movement Disorders Program (C.J., A.M., D.E.-F.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; The Manton Center for Orphan Disease Research (D.E.-F.), Boston Children's Hospital; and Intellectual and Developmental Disabilities Research Center (D.E.-F.), Boston Children's Hospital, MA
| | - Jasna Kojic
- University of Central Florida - College of Medicine (A.R.K., J.J., J.K.), Orlando; Movement Disorders Program (C.J., A.M., D.E.-F.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; The Manton Center for Orphan Disease Research (D.E.-F.), Boston Children's Hospital; and Intellectual and Developmental Disabilities Research Center (D.E.-F.), Boston Children's Hospital, MA
| | - Alisa Mo
- University of Central Florida - College of Medicine (A.R.K., J.J., J.K.), Orlando; Movement Disorders Program (C.J., A.M., D.E.-F.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; The Manton Center for Orphan Disease Research (D.E.-F.), Boston Children's Hospital; and Intellectual and Developmental Disabilities Research Center (D.E.-F.), Boston Children's Hospital, MA
| | - Darius Ebrahimi-Fakhari
- University of Central Florida - College of Medicine (A.R.K., J.J., J.K.), Orlando; Movement Disorders Program (C.J., A.M., D.E.-F.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; The Manton Center for Orphan Disease Research (D.E.-F.), Boston Children's Hospital; and Intellectual and Developmental Disabilities Research Center (D.E.-F.), Boston Children's Hospital, MA
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Zhang L, Hu Y, Lu J, Zhao P, Zhang X, Tan L, Li J, Xiao C, Zeng L, He X. Identification of the first congenital ichthyosis case caused by a homozygous deletion in the ALOX12B gene due to chromosome 17 mixed uniparental disomy. Front Genet 2022; 13:931833. [PMID: 36003334 PMCID: PMC9393266 DOI: 10.3389/fgene.2022.931833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Uniparental disomy (UPD) is a rare genetic event caused by errors during gametogenesis and fertilization leading to two copies of a chromosome or chromosomal region inherited from one parent. MixUPD is one type of UPD that contains isodisomic and heterodisomic parts because of meiotic recombination. Using whole-exome sequencing (WES), we identified the first case of ichthyosis due to a maternal mixUPD on chromosome 17, which results in a homozygous deletion of partial intron 8 to exon 10 in ALOX12B, being predicted to lead to an internal protein deletion of 97 amino acids. We also performed a retrospective analysis of 198 patients with ALOX12B mutations. The results suggested that the exon 9 and 10 are located in the mutational hotspots of ALOX12B. In addition, our patient has microtia and congenital stenosis of the external auditory canals, which is very rare in patients with ALOX12B mutations. Our study reports the first case of autosomal recessive congenital ichthyosis (ARCI) due to a mixUPD of chromosome 17 and expands the spectrum of clinical manifestations of ARCI caused by mutations in the ALOX12B gene.
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Affiliation(s)
- Lei Zhang
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yanqiu Hu
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jingjing Lu
- Dermatology Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Peiwei Zhao
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiankai Zhang
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Li Tan
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jun Li
- Otolaryngology Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Cuiping Xiao
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- *Correspondence: Xuelian He, ; Cuiping Xiao, ; Linkong Zeng,
| | - Linkong Zeng
- Neonatology Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- *Correspondence: Xuelian He, ; Cuiping Xiao, ; Linkong Zeng,
| | - Xuelian He
- Precision Medical Center, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- *Correspondence: Xuelian He, ; Cuiping Xiao, ; Linkong Zeng,
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Zhang L, Liu X, Zhao Y, Wang Q, Zhang Y, Gao H, Zhang B, Cui W, Zhao Y. Genetic subtypes and phenotypic characteristics of 110 patients with Prader-Willi syndrome. Ital J Pediatr 2022; 48:121. [PMID: 35870983 PMCID: PMC9308266 DOI: 10.1186/s13052-022-01319-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a complex disorder caused by impaired paternally expressed genes on chromosome 15q11-q13. Variable findings have been reported about the phenotypic differences among PWS genetic subtypes. METHODS A total of 110 PWS patients were diagnosed from 8,572 pediatric patients included from July 2013 to December 2021 by MLPA and MS-MLPA assays. Atypical deletions were defined by genomic CNV-sequencing. Maternal uniparental disomy (UPD) was subgrouped by microsatellite genotyping. Clinical data were collected for phenotype-genotype associations. Twenty-one patients received growth hormone (GH) treatment, and the anthropometric and laboratory parameters were evaluated and compared. RESULTS Genetically, the 110 patients with PWS included 29 type I deletion, 56 type II deletion, 6 atypical deletion, 11 heterodisomy UPD, and 8 isodisomy UPD. The UPD group had significantly higher maternal age (31.4 ± 3.4 vs 27.8 ± 3.8 years), more anxiety (64.29% vs 26.09%) and autistic traits (57.14% vs 26.09%), and less hypopigmentation (42.11% vs 68.24%) and skin picking (42.86% vs 71.01%) than the deletion group. The type I deletion group was diagnosed at earlier age (3.7 ± 3.3 vs 6.2 ± 3.2 years) and more common in speech delay (95.45% vs 63.83%) than the type II. The isodisomy UPD group showed a higher tendency of anxiety (83.33% vs 50%) than the heterodisomy. GH treatment for 1 year significantly improved the SDS of height (- 0.43 ± 0.68 vs - 1.32 ± 1.19) and IGF-I (- 0.45 ± 0.48 vs - 1.97 ± 1.12). No significant changes were found in thyroid function or glucose/lipid metabolism. CONCLUSION We explored the physical, psychological and behavioral phenotype-genotype associations as well as the GH treatment effect on PWS from a large cohort of Chinese pediatric patients. Our data might promote pediatricians' recognition and early diagnosis of PWS.
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Affiliation(s)
- Lu Zhang
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China
| | - Xiaoliang Liu
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China
| | - Yunjing Zhao
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qingyi Wang
- Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Yuanyuan Zhang
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China
| | - Haiming Gao
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China
| | - Bijun Zhang
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China
| | - Wanting Cui
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China
| | - Yanyan Zhao
- Department of Clinical Genetics, Shengjing Hospital of China Medical University, No 36 Sanhao Street, Heping Ward, Shenyang, 110004, China.
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Ueda K, Ogawa S, Matsuda K, Hasegawa Y, Nishi E, Yanagi K, Kaname T, Yamamoto T, Okamoto N. Blended phenotype of combination of HERC2 and AP3B2 deficiency and Angelman syndrome caused by paternal isodisomy of chromosome 15. Am J Med Genet A 2021; 185:3092-3098. [PMID: 34042275 DOI: 10.1002/ajmg.a.62371] [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: 12/06/2020] [Revised: 03/11/2021] [Accepted: 04/01/2021] [Indexed: 01/26/2023]
Abstract
Angelman syndrome is a neurodevelopmental disorder characterized by intellectual disability (ID), a distinctive gait pattern, abnormal behaviors, severe impairment in language development, and characteristic facial features. Most cases are caused by the absence of a maternal contribution to the imprinted region on chromosome 15q11-q13. Here, we present the first reported case of a 3-year-old boy with an atypical phenotype of Angelman syndrome due to uniparental isodisomy with two recessive homozygous pathogenic variants: in HERC2 and AP3B2. Known phenotypes related to HERC2 and AP3B2 include ID and early infantile epileptic encephalopathy, respectively. The patient had severe global developmental delay and profound ID and showed a happy demeanor, stereotypic laughter, and hand-flapping movements, but also irritability. Craniofacial dysmorphic features, including brachycephaly, strabismus, wide ala nasi, short philtrum, wide open mouth, and slight hypopigmentation were seen. Progressive microcephaly was noted. Magnetic resonance imaging of the brain showed delayed myelination and cerebral atrophy. Trio whole exome sequencing and CGH-SNP array analysis revealed paternal uniparental isodisomy of chromosome 15 and two coexisting recessive diseases resulting from homozygous HERC2 and AP3B2 pathogenic variants. The pathogenic variant in HERC2 was inherited from his heterozygous-carrier father, and the variant in AP3B2 was de novo. We suppose that these unusual features were the combination of the effect of three concomitant disorders.
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Affiliation(s)
- Kimiko Ueda
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Satoru Ogawa
- Department of Pediatrics, Saiseikai Suita Hospital, Osaka, Japan
| | - Keiko Matsuda
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Yuiko Hasegawa
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Eriko Nishi
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Kumiko Yanagi
- Department of Genome Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Tadashi Kaname
- Department of Genome Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Toshiyuki Yamamoto
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
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