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Liu J, Guo K, Zhang R, Wang R, Ma D, Zhang X. Compound heterozygous ABCA12 variants identified in a Chinese patient with congenital ichthyosiform erythroderma: Advancing genotype-phenotype correlations and literature review. Mol Genet Genomic Med 2024; 12:e2431. [PMID: 38702946 PMCID: PMC11069050 DOI: 10.1002/mgg3.2431] [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: 06/14/2023] [Revised: 02/25/2024] [Accepted: 03/20/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Ichthyosis is a common keratotic skin disease with high clinical, etiological and genetic heterogeneity. There are four types of non-syndromic hereditary ichthyoses, among which autosomal recessive congenital ichthyosis (ARCI) is a heterogeneous group of recessive Mendelian disorders. ARCI present with different phenotypes and ABCA12 pathogenic variants have been shown to cause complex ARCI phenotypes, including harlequin ichthyosis (HI), lamellar ichthyosis (LI) and congenital ichthyosiform erythroderma (CIE). METHODS A sporadic male patient, clinically diagnosed with CIE, was enrolled in this study. Exome sequencing was combined with Sanger sequencing to confirm the diagnosis and identify the pathogenic variants. In silico predictions were made using multiple software programs, and the identified variants were interpreted using the ACMG guidelines. A review of all literature reported ABCA12 variants was performed to explore genotype-phenotype correlations. RESULTS Compound heterozygous ABCA12 variants [c.5381+1G>A and c.5485G>C (p.Asp1829His)] (NM_173076) were identified. The two variants were not detected in the public database. c.5381+1G>A is predicted to affect ABCA12 mRNA splicing and Asp1829 is highly conserved among various species. In silico analysis suggested that these two variants were responsible for the phenotype of the patient. Genotype-phenotype correlation analysis showed that biallelic truncation variants and/or exon/amino acid deletions in ABCA12 are the most common causes of HI. Biallelic missense variants are most common in LI and CIE. CONCLUSIONS The compound heterozygous ABCA12 variants caused the CIE phenotype observed in the patient. The spectrum of ABCA12 pathogenic variants were broaden. Genotype-phenotype correlation analysis provided detailed evidence which can be used in future prenatal diagnosis and can inform the need for genetic counselling for patients with ABCA12-related ARCIs.
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Affiliation(s)
- Jia‐Wei Liu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesBeijingChina
| | - Kexin Guo
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare HospitalNanjingChina
| | - Rui Zhang
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
| | - Rongrong Wang
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
| | - Dong‐Lai Ma
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesBeijingChina
| | - Xue Zhang
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
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Arias-Pérez RD, Gallego-Quintero S, Taborda NA, Restrepo JE, Zambrano-Cruz R, Tamayo-Agudelo W, Bermúdez P, Duque C, Arroyave I, Tejada-Moreno JA, Villegas-Lanau A, Mejía-García A, Zapata W, Hernandez JC, Cuartas-Montoya G. Ichthyosis: case report in a Colombian man with genetic alterations in ABCA12 and HRNR genes. BMC Med Genomics 2021; 14:140. [PMID: 34039366 PMCID: PMC8157432 DOI: 10.1186/s12920-021-00987-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Ichthyosis is a heterogeneous group of diseases caused by genetic disorders related to skin formation. They are characterized by generalized dry skin, scaling, hyperkeratosis and frequently associated with erythroderma. Among its different types, harlequin ichthyosis (HI) stands out due to its severity. HI is caused by mutations in the ABCA12 gene, which encodes essential proteins in epidermal lipid transport, and it helps maintain the homeostasis of the stratum corneum of the epidermis. However, due to the wide spectrum of genetic alterations that can cause ichthyosis, holistic medical care, and genetic studies are required to improve the diagnosis and outcomes of these diseases. Case presentation Here, we presented the case of a 19 years old male patient who was a premature infant and exhibited clinical features consistent with HI, including bright yellow hyperkeratotic plates with erythematous fissures that covered his entire body like a collodion baby. Currently, he exhibited erythroderma, photosensitivity, ectropion, auricular pavilion alterations, and musculoskeletal disorders, such as equinovarus feet, fingers, hands, and hypoplastic feet with contractures in flexion and marked difficulty in fine motor skills. In addition, he presented dyschromatopsia, Achilles reflex hyporeflexia, slight speech, dental alteration and deficient cognitive performance. After the genetic sequencing, variants were found in ABCA12 and HRNR which are related to several skin diseases, including ichthyosis. Conclusions Although in clinical practice, ichthyosis is a common entity, a severe type of ichthyosis is presented, highlighting the importance of appropriate genetic diagnosis, given the broad spectrum of genetic alterations with similar phenotypic and clinical characteristics. These pathologies must be known to guarantee initial support measures to prevent complications and offer multidisciplinary management to those patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-00987-y.
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Affiliation(s)
- Ruben D Arias-Pérez
- Grupo de Investigaciones Biomédicas Uniremington, Programa de Medicina, Facultad de Ciencias de La Salud, Corporación Universitaria Remington, Medellín, Colombia
| | - Salomón Gallego-Quintero
- Grupo de Investigaciones Biomédicas Uniremington, Programa de Medicina, Facultad de Ciencias de La Salud, Corporación Universitaria Remington, Medellín, Colombia
| | - Natalia A Taborda
- Grupo de Investigaciones Biomédicas Uniremington, Programa de Medicina, Facultad de Ciencias de La Salud, Corporación Universitaria Remington, Medellín, Colombia
| | - Jorge E Restrepo
- Grupo OBSERVATOS, Facultad de Educación Y Ciencias Sociales, Tecnológico de Antioquia -Institución Universitaria, Medellín, Colombia
| | - Renato Zambrano-Cruz
- Grupo Neurociencia Y Cognición, Facultad de Psicología, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - William Tamayo-Agudelo
- Grupo Neurociencia Y Cognición, Facultad de Psicología, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Patricia Bermúdez
- Grupo GIOM, Facultad de Odontología, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Constanza Duque
- Grupo GIOM, Facultad de Odontología, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Ismael Arroyave
- Grupo GIOM, Facultad de Odontología, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Johanna A Tejada-Moreno
- Grupo de Genética Molecular (GENMOL), Facultad de Ciencias Exactas y Naturales (FCEN), Universidad de Antioquia UdeA, Medellín, Colombia
| | - Andrés Villegas-Lanau
- Grupo de Genética Molecular (GENMOL), Facultad de Ciencias Exactas y Naturales (FCEN), Universidad de Antioquia UdeA, Medellín, Colombia
| | - Alejandro Mejía-García
- Grupo de Genética Molecular (GENMOL), Facultad de Ciencias Exactas y Naturales (FCEN), Universidad de Antioquia UdeA, Medellín, Colombia
| | - Wildeman Zapata
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Juan C Hernandez
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia.
| | - Gina Cuartas-Montoya
- Grupo Neurociencia Y Cognición, Facultad de Psicología, Universidad Cooperativa de Colombia, Medellín, Colombia
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Zhou XJ, Lin YJ, Chen XW, Zheng JH, Zhou YJ. Prenatal diagnosis of harlequin ichthyosis by ultrasonography: a case report. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:183. [PMID: 33569485 PMCID: PMC7867921 DOI: 10.21037/atm-20-8223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Autosomal recessive congenital ichthyosis is a genetically and phenotypically heterogeneous group of skin disorders, including harlequin ichthyosis (HI), lamellar ichthyosis, and bullous congenital ichthyosiform erythroderma. HI is the most phenotypically severe autosomal recessive congenital ichthyosis associated with the mutation of the adenosine triphosphate—binding cassette subfamily A member 12 (ABCA12) gene. The clinical manifestations include generalized hyperkeratotic plaques and deep fissures, ectropion, eclabium, and contractures. However, the severe HI may easily be misdiagnosed as epidermolysis bullosa or syndromic ichthyosis. Meanwhile, no consensus exists about the best used in clinical trials or clinical practice when more elaborate scoring systems have been proposed to evaluate skin xerosis, palmoplantar keratoderma, and disease extension an accurate prenatal diagnosis is necessary. Until the ABCA12 gene was identified as the pathogenic gene, prenatal diagnosis of HI had been performed by the invasive techniques of fetal skin biopsy. Now, advances in ultrasound technology and fetal DNA-based analysis have replaced it. The mortality rate is markedly high and prompt; prenatal diagnosis of neonate HI is critical for appropriate perinatal and postnatal management. It is also essential to prepare parents for future pregnancies and reduce the family’s physical and mental distress and financial burden. This report presents a rare case of harlequin ichthyosis diagnosed by the ultrasound and discusses the significance of prenatal ultrasound diagnosis and molecular diagnosis in the prenatal diagnosis of HI.
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Affiliation(s)
- Xiao-Jing Zhou
- Seven Section of Department of Gynaecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu-Jie Lin
- Department of Ultrasound, the Julu County Hospital, Xingtai, China
| | - Xi-Wei Chen
- Seven Section of Department of Gynaecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia-Hua Zheng
- Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ying-Jie Zhou
- Seven Section of Department of Gynaecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
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Montalván-Suárez M, Esperón-Moldes US, Rodríguez-Pazos L, Ordóñez-Ugalde A, Moscoso F, Ugalde-Noritz N, Santomé L, Fachal L, Tettamanti-Miranda D, Ruiz JC, Ginarte M, Vega A. A novel ABCA12 pathologic variant identified in an Ecuadorian harlequin ichthyosis patient: A step forward in genotype-phenotype correlations. Mol Genet Genomic Med 2019; 7:e608. [PMID: 30916489 PMCID: PMC6503032 DOI: 10.1002/mgg3.608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/10/2019] [Accepted: 01/24/2019] [Indexed: 11/22/2022] Open
Abstract
Background Autosomal recessive congenital ichthyoses (ARCI) have been associated with different phenotypes including: harlequin ichthyosis (HI), congenital ichthyosiform erythroderma (CIE), and lamellar ichthyosis (LI). While pathogenic variants in all ARCI genes are associated with LI and CIE phenotypes, the unique gene associated with HI is ABCA12. In HI, the most severe ARCI form, pathogenic variants in both ABCA12 gene alleles usually have a severe impact on protein function. The presence of at least one non‐truncating variant frequently causes a less severe congenital ichthyosis phenotype (LI and CIE). Methods We report the case of a 4‐year‐old Ecuadorian boy with a severe skin disease. Genetic diagnosis was performed by NGS. In silico predictions were performed using Alamut software v2.11. A review of the literature was carried out to identify all patients carrying ABCA12 splice‐site and missense variants, and to explore their genotype‐phenotype correlations. Results Genetic testing revealed a nonsense substitution, p.(Arg2204*), and a new missense variant, p.(Val1927Leu), in the ABCA12 gene. After performing in silico analysis and a comprehensive review of the literature, we conclude that p.(Val1927Leu) affects a well conserved residue which could either disturb the protein function or alter the splicing process, both alternatives could explain the severe phenotype of our patient. Conclusion This case expands the spectrum of ABCA12 reported disease‐causing variants which is important to unravel genotype‐phenotype correlations and highlights the importance of missense variants in the development of HI.
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Affiliation(s)
- Martha Montalván-Suárez
- Sistema de Investigación y Desarrollo SINDE, Universidad Católica de Santiago de Guayaquil and Universidad de Guayaquil, Guayaquil, Ecuador
| | - Uxia Saraiva Esperón-Moldes
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain.,Departamento de Ciencias Forenses, Anatomía Patolóxica, Xinecoloxía, Obstetricia e Pediatría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Laura Rodríguez-Pazos
- Servicio de Dermatología del Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Andrés Ordóñez-Ugalde
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain.,Laboratorio Biomolecular, Cuenca, Ecuador.,Unidad de Genética y Molecular del Hospital de Especialidades José Carrasco Arteaga, Cuenca, Ecuador
| | | | - Nora Ugalde-Noritz
- Unidad de Genética y Molecular del Hospital de Especialidades José Carrasco Arteaga, Cuenca, Ecuador
| | - Luis Santomé
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | - Laura Fachal
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | | | - Juan Carlos Ruiz
- Universidad Espíritu Santo and Hospital Luis Vernaza, Guayaquil, Ecuador.,Instituto de Biomedicina Universidad Católica de Santiago de Guayaquil and Centro de Investigación, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Manuel Ginarte
- Servicio de Dermatología del Complexo Hospitalario Universitario de Santiago, Facultad de Medicina, Santiago de Compostela, Spain
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
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