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Kim SJ, Yoon JS, Hwang IT. A Novel Heterozygous ACAN Variant in a Short Patient Born Small for Gestational Age with Recurrent Patellar Dislocation: A Case Report. J Clin Res Pediatr Endocrinol 2022; 14:481-484. [PMID: 34210114 PMCID: PMC9724056 DOI: 10.4274/jcrpe.galenos.2021.2021.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
ACAN variants can manifest as various clinical features, including short stature, advanced bone age (BA), and skeletal defects. Here, we report rare clinical manifestations of ACAN defects in a 9 year, 5 month-old girl born small for gestational age (SGA), who presented with short stature, and was initially diagnosed with idiopathic growth hormone deficiency. She displayed several dysmorphic features, including genu valgum, cubitus valgus, and recurrent patellar dislocations. She presented with progressive advancement of BA compared with chronological age. Whole exome sequencing confirmed the presence of a novel heterozygous nonsense variant, c.1968C>G, p.(Tyr656*), in ACAN. ACAN variants should be considered in short stature patients born SGA with joint problems, particularly those with recurrent patellar dislocation and genu valgum.
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Affiliation(s)
- Su Ji Kim
- Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Department of Pediatrics, Seoul, Korea
| | - Jong Seo Yoon
- Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Department of Pediatrics, Seoul, Korea
| | - Il Tae Hwang
- Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Department of Pediatrics, Seoul, Korea,* Address for Correspondence: Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Department of Pediatrics, Seoul, Korea Phone: +82-10-2396-1772 E-mail:
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Yeter B, Aslanger AD, Yeşil G, Elçioğlu NH. A Novel Mutation in the TRIP11 Gene: Diagnostic Approach from Relatively Common Skeletal Dysplasias to an Extremely Rare Odontochondrodysplasia. J Clin Res Pediatr Endocrinol 2022; 14:475-480. [PMID: 34111908 PMCID: PMC9724053 DOI: 10.4274/jcrpe.galenos.2021.2021.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Odontochondrodysplasia (ODCD, OMIM #184260) is a rare, non-lethal skeletal dysplasia characterized by involvement of the spine and metaphyseal regions of the long bones, pulmonary hypoplasia, short stature, joint hypermobility, and dentinogenesis imperfecta. ODCD is inherited in an autosomal recessive fashion with an unknown frequency caused by mutations of the thyroid hormone receptor interactor 11 gene (TRIP11; OMIM *604505). The TRIP11 gene encodes the Golgi microtubule-associated protein 210 (GMAP-210), which is an indispensable protein for the function of the Golgi apparatus. Mutations in TRIP11 also cause achondrogenesis type 1A (ACG1A). Null mutations of TRIP11 lead to ACG1A, also known as a lethal skeletal dysplasia, while hypomorphic mutations cause ODCD. Here we report a male child diagnosed as ODCD with a novel compound heterozygous mutation who presented with skeletal changes, short stature, dentinogenesis imperfecta, and facial dysmorphism resembling achondroplasia and hypochondroplasia.
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Affiliation(s)
- Burcu Yeter
- Marmara University Faculty of Medicine, Department of Pediatric Genetics, İstanbul, Turkey,* Address for Correspondence: Marmara University Faculty of Medicine, Department of Pediatric Genetics, İstanbul, Turkey Phone: +90 507 973 08 40 E-mail:
| | - Ayca Dilruba Aslanger
- İstanbul University Faculty of Medicine, Department of Medical Genetics, İstanbul, Turkey
| | - Gözde Yeşil
- İstanbul University Faculty of Medicine, Department of Medical Genetics, İstanbul, Turkey
| | - Nursel H. Elçioğlu
- Marmara University Faculty of Medicine, Department of Pediatric Genetics, İstanbul, Turkey,Eastern Mediterranean University Faculty of Medicine, Department of Pediatric Genetics, Mersin, Turkey
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Bajaj S, Satoskar P, Nair A, Sheth F, Sheth J, Sheth H. An ultra-rare case of immunoskeletal dysplasia with neurodevelopmental abnormalities in an Indian patient with homozygous c.953C > T variant in EXTL3 gene: a case report. BMC Pediatr 2022; 22:78. [PMID: 35114981 PMCID: PMC8812182 DOI: 10.1186/s12887-022-03143-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/26/2022] [Indexed: 12/19/2022] Open
Abstract
Background Immunoskeletal dysplasia with neurodevelopmental abnormalities (ISDNA) is an ultra-rare genetic condition that belongs to the group of spondyloepimetaphyseal dysplasias. It is caused due to presence of biallelic variants in the EXTL3 gene. The encoded exostosin like glycosyltransferase 3 (EXTL3) protein plays a key role in heparan sulfate synthesis. The skeletal and nervous systems are prominently affected in ISDNA with variability in immunological manifestations. Here, we report the 15th case of ISDNA (third patient of an Indian ancestry) in the world, along with a review of literature. Case presentation A 15-month-old female child with clinical indications of global developmental delay, short stature, coarse facial features, and hypotonia was referred to our clinic. Spondyloepimetaphyseal dysplasias associated with extra-skeletal manifestations was suspected based on clinic-radiological correlation. Whole exome sequencing analysis revealed the presence of a homozygous known pathogenic variant c.953C > T (p. Pro318Leu) in exon 3 of the EXTL3 gene, thereby confirming diagnosis of ISDNA. Conclusion We present an ultra-rare case of ISDNA- third patient of Indian ancestry and only the 15th reported case in the literature. On review of all cases in the literature, we find that the affected individuals show abnormalities primarily in three systems namely- skeletal, nervous and immune system. Notably, patients harbouring the same variant in EXTL3 gene show phenotypic variability especially with respect to presence or absence of immunological manifestations, suggesting a role of unknown modifiers. Hence, it is currently not possible to correlate the variant position in the EXTL3 gene with disease severity.
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Affiliation(s)
- Shruti Bajaj
- The Purple Gene Clinic, Simplex Khushaangan, SV Road, Malad West, Mumbai, 400064, Maharashtra, India
| | - Purnima Satoskar
- Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital and Seth G. S. Medical College, Acharya Donde Marg, Parel, Mumbai, 400012, India
| | - Aadhira Nair
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, 380015, Ahmedabad, India
| | - Frenny Sheth
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, 380015, Ahmedabad, India
| | - Jayesh Sheth
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, 380015, Ahmedabad, India
| | - Harsh Sheth
- FRIGE's Institute of Human Genetics, FRIGE House, Jodhpur Gam Road, Satellite, 380015, Ahmedabad, India.
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Del Pino M, Sanchez-Soler MJ, Parrón-Pajares M, Aza-Carmona M, Heath KE, Fano V. Description of four patients with TRIP11 variants expand the clinical spectrum of odontochondroplasia (ODCD) and demonstrate the existence of common variants. Eur J Med Genet 2021; 64:104198. [PMID: 33746040 DOI: 10.1016/j.ejmg.2021.104198] [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: 11/05/2020] [Revised: 03/01/2021] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Abstract
More than two decades since the first clinical and radiological description of odontochondroplasia (ODCD) was reported, biallelic loss of function variants in the Thyroid hormone receptor interactor 11 gene (TRIP11) were identified, the same gene implicated in the lethal disorder achondrogenesis (ACG1A). Here we report the clinical and radiological follow-up of four ODCD patients, including two siblings and an adult who interestingly has the mildest form observed to date. Four TRIP11 variants were detected, two previously unreported. Subsequently, we review the clinical and radiological findings of the 14 reported ODCD patients. The majority of ODCD patients are compound heterozygotes for TRIP11 variants, 12/14 have a null allele and a splice variant whilst one is homozygous for an in-frame splicing variant, with the splice variants resulting in residual GMAP activity and hypothesized to explain why they have ODCD and not ACG1A. However, adult patient 4 has two potentially null alleles and it remains unknown why she has very mild clinical features. The c.586C>T; p.(Gln196*) variant, previously shown by mRNA studies to result in p.Val105_Gln196del, is the most frequent variant, present in seven individuals from four families, three from different regions of the world, suggesting that it may be a variant hotspot. Another variant, c.2993_2994del; p.(Lys998Serfs*5), has been observed in two individuals with a possible common ancestor. In summary, although there are clinical and radiological characteristics common to all individuals, we demonstrate that the clinical spectrum of TRIP11-associated dysplasias is even more diverse than previously described and that common genetic variants may exist.
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Affiliation(s)
- Mariana Del Pino
- Dept of Growth and Development, Hospital Garrahan, Buenos Aires, Argentina.
| | - Maria José Sanchez-Soler
- Medical Genetics Section, Dept of Pediatrics, Hospital Clinico Universitario Virgen de la Arrixaca, and IMIB-Arrixaca, Murcia, Spain; Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, Spain; CIBERER, ISCIII, Madrid, Spain
| | - Manuel Parrón-Pajares
- Dept of Radiology, Hospital Universitario La Paz, Madrid, Spain; Skeletal dysplasia multidisciplinary Unit (UMDE) and ERN-BOND, Hospital Universitario la Paz, Madrid, Spain
| | - Miriam Aza-Carmona
- CIBERER, ISCIII, Madrid, Spain; Skeletal dysplasia multidisciplinary Unit (UMDE) and ERN-BOND, Hospital Universitario la Paz, Madrid, Spain; Institute of Medical & Molecular Genetics (INGEMM), UAM, IdiPAZ Madrid, Spain
| | - Karen E Heath
- CIBERER, ISCIII, Madrid, Spain; Skeletal dysplasia multidisciplinary Unit (UMDE) and ERN-BOND, Hospital Universitario la Paz, Madrid, Spain; Institute of Medical & Molecular Genetics (INGEMM), UAM, IdiPAZ Madrid, Spain.
| | - Virginia Fano
- Dept of Growth and Development, Hospital Garrahan, Buenos Aires, Argentina
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Wehrle A, Witkos TM, Unger S, Schneider J, Follit JA, Hermann J, Welting T, Fano V, Hietala M, Vatanavicharn N, Schoner K, Spranger J, Schmidts M, Zabel B, Pazour GJ, Bloch-Zupan A, Nishimura G, Superti-Furga A, Lowe M, Lausch E. Hypomorphic mutations of TRIP11 cause odontochondrodysplasia. JCI Insight 2019; 4:124701. [PMID: 30728324 PMCID: PMC6413787 DOI: 10.1172/jci.insight.124701] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/20/2018] [Indexed: 12/24/2022] Open
Abstract
Odontochondrodysplasia (ODCD) is an unresolved genetic disorder of skeletal and dental development. Here, we show that ODCD is caused by hypomorphic TRIP11 mutations, and we identify ODCD as the nonlethal counterpart to achondrogenesis 1A (ACG1A), the known null phenotype in humans. TRIP11 encodes Golgi-associated microtubule-binding protein 210 (GMAP-210), an essential tether protein of the Golgi apparatus that physically interacts with intraflagellar transport 20 (IFT20), a component of the ciliary intraflagellar transport complex B. This association and extraskeletal disease manifestations in ODCD point to a cilium-dependent pathogenesis. However, our functional studies in patient-derived primary cells clearly support a Golgi-based disease mechanism. In spite of reduced abundance, residual GMAP variants maintain partial Golgi integrity, normal global protein secretion, and subcellular distribution of IFT20 in ODCD. These functions are lost when GMAP-210 is completely abrogated in ACG1A. However, a similar defect in chondrocyte maturation is observed in both disorders, which produces a cellular achondrogenesis phenotype of different severity, ensuing from aberrant glycan processing and impaired extracellular matrix proteoglycan secretion by the Golgi apparatus. Bi-allelic mutations of TRIP11 cause a spectrum of skeletal phenotypes whose severity is primarily based on impaired secretory trafficking and aberrant glycan processing.
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Affiliation(s)
- Anika Wehrle
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tomasz M Witkos
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Sheila Unger
- Division of Genetic Medicine, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Judith Schneider
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - John A Follit
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Johannes Hermann
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tim Welting
- Laboratory for Experimental Orthopedics, Department of Orthopaedic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Virginia Fano
- Hospital de Pediatria JP Garrahan, Buenos Aires, Argentina
| | - Marja Hietala
- Medical Biochemistry and Genetics, University of Turku, Turku, Finland
| | | | - Katharina Schoner
- Institute of Pathology, Philipps-University Marburg, Marburg, Germany
| | - Jürgen Spranger
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Miriam Schmidts
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernhard Zabel
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gregory J Pazour
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Agnes Bloch-Zupan
- Centre de Référence des Manifestations Odontologiques des Maladies Rares, Pôle de Médecine et Chirurgie Bucco-dentaires, Hôpitaux Universitaires de Strasbourg (HUS), Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Université de Strasbourg, Faculté de Chirurgie Dentaire, Institute of Advanced Studies, USIAS, Strasbourg, France.,HUS, Pôle de Médecine et Chirurgie Bucco-dentaires Hôpital Civil, Centre de référence des maladies rares orales et dentaires, O-Rares, Filière Santé Maladies rares TETE COU, European Reference Network ERN CRANIO, Strasbourg, France.,Université de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), CERBM, INSERM U1258, CNRS- UMR7104, Illkirch, France
| | - Gen Nishimura
- Department of Radiology and Medical Imaging, Tokyo Metropolitan Kiyose Children's Hospital, Kiyose, Japan
| | - Andrea Superti-Furga
- Division of Genetic Medicine, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Martin Lowe
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Ekkehart Lausch
- Department of Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Unger S, Antoniazzi F, Brugnara M, Alanay Y, Caglayan A, Lachlan K, Ikegawa S, Nishimura G, Zabel B, Spranger J, Superti-Furga A. Clinical and radiographic delineation of odontochondrodysplasia. Am J Med Genet A 2008; 146A:770-8. [DOI: 10.1002/ajmg.a.32214] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Verloes A, Lepage P, Baumann C, Maroteaux P, Merrer ML. Spondylometaphyseal dysplasia, east-African type: a new form of early, severe SMD with rounded vertebrae. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 113:362-6. [PMID: 12457408 DOI: 10.1002/ajmg.b.10738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Spondylometaphyseal dysplasias (SMD) are a heterogeneous group of bone dysplasias characterized by vertebral and metaphyseal changes of various severities. We report two unrelated patients of east African origin with a skeletal disorder consisting of 1) severe metaphyseal dysplasia of early onset, sparing hand bones, with bracket-shaped metaphyses; 2) dysplastic pelvis with irregular iliac rim; and 3) oval-shaped vertebral bodies. Contrasting with most types of SMD, the spinal dysplasia is limited to mild changes in the vertebral body shape that tend to soften with time, whereas the iliac rims have a striking lacy appearance. Except for the most common types (Kozlowski type and Schmidt type), most of the literature on SMD deals with single case reports, without longitudinal data, for which molecular definition is still lacking and classification remains unclear. These two patients could belongs to the A4 group in the classification of Maroteaux and Spranger [1991: Pediatr Radiol 2l:293-297], and illustrate the difficulties of a clinical classification of SMD.
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Affiliation(s)
- Alain Verloes
- Clinical Genetic Unit, Hôpital Robert Debré, Paris, France.
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