1
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Siebert MJ, Roach JW, Stotts AK. Congenital Ankylosis of the Knee Treated with Van Nes Rotationplasty: A Case Report. JBJS Case Connect 2023; 13:01709767-202312000-00010. [PMID: 37831787 DOI: 10.2106/jbjs.cc.23.00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
CASE This is a case of a female patient born with thrombocytopenia-absent radius syndrome, with bilateral upper extremity phocomelia, bilateral hip dislocations, and congenital fusion of the right knee with progressively worsening flexion contracture. At age 3 years and 5 months, the patient was treated with excision of the knee ankylosis and Van Nes rotationplasty. This proved durable at age 20 years (final follow-up) without any need for further surgery and without complication. CONCLUSION This is the first known report of Van Nes rotationplasty as a durable treatment option in the management of congenital knee ankylosis, which may avoid reoperation and eliminate risk of recurrence.
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Affiliation(s)
- Matthew J Siebert
- Shriner's Hospital for Children, Salt Lake City, Utah
- Primary Children's Hospital, Salt Lake City, Utah
| | - James W Roach
- Shriner's Hospital for Children, Salt Lake City, Utah
- Primary Children's Hospital, Salt Lake City, Utah
| | - Alan K Stotts
- Shriner's Hospital for Children, Salt Lake City, Utah
- Primary Children's Hospital, Salt Lake City, Utah
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2
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Wang PQ, Chan A, Drosdowech D. Surgical Management and Rehabilitation of an Olecranon Fracture in a Patient with Thrombocytopenia-Absent Radii: A Case Report. JBJS Case Connect 2021; 11:01709767-202106000-00119. [PMID: 34115653 DOI: 10.2106/jbjs.cc.20.00508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 29-year-old right-hand dominant woman with thrombocytopenia-absent radii syndrome was surgically treated for a right olecranon fracture. Given her forearm deformity and short lever arm, a custom-modified corrective elbow flexion splint was used during rehabilitation. Radiographic union was achieved. Although functional outcome scores were similar to the ones previously reported in the general population, the patient had persistent extension contracture. CONCLUSION Despite good functional outcomes, the patient had reduced range of motion. With severe limb deformity, the greatest challenge is to provide optimal rehabilitation protocols and individualized tools.
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Affiliation(s)
- Patrick Qi Wang
- Schulich School of Medicine and Dentistry, University of Western Ontario, Department of Orthopaedics, London, ON, Canada
| | - Andrea Chan
- St. Joseph's Health Care Centre, Roth|MacFarlane Hand and Upper Limb Centre, London, ON, Canada
| | - Darren Drosdowech
- Schulich School of Medicine and Dentistry, University of Western Ontario, Department of Orthopaedics, London, ON, Canada
- St. Joseph's Health Care Centre, Roth|MacFarlane Hand and Upper Limb Centre, London, ON, Canada
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3
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Travessa AM, Dias P, Santos A, Custódio S, Sousa A, Sousa AB. Upper limb phocomelia: A prenatal case of thrombocytopenia-absent radius (TAR) syndrome illustrating the importance of chromosomal microarray in limb reduction defects. Taiwan J Obstet Gynecol 2020; 59:318-322. [PMID: 32127157 DOI: 10.1016/j.tjog.2020.01.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To describe the ultrasonographic, pathologic and molecular findings in a fetus with TAR syndrome, and to illustrate the contribution of chromosomal microarray analysis (CMA) to the etiological investigation of fetal upper limb reduction defects. CASE REPORT A 35-year-old woman was referred for Genetic Counseling after pregnancy termination for severe upper limb bilateral phocomelia detected in the second trimester. Fetal autopsy showed severe shortening of the arms and forearms. The fetal skeletal survey confirmed the absence of the radii, ulnae and humeri. CMA revealed an interstitial deletion in 1q21 including the RBM8A gene. Subsequent Sanger sequencing of this gene identified a hypomorphic mutant allele, c.-21G > A, confirming the diagnosis of TAR syndrome. CONCLUSION The differential diagnosis of upper limb defects is broad. Identification of their cause is essential for adequate genetic counseling including prognosis and recurrence risk estimation. CMA should be considered in fetuses with upper limb reduction defects, especially when the thumbs are present.
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Affiliation(s)
- André M Travessa
- Medical Genetics Unit, Department of Pediatrics, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal; Institute of Histology and Developmental Biology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
| | - Patrícia Dias
- Medical Genetics Unit, Department of Pediatrics, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal
| | - Antónia Santos
- Center for Prenatal Diagnosis, Department of Obstetrics, Garcia de Orta Hospital, Almada, Portugal
| | - Sónia Custódio
- Medical Genetics Unit, Department of Pediatrics, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal
| | - Ana Sousa
- Medical Genetics Unit, Department of Pediatrics, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal
| | - Ana Berta Sousa
- Medical Genetics Unit, Department of Pediatrics, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal; Laboratory of Basic Immunology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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4
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Boussion S, Escande F, Jourdain AS, Smol T, Brunelle P, Duhamel C, Alembik Y, Attié-Bitach T, Baujat G, Bazin A, Bonnière M, Carassou P, Carles D, Devisme L, Goizet C, Goldenberg A, Grotto S, Guichet A, Jouk PS, Loeuillet L, Mechler C, Michot C, Pelluard F, Putoux A, Whalen S, Ghoumid J, Manouvrier-Hanu S, Petit F. TAR syndrome: Clinical and molecular characterization of a cohort of 26 patients and description of novel noncoding variants of RBM8A. Hum Mutat 2020; 41:1220-1225. [PMID: 32227665 DOI: 10.1002/humu.24021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/18/2020] [Accepted: 03/22/2020] [Indexed: 11/07/2022]
Abstract
Thrombocytopenia-absent radius (TAR) syndrome is characterized by radial defect and neonatal thrombocytopenia. It is caused by biallelic variants of RBM8A gene (1q21.1) with the association of a null allele and a hypomorphic noncoding variant. RBM8A encodes Y14, a core protein of the exon junction complex involved in messenger RNA maturation. To date, only two hypomorphic variants have been identified. We report on a cohort of 26 patients affected with TAR syndrome and carrying biallelic variants in RBM8A. Half patients carried a 1q21.1 deletion and one of the two known hypomorphic variants. Four novel noncoding variants of RBM8A were identified in the remaining patients. We developed experimental models enabling their functional characterization in vitro. Two variants, located respectively in the 5'-untranslated region (5'-UTR) and 3'-UTR regions, are responsible for a diminished expression whereas two intronic variants alter splicing. Our results bring new insights into the molecular knowledge of TAR syndrome and enabled us to propose genetic counseling for patients' families.
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Affiliation(s)
- Simon Boussion
- Clinical Genetics Department, Reference Center for Developmental Anomalies, CHU Lille, Lille, France
- EA7364-RADEME, Lille University, Lille, France
| | - Fabienne Escande
- EA7364-RADEME, Lille University, Lille, France
- Biochemistry and Molecular Oncology Laboratory, CHU Lille, Lille, France
| | - Anne-Sophie Jourdain
- EA7364-RADEME, Lille University, Lille, France
- Biochemistry and Molecular Oncology Laboratory, CHU Lille, Lille, France
| | - Thomas Smol
- EA7364-RADEME, Lille University, Lille, France
- Medical Genetics Department, CHU Lille, Lille, France
| | - Perrine Brunelle
- EA7364-RADEME, Lille University, Lille, France
- Biochemistry and Molecular Oncology Laboratory, CHU Lille, Lille, France
| | | | - Yves Alembik
- Medical Genetics Department, CHU Strasbourg, Strasbourg, France
| | - Tania Attié-Bitach
- Histology, Embryology and Cytogenetics Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Geneviève Baujat
- Clinical Genetics Department, Necker-Enfants Malades Hospital, AP-HP, INSERM UMR, IMAGINE Institute, Paris, France
| | - Anne Bazin
- Antenatal Diagnosis Department, René Dubois Hospital, Pontoise, France
| | - Maryse Bonnière
- Histology, Embryology and Cytogenetics Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | | | | | - Louise Devisme
- EA7364-RADEME, Lille University, Lille, France
- Anatomo-Pathology Institute, CHU Lille, Lille, France
| | - Cyril Goizet
- Medical Genetics Department, CHU Bordeaux, MRGM Laboratory, INSERM, Bordeaux University, Bordeaux, France
| | - Alice Goldenberg
- Genetics Department, Reference Center for Developmental Anomalies, CHU Rouen, Rouen, France
| | - Sarah Grotto
- Genetics Department, Robert Debré Hospital, AP-HP, Paris, France
| | | | | | | | - Charlotte Mechler
- Foetopathology Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Caroline Michot
- Clinical Genetics Department, Necker-Enfants Malades Hospital, AP-HP, INSERM UMR, IMAGINE Institute, Paris, France
| | - Fanny Pelluard
- INSERM U1053-UMR BaRITOn, Foetopathology Department, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Audrey Putoux
- Genetics Department, Hospices Civils de Lyon, Lyon, France
- GENDEV Team, CRNL, INSERM U1028, CNRS UMR 5292, UCBL1, Lyon, France
| | - Sandra Whalen
- Clinical Genetics, Reference Center for Developmental Anomalies, Armand Trousseau Hospital, AP-HP, Paris, France
| | - Jamal Ghoumid
- Clinical Genetics Department, Reference Center for Developmental Anomalies, CHU Lille, Lille, France
- EA7364-RADEME, Lille University, Lille, France
| | - Sylvie Manouvrier-Hanu
- Clinical Genetics Department, Reference Center for Developmental Anomalies, CHU Lille, Lille, France
- EA7364-RADEME, Lille University, Lille, France
| | - Florence Petit
- Clinical Genetics Department, Reference Center for Developmental Anomalies, CHU Lille, Lille, France
- EA7364-RADEME, Lille University, Lille, France
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5
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Brodie SA, Rodriguez-Aulet JP, Giri N, Dai J, Steinberg M, Waterfall JJ, Roberson D, Ballew BJ, Zhou W, Anzick SL, Jiang Y, Wang Y, Zhu YJ, Meltzer PS, Boland J, Alter BP, Savage SA. 1q21.1 deletion and a rare functional polymorphism in siblings with thrombocytopenia-absent radius-like phenotypes. Cold Spring Harb Mol Case Stud 2019; 5:mcs.a004564. [PMID: 31836590 PMCID: PMC6913155 DOI: 10.1101/mcs.a004564] [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: 07/18/2019] [Accepted: 09/16/2019] [Indexed: 11/24/2022] Open
Abstract
Thrombocytopenia-absent radii (TAR) syndrome, characterized by neonatal thrombocytopenia and bilateral radial aplasia with thumbs present, is typically caused by the inheritance of a 1q21.1 deletion and a single-nucelotide polymorphism in RBM8A on the nondeleted allele. We evaluated two siblings with TAR-like dysmorphology but lacking thrombocytopenia in infancy. Family NCI-107 participated in an IRB-approved cohort study and underwent comprehensive clinical and genomic evaluations, including aCGH, whole-exome, whole-genome, and targeted sequencing. Gene expression assays and electromobility shift assays (EMSAs) were performed to evaluate the variant of interest. The previously identified TAR-associated 1q21.1 deletion was present in the affected siblings and one healthy parent. Multiple sequencing approaches did not identify previously described TAR-associated SNPs or mutations in relevant genes. We discovered rs61746197 A > G heterozygosity in the parent without the deletion and apparent hemizygosity in both siblings. rs61746197 A > G overlaps a RelA–p65 binding motif, and EMSAs indicate the A allele has higher transcription factor binding efficiency than the G allele. Stimulation of K562 cells to induce megakaryocyte differentiation abrogated the shift of both reference and alternative probes. The 1q21.1 TAR-associated deletion in combination with the G variant of rs61746197 on the nondeleted allele is associated with a TAR-like phenotype. rs61746197 G could be a functional enhancer/repressor element, but more studies are required to identify the specific factor(s) responsible. Overall, our findings suggest a role of rs61746197 A > G and human disease in the setting of a 1q21.1 deletion on the other chromosome.
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Affiliation(s)
- Seth A Brodie
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Jean Paul Rodriguez-Aulet
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Neelam Giri
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Jieqiong Dai
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Mia Steinberg
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Joshua J Waterfall
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - David Roberson
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Bari J Ballew
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Weiyin Zhou
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Sarah L Anzick
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Yuan Jiang
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Yonghong Wang
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Yuelin J Zhu
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Paul S Meltzer
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Joseph Boland
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, NCI-Frederick, Rockville, Maryland 20850, USA
| | - Blanche P Alter
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
| | - Sharon A Savage
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20859, USA
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6
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Ceylan AC, Sahin I, Erdem HB, Kayhan G, Simsek-Kiper PO, Utine GE, Percin F, Boduroglu K, Alikasifoglu M. An eight-case 1q21 region series: novel aberrations and clinical variability with new features. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:548-557. [PMID: 30773728 DOI: 10.1111/jir.12592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/04/2018] [Accepted: 12/31/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Rearrangement of the 1q21 region of chromosome 1 manifests as multiple phenotypes, including microcephaly, intellectual disability, dysmorphic facial features, eye abnormalities, cardiac defects, genitourinary anomalies, autism spectrum disorder, psychiatric conditions and seizures. Herein, we describe eight patients with 1q21 deletion and duplication syndromes, and novel deletions and findings. METHODS Chromosomal microarray analysis was performed to identify the existence of copy number variation. Quantitative polymerase chain reaction was applied using specific primers for the control and 1q21 region of chromosome 1. Mutational analysis was performed in case 5 using direct genomic sequencing for exons 1-6 in RBM8A. RESULTS Copy number variation analysis identified seven deletions and one duplication of the 1q21 region in the eight patients. In addition, four variations were de novo, and two deletions are reported here for the first time. One of the cases (case 7) presents moderate intellectual disability and dysmorphic facial findings, whereas chromosomal microarray analysis showed that case 7 had an 889-kb deletion in the 1q21 proximal region (GPR89A, PDZK1, CD160, POLR3C and NBPF12). CONCLUSION Although the deletion in case 5 did not include the thrombocytopenia-absent radius syndrome critical region or the RBM8A gene, he had pectoral muscle hypoplasia, radius and humerus hypoplasia and short curved ribs, which are indicative of a potential thrombocytopenia-absent radius region modifier. The findings in case 7 suggest that the proximal part of the 1q21 microdeletion syndrome region might be very important for the onset of clinical manifestations. Some novel findings were observed in the presented cases, such as radius and humerus hypoplasia and brain stem hypoplasia. The presented findings expand the spectrum of 1q21 aberrations and provide evidence of genotype-phenotype correlations for this region.
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Affiliation(s)
- A C Ceylan
- Faculty of Medicine, Department of Medical Genetics, Hacettepe University, Ankara, Turkey
- Department of Medical Genetics, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - I Sahin
- Faculty of Medicine, Department of Medical Genetics, Ataturk University, Erzurum, Turkey
- Department of Medical Genetics, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - H B Erdem
- Faculty of Medicine, Department of Medical Genetics, Ataturk University, Erzurum, Turkey
- Department of Medical Genetics, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - G Kayhan
- Faculty of Medicine, Department of Medical Genetics, Gazi University, Ankara, Turkey
| | - P O Simsek-Kiper
- Faculty of Medicine, Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
| | - G E Utine
- Faculty of Medicine, Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
| | - F Percin
- Faculty of Medicine, Department of Medical Genetics, Gazi University, Ankara, Turkey
| | - K Boduroglu
- Faculty of Medicine, Department of Medical Genetics, Hacettepe University, Ankara, Turkey
- Faculty of Medicine, Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
| | - M Alikasifoglu
- Faculty of Medicine, Department of Medical Genetics, Hacettepe University, Ankara, Turkey
- Faculty of Medicine, Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
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7
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Chen CP, Chang SY, Chen YN, Chern SR, Wu PS, Chen SW, Lai ST, Chuang TY, Yang CW, Chen LF, Wang W. Prenatal diagnosis of a familial 1q21.1-q21.2 microdeletion in a fetus with polydactyly of left foot on prenatal ultrasound. Taiwan J Obstet Gynecol 2019; 57:739-744. [PMID: 30342663 DOI: 10.1016/j.tjog.2018.08.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE We present prenatal diagnosis of a familial 1q21.1-q21.2 microdeletion in a fetus with polydactyly of left foot on prenatal ultrasound. CASE REPORT A 30-year-old, gravida 2, para 1, woman underwent amniocentesis at 22 weeks of gestation because of fetal polydactyly of left foot and echogenic heart foci on prenatal ultrasound. She and her husband and the 2-year-old son were healthy, and there was no family history of mental disorders, skeletal abnormalities and congenital malformations. Amniocentesis revealed a karyotype of 46,XX. Simultaneous array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed a 1.317-Mb 1q21.1-q21.2 microdeletion encompassing PRKAB2, FMO5, CHD1L, BCL9, ACP6, GJA5, GJA8 and GPR89B. aCGH analysis of the family members revealed that the phenotypically normal father and elder son carried the same 1q21.1-q21.2 microdeletion. The mother did not have such a deletion. The parents elected to continue the pregnancy, and a 3416-g female baby was delivered at 40 weeks of gestation with neither facial dysmorphism nor gross abnormalities except postaxial polydactyly of the left foot. CONCLUSION Fetuses with a 1q21.1-q21.2 microdeletion may present polydactyly on prenatal ultrasound, and aCGH is helpful for prenatal diagnosis under such a circumstance.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Shu-Yuan Chang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Ni Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | | | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shih-Ting Lai
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tzu-Yun Chuang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chien-Wen Yang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Li-Feng Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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8
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Gamba BF, Zechi-Ceide RM, Kokitsu-Nakata NM, Vendramini-Pittoli S, Rosenberg C, Krepischi Santos ACV, Ribeiro-Bicudo L, Richieri-Costa A. Interstitial 1q21.1 Microdeletion Is Associated with Severe Skeletal Anomalies, Dysmorphic Face and Moderate Intellectual Disability. Mol Syndromol 2016; 7:344-348. [PMID: 27920638 DOI: 10.1159/000450971] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 01/28/2023] Open
Abstract
We report on a Brazilian patient with a 1.7-Mb interstitial microdeletion in chromosome 1q21.1. The phenotypic characteristics include microcephaly, a peculiar facial gestalt, cleft lip/palate, and multiple skeletal anomalies represented by malformed phalanges, scoliosis, abnormal modeling of vertebral bodies, hip dislocation, abnormal acetabula, feet anomalies, and delayed neuropsychological development. Deletions reported in this region are clinically heterogeneous, ranging from subtle phenotypic manifestations to severe congenital heart defects and/or neurodevelopmental findings. A few genes within the deleted region are associated with congenital anomalies, mainly the RBM8A, DUF1220, and HYDIN2 paralogs. Our patient presents with a spectrum of unusual malformations of 1q21.1 deletion syndrome not reported up to date.
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Affiliation(s)
- Bruno F Gamba
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Roseli M Zechi-Ceide
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Nancy M Kokitsu-Nakata
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Siulan Vendramini-Pittoli
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Carla Rosenberg
- Centro de Estudos do Genoma Humano, University of São Paulo, São Paulo, Goiania, Brazil
| | | | - Lucilene Ribeiro-Bicudo
- Departamento de Genética, Instituto de Ciências Biológicas, Universidade Federal De Goias, Goiania, Brazil
| | - Antonio Richieri-Costa
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
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9
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Tassano E, Gimelli S, Divizia MT, Lerone M, Vaccari C, Puliti A, Gimelli G. Thrombocytopenia-absent radius (TAR) syndrome due to compound inheritance for a 1q21.1 microdeletion and a low-frequency noncoding RBM8A SNP: a new familial case. Mol Cytogenet 2015; 8:87. [PMID: 26550033 PMCID: PMC4635577 DOI: 10.1186/s13039-015-0188-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Thrombocytopenia-absent radius syndrome (TAR; MIM 274000) is a rare autosomal recessive disorder combining specific skeletal abnormalities with a reduced platelet count. TAR syndrome has been associated with the compound inheritance of an interstitial microdeletion in 1q21.1 and a low frequency noncoding RBM8A SNP. RESULTS Here, we report on a patient with scapulo-humeral hypoplasia, bilateral radio-ulnar agenesis with intact thumbs, bilateral proximal positioning of the first metacarpal, bilateral fifth finger clinodactyly, bilateral radial deviation of the hands, and thrombocytopenia. Molecular studies showed compound heterozygosity for the 1q21.1 microdeletion and the RBM8A rs139428292 variant in hemizygous state, inherited from the father and the mother, respectively. A second aborted fetus presented TAR features and 1q21.1 microdeletion. DISCUSSION The complex inheritance pattern resulted in reduced expression of Y14, the protein encoded by RBM8A, and a component of the core exon-junction complex (EJC) in platelets. Further studies are needed to explain how Y14 insufficiency and subsequent defects of the EJC could cause the skeletal, haematological and additional features of TAR syndrome. In this study, we discuss other factors that could influence the overall phenotype of patients affected by TAR syndrome. CONCLUSION In this study, we discuss other factors that could influence the overall phenotype of patients affected by TAR syndrome.
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Affiliation(s)
- Elisa Tassano
- />Laboratorio di Citogentica, Istituto Giannina Gaslini, L.go G.Gaslini 5, 16147 Genoa, Italy
| | - Stefania Gimelli
- />Service of Genetic Medicine, University Hospitals of Geneva, 1211 Geneva, Switzerland
| | | | - Margherita Lerone
- />U.O.C. Medical Genetics, Istituto Giannina Gaslini, 16147 Genoa, Italy
| | | | - Aldamaria Puliti
- />U.O.C. Medical Genetics, Istituto Giannina Gaslini, 16147 Genoa, Italy
- />DiNOGMI, University of Genoa, 16147 Genoa, Italy
| | - Giorgio Gimelli
- />Laboratorio di Citogentica, Istituto Giannina Gaslini, L.go G.Gaslini 5, 16147 Genoa, Italy
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Al Kaissi A, Ganger R, Rötzer KM, Klaushofer K, Grill F. A child with split-hand/foot associated with tibial hemimelia (SHFLD syndrome) and thrombocytopenia maps to chromosome region 17p13.3. Am J Med Genet A 2014; 164A:2338-43. [PMID: 24838992 DOI: 10.1002/ajmg.a.36614] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 03/14/2014] [Indexed: 11/10/2022]
Abstract
We describe a-2-year-old boy who presented with a neonatal history of thrombocytopenia associated with a constellation of limb malformations mimicking split hand/foot malformation with long bone deficiency (SHFLD) syndrome. Limb malformations consisted of unilateral monodactyly with radial aplasia, unilateral split foot and bilateral club foot. Tibial aplasia of one limb and tibial hypoplasia of the other limb were notable. Partial agenesis of the sacrum was additional skeletal malformation. Craniofacial features included dense thick scalp hair, narrow frontal area, thick eye-brows, deep-set eyes, depressed nasal bridge, and small overhanging nasal tip, full-cheeks, and large ears. Array-CGH showed duplication of the short arm of chromosome 17p13.3 in the boy and his father, respectively. The father was free from any skeletal abnormalities, though he shares similar craniofacial dysmorphic features like his son. In addition, a paternal sib (uncle of the proband) manifested a phenotype similar to that of the proband. To the best of our knowledge the overall phenotypic and genotypic characterizations were consistent but not completely compatible with the traditional type of TAR syndrome or with SHFLD syndrome. We report on what might be a novel variant of SHFLD associated with transient thrombocytopenia, dysmorphic facial features, and a constellation of bone malformations.
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Affiliation(s)
- Ali Al Kaissi
- Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK, Vienna, Austria; AUVA Trauma Centre Meidling, First Medical Department, Hanusch Hospital, Vienna, Austria; Paediatric Department, Orthopaedic Hospital of Speising, Vienna, Austria
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Abstract
The inherited bone marrow failure syndromes (IBMFS) are a set of clinically related yet heterogeneous disorders in which at least one hematopoietic cell lineage is significantly reduced. Many of the IBMFS have notably increased cancer risks, as well as other physical findings. Highly penetrant germline mutations in key pathways, such as DNA repair, telomere biology, or ribosomal biogenesis, are causative of Fanconi anemia (FA), dyskeratosis congenita (DC), and Diamond-Blackfan anemia (DBA), respectively. Next-generation sequencing (NGS) generally refers to high-throughput, large-scale sequencing technologies and is being used more frequently to understand disease etiology. In the IBMFS, NGS has facilitated the discovery of germline mutations that cause thrombocytopenia absent radii syndrome (TAR), a subset of DC and DBA, and other uncharacterized, but related, disorders. Panels of large numbers of genes are being used to molecularly characterize patients with IBMFS, such as FA and DBA. NGS is also accelerating the discovery of the genetic etiology of previously unclassified IBMFS. In this review, we will highlight recent studies that have employed NGS to ascertain the genetic etiology of IBMFS, namely, FA, DC, DBA, and TAR, and discuss the translational utility of these findings.
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Affiliation(s)
- Payal P. Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Children’s National Medical Center, Washington, DC
| | - Sharon A. Savage
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Bottillo I, Castori M, De Bernardo C, Fabbri R, Grammatico B, Preziosi N, Scassellati GS, Silvestri E, Spagnuolo A, Laino L, Grammatico P. Prenatal diagnosis and post-mortem examination in a fetus with thrombocytopenia-absent radius (TAR) syndrome due to compound heterozygosity for a 1q21.1 microdeletion and a RBM8A hypomorphic allele: a case report. BMC Res Notes 2013; 6:376. [PMID: 24053387 PMCID: PMC3849061 DOI: 10.1186/1756-0500-6-376] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 09/17/2013] [Indexed: 11/14/2022] Open
Abstract
Background Thrombocytopenia–absent radius syndrome is a rare autosomal recessive disorder characterized by megakaryocytic thrombocytopenia and longitudinal limb deficiencies mostly affecting the radial ray. Most patients are compound heterozygotes for a 200 kb interstitial microdeletion in 1q21.1 and a hypomorphic allele in RBM8A, mapping in the deleted segment. At the moment, the complete molecular characterization of thrombocytopenia–absent radius syndrome is limited to a handful of patients mostly ascertained in the pediatric age Case presentation We report on a fetus with bilateral upper limb deficiency found at standard prenatal ultrasound examination. The fetus had bilateral radial agenesis and humeral hypo/aplasia with intact thumbs, micrognathia and urinary anomalies, indicating thrombocytopenia–absent radius syndrome. Molecular studies demonstrated compound heterozygosity for the 1q21.1 microdeletion and the RBM8A rs139428292 variant at the hemizygous state, inherited from the mother and father, respectively Conclusion The molecular information allowed prenatal diagnosis in the following pregnancy resulting in the birth of a healthy carrier female. A review was carried out with the attempt to the trace the fetal ultrasound presentation of thrombocytopenia–absent radius syndrome and discussing opportunities for second-tier molecular studies within a multidisciplinary setting.
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Affiliation(s)
- Irene Bottillo
- Department of Molecular Medicine, Medical Genetics, San Camillo-Forlanini Hospital, Sapienza University, Rome, Italy.
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Albers CA, Newbury-Ecob R, Ouwehand WH, Ghevaert C. New insights into the genetic basis of TAR (thrombocytopenia-absent radii) syndrome. Curr Opin Genet Dev 2013; 23:316-23. [PMID: 23602329 DOI: 10.1016/j.gde.2013.02.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 02/15/2013] [Accepted: 02/25/2013] [Indexed: 12/31/2022]
Abstract
Thrombocytopenia with absent radii (TAR) syndrome is a rare disorder combining specific skeletal abnormalities with a reduced platelet count. Rare proximal microdeletions of 1q21.1 are found in the majority of patients but are also found in unaffected parents. Recently it was shown that TAR syndrome is caused by the compound inheritance of a low-frequency noncoding SNP and a rare null allele in RBM8A, a gene encoding the exon-junction complex subunit member Y14 located in the deleted region. This finding provides new insight into the complex inheritance pattern and new clues to the molecular mechanisms underlying TAR syndrome. We discuss TAR syndrome in the context of abnormal phenotypes associated with proximal and distal 1q21.1 microdeletion and microduplications with incomplete penetrance and variable expressivity.
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Genetics of familial forms of thrombocytopenia. Hum Genet 2012; 131:1821-32. [DOI: 10.1007/s00439-012-1215-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/01/2012] [Indexed: 12/21/2022]
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Omran A, Sahmoud S, Peng J, Ashhab U, Yin F. Thrombocytopenia and absent radii (TAR) syndrome associated with bilateral congenital cataract: a case report. J Med Case Rep 2012; 6:168. [PMID: 22742195 PMCID: PMC3404954 DOI: 10.1186/1752-1947-6-168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 06/28/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Thrombocytopenia with absent radii is a rare congenital defect with hypomegakaryocytic thrombocytopenia and bilateral radial aplasia that may have additional anomalies. We report the case of a girl baby with thrombocytopenia and absent radii syndrome and bilateral congenital cataract. This anomaly has not been previously reported in the children of a non- consanguineous marriage. CASE PRESENTATION This case report describes a two-day-old girl baby of Arab origin with thrombocytopenia and absent radii syndrome and bilateral congenital cataract. CONCLUSIONS This report describes a finding of bilateral congenital cataract associated with thrombocytopenia and absent radii syndrome that has been reported only once before in the literature. This case report highlights a new ocular manifestation in one of the bone marrow failure syndromes.
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Affiliation(s)
- Ahmed Omran
- Department of Pediatrics, Xiangya Hospital of Central South University, No, 87 Xiangya Road, Changsha, Hunan, 410008, China.
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