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Siegert S, Mindler GT, Brücke C, Kranzl A, Patsch J, Ritter M, Janecke AR, Vodopiutz J. Expanding the Phenotype of the FAM149B1-Related Ciliopathy and Identification of Three Neurogenetic Disorders in a Single Family. Genes (Basel) 2021; 12:genes12111648. [PMID: 34828254 PMCID: PMC8622907 DOI: 10.3390/genes12111648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 12/02/2022] Open
Abstract
Biallelic truncating FAM149B1 variants result in cilia dysfunction and have been reported in four infants with Joubert syndrome and orofaciodigital syndrome type VI, respectively. We report here on three adult siblings, 18 to 40 years of age, homozygous for the known FAM149B1 c.354_357delinsCACTC (p.Gln118Hisfs*20) variant. Detailed clinical examinations were performed including ocular and gait analyses, skeletal- and neuroimaging. All three patients presented with neurological and oculomotor symptoms since birth and mild skeletal dysplasia in infancy resulting in characteristic gait abnormalities. We document mild skeletal dysplasia, abnormal gait with increased hip rotation and increased external foot rotation, ataxia, variable polydactyly, ocular Duane syndrome, progressive ophthalmoplegia, nystagmus, situs inversus of the retinal vessels, olfactory bulb aplasia, and corpus callosal dysgenesis as novel features in FAM149B1-ciliopathy. We show that intellectual disability is mild to moderate and retinal, renal and liver function is normal in these affected adults. Our study thus expands the FAM149B1-related Joubert syndrome to a mainly neurological and skeletal ciliopathy phenotype with predominant oculomotor dysfunction but otherwise stable outcome in adults. Diagnosis of FAM149B1-related disorder was impeded by segregation of multiple neurogenetic disorders in the same family, highlighting the importance of extended clinical and genetic studies in families with complex phenotypes.
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Affiliation(s)
- Sandy Siegert
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria;
| | - Gabriel T. Mindler
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, 1130 Vienna, Austria; (G.T.M.); (A.K.)
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
| | - Christof Brücke
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Andreas Kranzl
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, 1130 Vienna, Austria; (G.T.M.); (A.K.)
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
- Laboratory for Gait and Movement Analysis, Orthopaedic Hospital Speising, 1130 Vienna, Austria
| | - Janina Patsch
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Markus Ritter
- Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Andreas R. Janecke
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria;
- Division of Human Genetics, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Julia Vodopiutz
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria;
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
- Correspondence: ; Tel.: +43-1-40400-31880
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Haberlandt E, Valovka T, Janjic T, Müller T, Blatsios G, Karall D, Janecke AR. Characteristic facial features and cortical blindness distinguish the DOCK7-related epileptic encephalopathy. Mol Genet Genomic Med 2021; 9:e1607. [PMID: 33471954 PMCID: PMC8104163 DOI: 10.1002/mgg3.1607] [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: 11/23/2020] [Revised: 12/26/2020] [Accepted: 01/04/2021] [Indexed: 12/24/2022] Open
Abstract
Background The epileptic encephalopathies display extensive locus and allelic heterogeneity. Biallelic truncating DOCK7 variants were recently reported in five children with early‐onset epilepsy, intellectual disability, and cortical blindness, indicating that DOCK7 deficiency causes a specific type of epileptic encephalopathy. Methods We identified 23‐ and 27‐year‐old siblings with the clinical pattern reported for DOCK7 deficiency, and conducted genome‐wide linkage analysis and WES. The consequences of a DOCK7 variant were analyzed on the transcript and protein level in patients’ fibroblasts. Results We identified a novel homozygous DOCK7 frameshift variant, an intragenic tandem duplication of 124‐kb, previously missed by CGH array, in adult patients. Patients display atrophy in the occipital lobe and pontine hypoplasia with marked pontobulbar sulcus, and focal atrophy of occasional cerebellar folia is a novel finding. Recognizable dysmorphic features include normo‐brachycephaly, narrow forehead, low anterior and posterior hairlines, prominent ears, full cheeks, and long eyelashes. Our patients function on the level of 4‐year‐old children, never showed signs of regression, and seizures are largely controlled with multi‐pharmacotherapy. Studies of patients’ fibroblasts showed nonsense‐mediated RNA decay and lack of DOCK7 protein. Conclusion DOCK7 deficiency causes a definable clinical entity, a recognizable type of epileptic encephalopathy.
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Affiliation(s)
- Edda Haberlandt
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.,Krankenhaus der Stadt Dornbirn, Kinder- und Jugendheilkunde, Dornbirn, Austria
| | - Taras Valovka
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Tanja Janjic
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Müller
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Georgios Blatsios
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniela Karall
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas R Janecke
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.,Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
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Cariboni A, Balasubramanian R. Kallmann syndrome and idiopathic hypogonadotropic hypogonadism: The role of semaphorin signaling on GnRH neurons. HANDBOOK OF CLINICAL NEUROLOGY 2021; 182:307-315. [PMID: 34266601 DOI: 10.1016/b978-0-12-819973-2.00022-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Idiopathic hypogonadotropic hypogonadism and Kallmann syndrome are rare genetic disorders characterized by isolated gonadotropin-releasing hormone (GnRH) deficiency (IGD) and delayed or absent puberty. Defective GnRH neuron migration during development or secretion of mature GnRH neurons secondary to molecular defects in several key developmental and neuroendocrine pathways are thought to be the primary causes of these disorders. Recent studies have highlighted the importance of semaphorins and their receptors in this system, by showing that these molecules play distinct roles during the development and plasticity of these neurons. Accordingly, mutations in the semaphoring-signaling pathway genes have been found in patients affected by IGD, underlying the importance of semaphorin-mediated signaling pathways in the neuroendocrine axis that control reproduction.
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Affiliation(s)
- Anna Cariboni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
| | - Ravikumar Balasubramanian
- Reproductive Endocrine Unit of the Department of Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States
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4
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Gileta AF, Helgeson ML, Leonard JMM, Pyle LC, Subramanian HP, Arndt K, Hawkes CP, Del Gaudio D. Further delineation of a recognizable type of syndromic short stature caused by biallelic SEMA3A loss-of-function variants. Am J Med Genet A 2020; 185:889-893. [PMID: 33369061 DOI: 10.1002/ajmg.a.62023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/30/2022]
Abstract
The semaphorin protein family is a diverse set of extracellular signaling proteins that perform fundamental roles in the development and operation of numerous biological systems, notably the nervous, musculoskeletal, cardiovascular, endocrine, and reproductive systems. Recently, recessive loss-of-function (LoF) variants in SEMA3A (semaphorin 3A) have been shown to result in a recognizable syndrome characterized by short stature, skeletal abnormalities, congenital heart defects, and variable additional anomalies. Here, we describe the clinical and molecular characterization of a female patient presenting with skeletal dysplasia, hypogonadotropic hypogonadism (HH), and anosmia who harbors a nonsense variant c.1633C>T (p.Arg555*) and a deletion of exons 15, 16, and 17 in SEMA3A in the compound heterozygous state. These variants were identified through next-generation sequencing analysis of a panel of 26 genes known to be associated with HH/Kallmann syndrome. Our findings further substantiate the notion that biallelic LoF SEMA3A variants cause a syndromic form of short stature and expand the phenotypic spectrum associated with this condition to include features of Kallmann syndrome.
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Affiliation(s)
- Alexander F Gileta
- Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA
| | - Maria L Helgeson
- Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA
| | - Jacqueline M M Leonard
- Division of Human Genetics and Roberts Individualized Medical Genetics Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Louise C Pyle
- Division of Human Genetics and Roberts Individualized Medical Genetics Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hari P Subramanian
- Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA
| | - Kelly Arndt
- Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA
| | - Colin P Hawkes
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Daniela Del Gaudio
- Department of Human Genetics, The University of Chicago, Chicago, Illinois, USA
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5
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Baumann M, Beaver EM, Palomares-Bralo M, Santos-Simarro F, Holzer P, Povysil G, Müller T, Valovka T, Janecke AR. Further delineation of putative ACTB loss-of-function variants: A 4-patient series. Hum Mutat 2020; 41:753-758. [PMID: 31898838 PMCID: PMC7155001 DOI: 10.1002/humu.23970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/10/2019] [Accepted: 12/27/2019] [Indexed: 12/18/2022]
Abstract
ACTB encodes β‐cytoplasmic actin, an essential component of the cytoskeleton. Based on chromosome 7p22.1 deletions that include the ACTB locus and on rare truncating ACTB variants, a phenotype resulting from ACTB haploinsufficiency was recently proposed. We report putative ACTB loss‐of‐function variants in four patients. To the best of our knowledge, we report the first 7p22.1 microdeletion confined to ACTB and the second ACTB frameshifting mutation that predicts mRNA decay. A de‐novo ACTB p.(Gly302Ala) mutation affects β‐cytoplasmic actin distribution. All four patients share a facial gestalt that is distinct from that of individuals with dominant‐negative ACTB variants in Baraitser‐Winter cerebrofrontofacial syndrome. Two of our patients had strikingly thin and sparse scalp hair. One patient had sagittal craniosynostosis and hypospadias. All three affected male children have attention deficits and mild global developmental delay. Mild intellectual disability was present in only one patient. Heterozygous ACTB deletion can allow for normal psychomotor function.
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Affiliation(s)
- Matthias Baumann
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Erin M Beaver
- Mercy Kids Genetics, Mercy Children's Hospital St. Louis, St. Louis, Missouri
| | - María Palomares-Bralo
- Institute of Medical and Molecular Genetics, University Hospital La Paz, Madrid, Spain
| | | | - Peter Holzer
- Intelligent Predictive Networks GmbH, Vienna, Austria
| | - Gundula Povysil
- Institute of Bioinformatics, Johannes Kepler University, Linz, Austria
| | - Thomas Müller
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Taras Valovka
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas R Janecke
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.,Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
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6
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Hu F, Sun L. Recognizable type of pituitary, heart, kidney and skeletal dysplasia mostly caused by SEMA3A mutation: A case report. World J Clin Cases 2019; 7:3310-3315. [PMID: 31667184 PMCID: PMC6819303 DOI: 10.12998/wjcc.v7.i20.3310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/29/2019] [Accepted: 09/11/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The SEMA3A gene, which is located at 7q21.11, is involved in hypothalamic neuron migration, heart development, kidney development, and skeleton metabolism. Mutation of the SEMA3A gene is associated with Kallmann syndrome 16 with or without a normal sense of smell. In addition, two case reports showed that mutation of the SEMA3A gene could cause short stature, low gonadotropin, hypogonadism, thoracic deformity, a high scapula, rib and lower limb deformity, facial deformity (long face, epicanthic folds, backwards ears), and arterial malformation.
CASE SUMMARY We reported the case of a 26-year-old Chinese man who was admitted because of short stature. Physical examination showed that he had many abnormal symptoms, including a short neck, facial moles, knee valgus, transverse palm, continuous grade 5/6 murmurs in the pulmonary auscultation area, no whiskers, or pubic hair, no Adam’s apple, short penis and cryptorchidism. Radiological examination showed pituitary, gonad, heart, kidney and skeletal dysplasia. The laboratory tests revealed low growth hormone, luteinizing hormone, follicle-stimulating hormone, testosterone and estrogen. Clinical whole-exome detection showed that our patient, unlike previously reported patients, has a new SEMA3A gene mutation (c.950A>G). Now, his height has increased by 3 cm. In addition, he has a good appetite and reduced subcutaneous fat over 3 mo of recombinant human growth hormone injections therapy. Unfortunately, he refuses further treatment about gonad.
CONCLUSION Patients who come to a hospital because of their short stature must undergo gene detection if they have other simultaneous abnormal phenotypes.
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Affiliation(s)
- Fang Hu
- Department of Endocrinology and Metabolism, Fifth Affiliated Hospital Sun Yat-Sen University, Sun Yat-Sen University, Zhuhai 519000, Guangdong Province, China
| | - Liao Sun
- Department of Endocrinology and Metabolism, Fifth Affiliated Hospital Sun Yat-Sen University, Sun Yat-Sen University, Zhuhai 519000, Guangdong Province, China
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Ufartes R, Schwenty-Lara J, Freese L, Neuhofer C, Möller J, Wehner P, van Ravenswaaij-Arts CMA, Wong MTY, Schanze I, Tzschach A, Bartsch O, Borchers A, Pauli S. Sema3a plays a role in the pathogenesis of CHARGE syndrome. Hum Mol Genet 2018; 27:1343-1352. [DOI: 10.1093/hmg/ddy045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/02/2018] [Indexed: 12/28/2022] Open
Affiliation(s)
- Roser Ufartes
- Institute of Human Genetics, University Medical Center Göttingen, 37073 Göttingen, Germany
| | - Janina Schwenty-Lara
- Department of Biology, Molecular Embryology, Philipps-Universität Marburg, 35043 Marburg, Germany
| | - Luisa Freese
- Institute of Human Genetics, University Medical Center Göttingen, 37073 Göttingen, Germany
| | - Christiane Neuhofer
- Institute of Human Genetics, University Medical Center Göttingen, 37073 Göttingen, Germany
| | - Janika Möller
- Department of Biology, Molecular Embryology, Philipps-Universität Marburg, 35043 Marburg, Germany
| | - Peter Wehner
- Department of Developmental Biochemistry, Georg August University Göttingen, 37077 Göttingen, Germany
| | - Conny M A van Ravenswaaij-Arts
- Department of Genetics, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Monica T Y Wong
- Department of Genetics, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Ina Schanze
- Institute of Human Genetics, University Medical Center Magdeburg, 39120 Magdeburg, Germany
| | - Andreas Tzschach
- TU Dresden, Faculty of Medicine Carl Gustav Carus, Institute for Clinical Genetics, 01307 Dresden, Germany
| | - Oliver Bartsch
- Institute of Human Genetics, Johannes Gutenberg University Mainz, University Medical Centre, 55131 Mainz, Germany
| | - Annette Borchers
- Department of Biology, Molecular Embryology, Philipps-Universität Marburg, 35043 Marburg, Germany
| | - Silke Pauli
- Institute of Human Genetics, University Medical Center Göttingen, 37073 Göttingen, Germany
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