Dual Diagnosis of Trichohepatoenteric Syndrome and Lipoid Proteinosis in a Turkish Child

Introduction

Trichohepatoenteric syndrome (THES) is caused by pathogenic mutations in TTC37 and SKIV2L genes and characterized by intractable diarrhea, facial dysmorphism, hair abnormality, immunodeficiency, and skin abnormalities. Lipoid proteinosis is caused by pathogenic mutations in ECM1 gene and characterized by deposition of hyaline-like material in various tissues resulting in heterogenous clinical findings.

Case Presentation

Four years after the diagnosis and management of THES, due to new clinical findings, another reason for underlying features of the patient was considered. WES was performed and a homozygous c.507delT (p.Arg171GlyfsTer7) mutation in the ECM1 gene was detected.

Conclusion

This case provides an example of co-existence of multiple genetic defects in a single patient born to consanguineous parents.

The spectrum of HNF1A gene mutations in patients with MODY 3 phenotype and identification of three novel germline mutations in Turkish Population

BACKGROUND

Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes mellitus characterized by autosomal dominant inheritance, early age of onset, and pancreatic beta cell dysfunction. Heterozygous mutations in several genes may cause MODY.

METHODS

In the present study, we investigated the molecular spectrum of HNF1A (hepatocyte nuclear factor 1a) mutations, in the individuals referred to a reference center for molecular genetic analysis. Mutations screening was performed in a group of 136 unrelated patients (average age 17.22 years) selected by clinical characterization of MODY. Mutation screening involved direct sequencing of the HNF1A gene.

RESULTS

Among 136 individuals analyzed, 10 were carrying heterozygous HNF1A mutations, 3 of them being novel. Clinical features, such as age of diabetes at diagnosis or severity of hyperglycemia, were not related to the mutation type or location. No clear phenotype - genotype correlations were identified.

CONCLUSIONS

As a conclusion MODY resulted from HNF1A mutations shows heterogeneity at both phenotypic and molecular levels in Turkish population.

Diffuse hypomyelination is not obligate for POLR3-related disorders

OBJECTIVE

To report atypical MRI patterns associated with POLR3A and POLR3B mutations.

METHODS

This was a multicenter retrospective study to collect neuroradiologic, clinical, and molecular data of patients with mutations in POLR3A and POLR3B without the classic MRI phenotype, i.e., diffuse hypomyelination associated with relative T2 hypointensity of the ventrolateral thalamus, globus pallidus, optic radiation, corticospinal tract at the level of the internal capsule, and dentate nucleus, cerebellar atrophy, and thinning of the corpus callosum.

RESULTS

Eight patients were identified: 6 carried mutations in POLR3A and 2 in POLR3B. We identified 2 novel MRI patterns: 4 participants presented a selective involvement of the corticospinal tracts, specifically at the level of the posterior limbs of the internal capsules; 4 patients presented moderate to severe cerebellar atrophy. Incomplete hypomyelination was observed in 5 participants.

CONCLUSION

Diffuse hypomyelination is not an obligatory feature of POLR3-related disorders. Two distinct patterns, selective involvement of the corticospinal tracts and cerebellar atrophy, are added to the MRI presentation of POLR3-related disorders.

Psychotic experiences, alcohol–cannabis abuse, stressful events and familial risk is associated with onset of clinical psychosis: Evidence from a 6-year longitudinal population-based cohort

Introduction

Both clinical and subclinical psychosis is probably a consequence of underlying genetic and environmental interactions.

Objectives

Defining differential impact of environmental/familial risk factors and psychotic experiences across the onset of clinical psychosis.

Aims

To assess mental health outcomes in a 6-year follow-up of a representative general population sample with a special focus on extended psychosis phenotype.

Methods

Addresses were contacted in multistage clustered area probability sampling frame covering 9 districts and 302 neighbourhoods (n: 4011) at baseline (T1) and 6 years after (n: 2142) (T2). Psychotic experiences were screened with Composite International Diagnostic Interview and probable cases were re-interviewed with SCID-I. Relations were tested using logistic regression models.

Results

Of subclinical psychotic symptoms at baseline, 6.4% transitioned to clinical psychosis; 44.4% persisted, 90.2% transitioned to any DSM disorder. Of newly onset clinical psychosis at T2, 62.8% had subclinical psychotic expressions at baseline. The risk of developing clinical psychosis was greater in those with baseline subclinical psychotic experiences, alcohol–cannabis abuse, stressful-forensic event history and family history of mental disorders. Most of risk factors associated with psychosis proneness at T1 were also associated with clinical psychotic outcome at T2 (Table 1).

Conclusions

Psychotic experiences takes attention for the risk to develop psychosis due to underlying genetic and environmental interactions; also may be an important risk factor to develop any mental disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Mannose binding lectin codon 54 polymorphism and susceptibility to recurrent respiratory tract infections in children: A meta-analysis

BACKGROUND

There have been studies focused on mannose binding lectin (MBL) polymorphism and susceptibility to recurrent respiratory tract infections (RRTI) with inconclusive results. This present study is a meta-analysis of possible MBL and RRTI association in children.

METHODS

A literature search was performed using Medline and PubMed and abstracts were reviewed for relevance. Any study was considered to be eligible for inclusion if it met the following criteria: the MBL gene polymorphism at codon 54 was determined, the outcome was recurrent respiratory tract infection in children and there were at least two comparison groups. The odds ratios(OR) of the genetic MBL polymorphisms were combined and calculated, and the forest plots of the OR value distributions were drawn. Chi-squared testing of heterogeneity was done (p<0.001).

RESULTS

Five eligible studies were included in the study. There has been heterogeneity between the studies (p=0.001). Our results did not show any association between MBL genotypes AA, BB, AB, alleles A and B and RRTI.

CONCLUSIONS

Our meta-analysis of accessible, published data has demonstrated no statistically significant association between MBL2 genotype and recurrent respiratory tract infection in children. Summary of the article's main point Here are discrepancies regarding the importance of MBL polymorphism and its impact on recurrent respiratory tract infections. Our meta analysis did not find statistically significant association between MBL codon 54 polymorphism and recurrent respiratory tract infection in children.

Pregnancy-associated plasma protein A gene polymorphism in pregnant women with preeclampsia and intrauterine growth restriction

Preeclampsia (PE) and intrauterine growth restriction (IUGR) are still among the most commonly researched titles in perinatology. To shed light on their etiology, new prevention and treatment strategies are the major targets of studies. In this study, we aimed to investigate the relation between gene polymorphism of one of the products of trophoblasts, pregnancy-associated plasma protein A (PAPP-A) and PE/IUGR.A total of 147 women (IUGR, n = 61; PE, n = 47; IUGR + PE, n = 37; eclampsia, n = 2) were compared with 103 controls with respect to the sequencing of exon 14 of the PAPP-A gene to detect (rs7020782) polymorphism. Genotypes "AA" and "CC" were given in the event of A or C allele homozygosity and "AC" in A and C allele heterozygosity. Our findings revealed that the rate of AA, CC homozygotes, and AC heterozygotes did not differ between groups. Moreover, there was no difference in the distribution of PAPP-A genotypes among the patients with IUGR, PE, IUGR + PE, or eclampsia. Finally, birth weight, rate of the presence of proteinuria, and total protein excretion on 24-hour urine were similar in the subgroups of AA, AC, and CC genotypes in the study group. Our study demonstrated no association between PAPP-A gene rs7020782 polymorphism and PE/IUGR.

Three patients with lafora disease: different clinical presentations and a novel mutation

Lafora disease is a rare, fatal, autosomal recessive hereditary disease characterized by epilepsy, myoclonus and progressive neurological deterioration. Diagnosis is made by polyglucosan inclusion bodies (Lafora bodies) shown in skin biopsy. Responsible mutations of Lafora disease involves either the EPM2A or NHLRC1 (EPM2B) gene. Mutations in the NHLRC1 gene are described as having a more benign clinical course and a later age of death compared with EPM2A mutations. We report 2 genetic mutations and clinical courses of Lafora disease in 3 adolescents with homozygote NHLRC1 mutation and novel homozygous EPM2A mutation.

[Lifetime prevalence and correlates of schizophrenia and disorders with psychotic symptoms in the general population of Izmir, Turkey]

OBJECTIVE

To estimate the lifetime prevalence of 12 DSM-IV disorders with psychotic symptoms in a general population survey.

METHOD

Addresses were contacted in a multistage clustered area probability sampling frame of administrative neighbourhoods and households, covering 9 districts and 302 neighbourhoods in the Izmir metropolitan area between November 2007 and October 2008. One household member aged between 15 and 64 years and available to complete the interview was randomly selected using a within-household sampling method. The primary screening instrument was the Composite International Diagnostic Interview 2.1. A systematic screening procedure was implemented to detect probable cases with any psychotic disorder. Those selected by the screens were re-interviewed with the Structured Clinical Interview for DSM-IV. Diagnoses of individuals who were not available for re-interview were made by combining screening information with case register diagnoses and/or the telephone interviews with relatives or spouse.

RESULTS

A total of 4011 individuals were screened for disorders with psychotic symptoms. After screening, 499 respondents were selected as a probable case. 277 of screen positive respondents were available for clinical reappraisal. Initial screening interviews and additional material were used for best estimate diagnoses of the remaining 172 respondents. Total lifetime prevalence of 12 DSM-IV disorders with psychotic symptoms was 2.62%. Lifetime prevalence of each disorder separately were as follows: 0.74% for schizophrenia, 0.20% for schizoaffective disorder, 0.05% for schizophreniform disorder, 0.10% for delusional disorder, 0.12% for brief psychotic disorder, 0.55% for major depressive disorder with psychotic features, 0.37% for bipolar I disorder, 0.20% for substance induced psychotic disorder, and 0.07% for psychotic disorders due to a general medical condition.

CONCLUSION

Total lifetime prevalence of disorders with psychotic symptoms is higher than any previously reported estimates in Turkey; with a prevalence of approximately 2.5%, these disorders can be considered a major public health concern.

The effect of interleukin-10 gene promoter polymorphisms on early-onset coronary artery disease

OBJECTIVE

We assessed the association between interleukin-10 (IL-10) -1082G/A and -592C/A polymorphisms, and coronary heart disease (CHD).

METHODS

A cross-sectional, observational study included 86 patients (mean age 43.36±4.930 years) diagnosed to have CHD and 88 healthy controls (mean age 47.07±8.135 years). IL-10 -1082G/A and -592C/A polymorphisms were analyzed using restriction fragment length polymorphism (RFLP) and agarose gel electrophoresis methods in both patient and control groups. Genotype distributions of the polymorphisms between CHD patients and controls were assessed by Chi-square analysis.

RESULTS

The genotype distribution of the -1082 G/A polymorphism was not different in premature CHD patients (GG: 38.3%; GA: 51.1%; AA: 10.6%) and controls (GG: 43.1%; GC: 43.1%; CC: 13.8%) (p=0.57). The prevalence of the A allele at -1082G/A polymorphism was 36.6% in patients and 35.3% in controls. Both allele and genotype frequencies of -592C/A polymorphism did not also differ significantly between patients with CHD and controls. We did not observe relationships between polymorphism-specific haplotypes and adverse angiographic and clinical outcomes. We have observed a significant difference of IL-10 -592C/A allelic frequency (OR=2.00 95% CI=0.9434-4.2579) between the younger CHD patients (<45 years, Group 2) and matched controls.

CONCLUSION

Our study suggests that IL-10-592C/A polymorphism may play a role in susceptibility to CHD in younger patients.