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Day WG, Horn C, Hogue JS, Magee J, Shayegan S, Pittman L. Novel Pathogenic C5 Gene Variants in a Patient with Neisseria Meningitis and Diffuse Cutaneous HSV-1 Infection. J Clin Immunol 2024; 44:52. [PMID: 38231272 DOI: 10.1007/s10875-024-01651-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024]
Affiliation(s)
- W Grant Day
- Department of Allergy and Immunology, Walter Reed National Military Medical Center, 4944 North Palmer Road, Bethesda, MD, 20814, USA.
| | - Christian Horn
- Department of Gastroenterology, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Jacob S Hogue
- Department of Genetics, Madigan Army Medical Center, Tacoma, WA, USA
| | - Jared Magee
- Department of Gastroenterology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - Luke Pittman
- Department of Allergy and Immunology, Walter Reed National Military Medical Center, 4944 North Palmer Road, Bethesda, MD, 20814, USA
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Homo RL, Borbon D, Hogue JS, Raymond W. Weight a Minute! Eye Did Not Expect That. Pediatr Rev 2023; 44:S52-S54. [PMID: 37777239 DOI: 10.1542/pir.2022-005756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Affiliation(s)
- Richelle Lu Homo
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
| | - Daniel Borbon
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
| | - Jacob S Hogue
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
| | - William Raymond
- Division of Ophthalmology, Department of Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, WA
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3
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Krick JA, Hogue JS, Studer MA, Reese TR, Weiss EM. Battlefield Triage and Resource Allocation during a Pandemic: Learning from the Past and Adapting for the Future. Med J (Ft Sam Houst Tex) 2022:38-42. [PMID: 35951230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The principle of medical triage, where patients are sorted into categories to guide the order in which they receive treatment, dates back to Baron Dominique Jean Larrey, the surgeon general of Napolean's armies. The concept evolved with military conflicts throughout the 19th century, was subsequently adapted to situations off the battlefield, and is now widely practiced where resources are limited.2 Military medical providers are taught triage principles early in their careers and its use is routinely integrated into military training scenarios and operational planning.
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Affiliation(s)
- Jeanne A Krick
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, WA
| | - Jacob S Hogue
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, WA
| | - Matthew A Studer
- Division of Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA
| | - Tyler R Reese
- Department of Family Medicine, Madigan Army Medical Center, Tacoma, WA
| | - Elliot M Weiss
- Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, and Treuman Katz Center for Pediatric Bioethics, Seattle, WA
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4
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Chooey J, Trexler C, Becker AM, Hogue JS. Esophageal atresia/tracheoesophageal fistula and proximal symphalangism in a patient with a NOG nonsense mutation. Am J Med Genet A 2021; 188:269-271. [PMID: 34472207 DOI: 10.1002/ajmg.a.62486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/27/2021] [Accepted: 08/13/2021] [Indexed: 11/07/2022]
Abstract
Esophageal atresia and tracheoesophageal fistula (EA/TEF) are relatively common malformations of the human foregut. The etiology remains incompletely understood with genetic causes identified in a small minority of affected patients. We present the case of a newborn with type C EA/TEF along with proximal symphalangism found to have a de novo NOG nonsense mutation. Patients with chromosome 17q deletions including the NOG gene have previously been reported to have EA/TEF but mutations in the gene have not been identified in patients with this malformation. This case provides evidence that haploinsufficiency for NOG may be the cause for EA/TEF in the 17q deletion syndrome and suggests that the clinical spectrum of NOG-related symphalangism spectrum disorders may include EA/TEF.
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Affiliation(s)
- Jonathan Chooey
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Connor Trexler
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Amy M Becker
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - Jacob S Hogue
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
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5
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Paris G, Friedman NL, Hogue JS. Choking and Cyanotic Episodes in a 3-month-old Male. Pediatr Rev 2021; 42:S103-S105. [PMID: 33386376 DOI: 10.1542/pir.2019-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Although parents are typically the most appropriate decision-makers for their children, there are limits to this authority. Medical providers may be ethically obligated to seek state intervention against a parental decision if the parent places a child at significant and imminent risk of serious harm. When parents make medical decisions for their children, they assess both the projected benefits and risks of their choices for their family. These assessments are impacted by uncertainty, which is a common feature of neonatal intensive care. The relative presence or absence of uncertainty may impact perceptions of parental decisions and a medical provider's decision to seek state intervention to overrule parents. In this article, we propose a model integrating prognostic uncertainty into pediatric decision-making that may aid providers in such assessments. We will demonstrate how to apply this model to 3 neonatal cases and propose that the presence of greater uncertainty ought to permit parents greater latitude to incorporate family values into their decision-making even if these decisions are contradictory to the recommendations of the medical team.
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Affiliation(s)
| | | | - Tyler R Reese
- Family Medicine, Madigan Army Medical Center, Tacoma, Washington
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Garren B, Stephan M, Hogue JS. NRAS associated RASopathy and embryonal rhabdomyosarcoma. Am J Med Genet A 2019; 182:195-200. [PMID: 31697451 DOI: 10.1002/ajmg.a.61395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/30/2019] [Accepted: 10/13/2019] [Indexed: 01/29/2023]
Abstract
RASopathies are a group of phenotypically overlapping disorders that arise from dysregulation of the RAS/MAPK pathway. These disorders include Noonan syndrome, Costello syndrome, cardiofaciocutaneous syndrome, and neurofibromatosis-Type 1. While somatic mutations in the three human Ras genes (KRAS, HRAS, and NRAS) are a common finding in a variety of cancers, germline mutations in each of the these genes cause developmental RASopathy phenotypes with mutations in specific genes typically correlating with specific phenotypes. We present the case of a germline heterozygous NRAS mutation producing a severe phenotype involving embryonal rhabdomyosarcoma, severe intellectual disability, and numerous melanocytic nevi in addition to more typical manifestations of Noonan syndrome. Additionally, the specific p.G12R NRAS mutation in this case is a common somatic mutation in cancer cells, and analysis of previously reported NRAS-RASopathy cases suggests that mutations at traditionally oncogenic codons are associated with elevated cancer risk not present with mutations at other sites.
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Affiliation(s)
- Benjamin Garren
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington
| | - Mark Stephan
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington
| | - Jacob S Hogue
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington
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8
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Stevens CA, Hogue JS, Hopkin RJ, Lombardo RC, Schrier Vergano SA. Congenital lumbar hernia-A feature of diabetic embryopathy? Am J Med Genet A 2018; 176:2243-2249. [PMID: 30276953 DOI: 10.1002/ajmg.a.40381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/15/2018] [Accepted: 06/03/2018] [Indexed: 01/31/2023]
Abstract
Congenital lumbar hernia is a rare anomaly consisting of protrusion of abdominal organs or extraperitoneal tissue through a defect in the lateral abdominal wall. The majority of affected patients have additional anomalies in a pattern described as the lumbocostovertebral syndrome. We report four patients born to mothers with poorly controlled diabetes with congenital lumbar hernia. All patients exhibited features of lumbocostovertebral syndrome with lumbar hernia, multiple vertebral segmentation anomalies in the lower thoracic and/or upper lumbar spine, rib anomalies, and unilateral renal agenesis. Additional anomalies present in the patients included preaxial hallucal polydactyly, abnormal situs, and sacral dysgenesis, anomalies known to be associated with diabetic embryopathy. At least 11 other patients have been previously reported with the lumbocostovertebral syndrome in the setting of maternal diabetes. We suggest that congenital lumbar hernia and the lumbocostovertebral syndrome are related to diabetic embryopathy.
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Affiliation(s)
- Cathy A Stevens
- Department of Pediatrics, Division of Medical Genetics, The University of Tennessee College of Medicine, Chattanooga, Tennessee
| | - Jacob S Hogue
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington
| | - Robert J Hopkin
- Department of Human Genetics, Cincinnati Children's Hospital, Cincinnati, Ohio.,Deparment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Rachel C Lombardo
- Department of Human Genetics, Cincinnati Children's Hospital, Cincinnati, Ohio.,Deparment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Samantha A Schrier Vergano
- Division of Medical Genetics and Metabolism, Children's Hospital of the King's Daughters, Norfolk, Virginia.,Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia
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9
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Gripp KW, Robbins KM, Sobreira NL, Witmer PD, Bird LM, Avela K, Makitie O, Alves D, Hogue JS, Zackai EH, Doheny KF, Stabley DL, Sol-Church K. Truncating mutations in the last exon of NOTCH3 cause lateral meningocele syndrome. Am J Med Genet A 2015; 167A:271-81. [PMID: 25394726 PMCID: PMC5589071 DOI: 10.1002/ajmg.a.36863] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 10/15/2014] [Indexed: 12/30/2022]
Abstract
Lateral meningocele syndrome (LMS, OMIM%130720), also known as Lehman syndrome, is a very rare skeletal disorder with facial anomalies, hypotonia and meningocele-related neurologic dysfunction. The characteristic lateral meningoceles represent the severe end of the dural ectasia spectrum and are typically most severe in the lower spine. Facial features of LMS include hypertelorism and telecanthus, high arched eyebrows, ptosis, midfacial hypoplasia, micrognathia, high and narrow palate, low-set ears and a hypotonic appearance. Hyperextensibility, hernias and scoliosis reflect a connective tissue abnormality, and aortic dilation, a high-pitched nasal voice, wormian bones and osteolysis may be present. Lateral meningocele syndrome has phenotypic overlap with Hajdu-Cheney syndrome. We performed exome resequencing in five unrelated individuals with LMS and identified heterozygous truncating NOTCH3 mutations. In an additional unrelated individual Sanger sequencing revealed a deleterious variant in the same exon 33. In total, five novel de novo NOTCH3 mutations were identified in six unrelated patients. One had a 26 bp deletion (c.6461_6486del, p.G2154fsTer78), two carried the same single base pair insertion (c.6692_93insC, p.P2231fsTer11), and three individuals had a nonsense point mutation at c.6247A > T (pK2083*), c.6663C > G (p.Y2221*) or c.6732C > A, (p.Y2244*). All mutations cluster into the last coding exon, resulting in premature termination of the protein and truncation of the negative regulatory proline-glutamate-serine-threonine rich PEST domain. Our results suggest that mutant mRNA products escape nonsense mediated decay. The truncated NOTCH3 may cause gain-of-function through decreased clearance of the active intracellular product, resembling NOTCH2 mutations in the clinically related Hajdu-Cheney syndrome and contrasting the NOTCH3 missense mutations causing CADASIL.
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Affiliation(s)
- Karen W. Gripp
- Division of Medical Genetics, A.I. duPont Hospital for Children, Wilmington, Delaware, and Sidney Kimmel Medical School at T. Jefferson University, Philadelphia, Pennsylvania
| | - Katherine M. Robbins
- Department of Biomedical Research, A.I. duPont Hospital for Children, Wilmington, Delaware
- Department of Biological Sciences, University of Delaware, Newark, Delaware
| | - Nara L. Sobreira
- Johns Hopkins University School of Medicine, Institute of Genetic Medicine, Baltimore, Maryland
| | - P. Dane Witmer
- Center for Inherited Disease Research, Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lynne M. Bird
- University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Kristiina Avela
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
| | - Outi Makitie
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, and Folkhälsan Institute of Genetics, Helsinki, Finland
| | - Daniela Alves
- Neurogenetics Unit, Department of Medical Genetics, Centro Hospitalar de São João, Porto, Portugal
| | | | - Elaine H. Zackai
- Division of Human Genetics and Molecular Biology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kimberly F. Doheny
- Center for Inherited Disease Research, Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Deborah L. Stabley
- Department of Biomedical Research, A.I. duPont Hospital for Children, Wilmington, Delaware
| | - Katia Sol-Church
- Department of Biomedical Research, A.I. duPont Hospital for Children, Wilmington, Delaware
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Kuechler A, Willemsen MH, Albrecht B, Bacino CA, Bartholomew DW, van Bokhoven H, van den Boogaard MJH, Bramswig N, Büttner C, Cremer K, Czeschik JC, Engels H, van Gassen K, Graf E, van Haelst M, He W, Hogue JS, Kempers M, Koolen D, Monroe G, de Munnik S, Pastore M, Reis A, Reuter MS, Tegay DH, Veltman J, Visser G, van Hasselt P, Smeets EEJ, Vissers L, Wieland T, Wissink W, Yntema H, Zink AM, Strom TM, Lüdecke HJ, Kleefstra T, Wieczorek D. De novo mutations in beta-catenin (CTNNB1) appear to be a frequent cause of intellectual disability: expanding the mutational and clinical spectrum. Hum Genet 2014; 134:97-109. [PMID: 25326669 DOI: 10.1007/s00439-014-1498-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022]
Abstract
Recently, de novo heterozygous loss-of-function mutations in beta-catenin (CTNNB1) were described for the first time in four individuals with intellectual disability (ID), microcephaly, limited speech and (progressive) spasticity, and functional consequences of CTNNB1 deficiency were characterized in a mouse model. Beta-catenin is a key downstream component of the canonical Wnt signaling pathway. Somatic gain-of-function mutations have already been found in various tumor types, whereas germline loss-of-function mutations in animal models have been shown to influence neuronal development and maturation. We report on 16 additional individuals from 15 families in whom we newly identified de novo loss-of-function CTNNB1 mutations (six nonsense, five frameshift, one missense, two splice mutation, and one whole gene deletion). All patients have ID, motor delay and speech impairment (both mostly severe) and abnormal muscle tone (truncal hypotonia and distal hypertonia/spasticity). The craniofacial phenotype comprised microcephaly (typically -2 to -4 SD) in 12 of 16 and some overlapping facial features in all individuals (broad nasal tip, small alae nasi, long and/or flat philtrum, thin upper lip vermillion). With this detailed phenotypic characterization of 16 additional individuals, we expand and further establish the clinical and mutational spectrum of inactivating CTNNB1 mutations and thereby clinically delineate this new CTNNB1 haploinsufficiency syndrome.
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Affiliation(s)
- Alma Kuechler
- Institut für Humangenetik, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany,
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11
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Barbera SE, Hogue JS, Hsieh DT, Elrod M, Olson C, Kutney K, Strawbridge H. Index of suspicion. Case 1: Global developmental delay and seizures in a 34-month-old boy. Case 2: Ecchymoses on legs and refusal to walk in a 16-year-old autistic boy. Case 3: Progressive breathing difficulty in a 5-year-old girl. Pediatr Rev 2014; 35:350-5. [PMID: 25086166 DOI: 10.1542/pir.35-8-350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Stephen E Barbera
- San Antonio Military Medical Center, Joint Base San Antonio-Ft Sam Houston, TX
| | - Jacob S Hogue
- San Antonio Military Medical Center, Joint Base San Antonio-Ft Sam Houston, TX
| | - David T Hsieh
- San Antonio Military Medical Center, Joint Base San Antonio-Ft Sam Houston, TX
| | - Marilisa Elrod
- Department of Pediatrics, Madigan Army Medical Center, Tacoma WA
| | - Christina Olson
- Department of Pediatrics, Naval Medical Center, San Diego, CA
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12
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Affiliation(s)
- Brian N Hughes
- Resident, Department of Pediatrics, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - Jacob S Hogue
- Division of Clinical Genetics, Department of Pediatrics, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - David T Hsieh
- Division of Child Neurology, Department of Pediatrics, San Antonio Military Medical Center, Fort Sam Houston, Texas
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13
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Marttila M, Lehtokari VL, Marston S, Nyman TA, Barnerias C, Beggs AH, Bertini E, Ceyhan-Birsoy O, Cintas P, Gerard M, Gilbert-Dussardier B, Hogue JS, Longman C, Eymard B, Frydman M, Kang PB, Klinge L, Kolski H, Lochmüller H, Magy L, Manel V, Mayer M, Mercuri E, North KN, Peudenier-Robert S, Pihko H, Probst FJ, Reisin R, Stewart W, Taratuto AL, de Visser M, Wilichowski E, Winer J, Nowak K, Laing NG, Winder TL, Monnier N, Clarke NF, Pelin K, Grönholm M, Wallgren-Pettersson C. Mutation update and genotype-phenotype correlations of novel and previously described mutations in TPM2 and TPM3 causing congenital myopathies. Hum Mutat 2014; 35:779-90. [PMID: 24692096 DOI: 10.1002/humu.22554] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 03/17/2014] [Indexed: 01/14/2023]
Abstract
Mutations affecting skeletal muscle isoforms of the tropomyosin genes may cause nemaline myopathy, cap myopathy, core-rod myopathy, congenital fiber-type disproportion, distal arthrogryposes, and Escobar syndrome. We correlate the clinical picture of these diseases with novel (19) and previously reported (31) mutations of the TPM2 and TPM3 genes. Included are altogether 93 families: 53 with TPM2 mutations and 40 with TPM3 mutations. Thirty distinct pathogenic variants of TPM2 and 20 of TPM3 have been published or listed in the Leiden Open Variant Database (http://www.dmd.nl/). Most are heterozygous changes associated with autosomal-dominant disease. Patients with TPM2 mutations tended to present with milder symptoms than those with TPM3 mutations, DA being present only in the TPM2 group. Previous studies have shown that five of the mutations in TPM2 and one in TPM3 cause increased Ca(2+) sensitivity resulting in a hypercontractile molecular phenotype. Patients with hypercontractile phenotype more often had contractures of the limb joints (18/19) and jaw (6/19) than those with nonhypercontractile ones (2/22 and 1/22), whereas patients with the non-hypercontractile molecular phenotype more often (19/22) had axial contractures than the hypercontractile group (7/19). Our in silico predictions show that most mutations affect tropomyosin-actin association or tropomyosin head-to-tail binding.
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Affiliation(s)
- Minttu Marttila
- The Folkhälsan Institute of Genetics and the Department of Medical Genetics, University of Helsinki, Haartman Institute, Biomedicum Helsinki, Finland
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14
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Minor A, Shinawi M, Hogue JS, Vineyard M, Hamlin DR, Tan C, Donato K, Wysinger L, Botes S, Das S, Del Gaudio D. Two novel RAD21 mutations in patients with mild Cornelia de Lange syndrome-like presentation and report of the first familial case. Gene 2013; 537:279-84. [PMID: 24378232 DOI: 10.1016/j.gene.2013.12.045] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/05/2013] [Accepted: 12/17/2013] [Indexed: 10/25/2022]
Abstract
Cornelia de Lange syndrome (CdLS) is a developmental disorder characterized by limb reduction defects, characteristic facial features and impaired cognitive development. Mutations in the NIPBL gene predominate; however, mutations in other cohesin complex genes have also been implicated, particularly in atypical and mild CdLS cases. Missense mutations and whole gene deletions in RAD21 have been identified in children with growth retardation, minor skeletal anomalies and facial features that overlap findings in individuals with CdLS. We report the first intragenic deletion and frameshift mutations identified in RAD21 in two patients presenting with atypical CdLS. One patient had an in-frame deletion of exon 13, while the second patient had a c.592_593dup frameshift mutation. The first patient presented with developmental delay, hypospadias, inguinal hernia and dysmorphic features while, the second patient presented with developmental delay, characteristic facial features, hirsutism, and hand and feet anomalies, with the first patient being milder than the second. The in-frame deletion mutation was found to be inherited from the mother who had a history of melanoma and other unspecified medical problems. This study expands the spectrum of RAD21 mutations and emphasizes the clinical utility of performing RAD21 mutation analysis in patients presenting with atypical forms of CdLS. Moreover, the variability of clinical presentation within families and low penetrance of mutations as well as the significance of performing molecular genetic testing in mildly affected patients are discussed.
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Affiliation(s)
- Agata Minor
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Marwan Shinawi
- Department of Pediatrics, Division Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jacob S Hogue
- Department of Pediatrics, San Antonio Military Medical Center, Fort Sam Houston, TX, USA
| | - Marisa Vineyard
- Department of Pediatrics, Division Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Damara R Hamlin
- Department of Pediatrics, San Antonio Military Medical Center, Fort Sam Houston, TX, USA
| | - Christopher Tan
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Kirsten Donato
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Latrice Wysinger
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Shaun Botes
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Soma Das
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
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Hogue JS, Buttke P, Braun LE, Fairchok MP. Mupirocin resistance related to increasing mupirocin use in clinical isolates of methicillin-resistant Staphylococcus aureus in a pediatric population. J Clin Microbiol 2010; 48:2599-600. [PMID: 20421433 PMCID: PMC2897475 DOI: 10.1128/jcm.02118-09] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 12/28/2009] [Accepted: 04/20/2010] [Indexed: 01/22/2023] Open
Abstract
We investigated the proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolates from pediatric patients demonstrating mupirocin resistance related to mupirocin use at our institution. No mupirocin resistance was found in 98% of isolates, whereas mupirocin prescriptions increased by 110%. Resistance rates remained low despite the increasing use of mupirocin.
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Affiliation(s)
- Jacob S Hogue
- Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA.
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Perkins D, Hogue JS, Fairchok M, Braun L, Viscount HB. Mupirocin Resistance Screening of Methicillin-Resistant Staphylococcus aureus Isolates at Madigan Army Medical Center. Mil Med 2008; 173:604-8. [DOI: 10.7205/milmed.173.6.604] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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