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Trizuljak J, Duben J, Blaháková I, Vrzalová Z, Kozubík KS, Štika J, Radová L, Bergerová V, Mejstříková S, Hořínová V, Jančálek R, Pospíšilová Š, Doubek M. Extensive, 3.8 Mb-Sized Deletion of 22q12 in a Patient with Bilateral Schwannoma, Intellectual Disability, Sensorineural Hearing Loss, and Epilepsy. Mol Syndromol 2023; 14:439-448. [PMID: 37908896 PMCID: PMC10613852 DOI: 10.1159/000528744] [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: 10/13/2022] [Accepted: 12/13/2022] [Indexed: 11/02/2023] Open
Abstract
Introduction In contrast with the well-known and described deletion of the 22q11 chromosome region responsible for DiGeorge syndrome, 22q12 deletions are much rarer. Only a few dozen cases have been reported so far. This region contains genes responsible for cell cycle control, chromatin modification, transmembrane signaling, cell adhesion, and neural development, as well as several cancer predisposition genes. Case Presentation We present a patient with cleft palate, sensorineural hearing loss, vestibular dysfunction, epilepsy, mild to moderate intellectual disability, divergent strabism, pes equinovarus, platyspondylia, and bilateral schwannoma. Using Microarray-based Comparative Genomic Hybridization (aCGH), we identified the de novo 3.8 Mb interstitial deletion at 22q12.1→22q12.3. We confirmed deletion of the critical NF2 region by MLPA analysis. Discussion Large 22q12 deletion in the proband encases the critical NF2 region, responsible for development of bilateral schwannoma. We compared the phenotype of the patient with previously reported cases. Interestingly, our patient developed cleft palate even without deletion of the MN1 gene, deemed responsible in previous studies. We also strongly suspect the DEPDC5 gene deletion to be responsible for seizures, consistent with previously reported cases.
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Affiliation(s)
- Jakub Trizuljak
- Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Jakub Duben
- Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Ivona Blaháková
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Zuzana Vrzalová
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Kateřina Staňo Kozubík
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Jiří Štika
- Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Lenka Radová
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Veronika Bergerová
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Soňa Mejstříková
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Věra Hořínová
- Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Outpatient Ward for Genetics, Hospital Jihlava, Jihlava, Czech Republic
| | - Radim Jančálek
- Department of Neurosurgery, St. Anne University Hospital, Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Šárka Pospíšilová
- Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Michael Doubek
- Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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Skalníková M, Staňo Kozubík K, Trizuljak J, Vrzalová Z, Radová L, Réblová K, Holbová R, Kurucová T, Svozilová H, Štika J, Blaháková I, Dvořáčková B, Prudková M, Stehlíková O, Šmída M, Křen L, Smejkal P, Pospíšilová Š, Doubek M. A GP1BA Variant in a Czech Family with Monoallelic Bernard-Soulier Syndrome. Int J Mol Sci 2022; 23:ijms23020885. [PMID: 35055070 PMCID: PMC8777725 DOI: 10.3390/ijms23020885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/14/2022] Open
Abstract
Bernard-Soulier syndrome (BSS) is a rare inherited disorder characterized by unusually large platelets, low platelet count, and prolonged bleeding time. BSS is usually inherited in an autosomal recessive (AR) mode of inheritance due to a deficiency of the GPIb-IX-V complex also known as the von Willebrand factor (VWF) receptor. We investigated a family with macrothrombocytopenia, a mild bleeding tendency, slightly lowered platelet aggregation tests, and suspected autosomal dominant (AD) inheritance. We have detected a heterozygous GP1BA likely pathogenic variant, causing monoallelic BSS. A germline GP1BA gene variant (NM_000173:c.98G > A:p.C33Y), segregating with the macrothrombocytopenia, was detected by whole-exome sequencing. In silico analysis of the protein structure of the novel GPIbα variant revealed a potential structural defect, which could impact proper protein folding and subsequent binding to VWF. Flow cytometry, immunoblot, and electron microscopy demonstrated further differences between p.C33Y GP1BA carriers and healthy controls. Here, we provide a detailed insight into its clinical presentation and phenotype. Moreover, the here described case first presents an mBSS patient with two previous ischemic strokes.
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Affiliation(s)
- Magdalena Skalníková
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
- Correspondence: (M.S.); (M.D.); Tel.: +421-54-949-8293 (M.S.)
| | - Kateřina Staňo Kozubík
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
| | - Jakub Trizuljak
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
- Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Zuzana Vrzalová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
| | - Lenka Radová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
| | - Kamila Réblová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
- Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Radka Holbová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
| | - Terézia Kurucová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
| | - Hana Svozilová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
- Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Jiří Štika
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
| | - Ivona Blaháková
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
| | - Barbara Dvořáčková
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
| | - Marie Prudková
- Department of Clinical Hematology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (M.P.); (P.S.)
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Olga Stehlíková
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
| | - Michal Šmída
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
| | - Leoš Křen
- Department of Pathology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
| | - Petr Smejkal
- Department of Clinical Hematology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (M.P.); (P.S.)
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Šárka Pospíšilová
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
- Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Michael Doubek
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic; (K.S.K.); (J.T.); (Z.V.); (L.R.); (K.R.); (R.H.); (T.K.); (H.S.); (J.Š.); (I.B.); (M.Š.); (Š.P.)
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.D.); (O.S.)
- Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Correspondence: (M.S.); (M.D.); Tel.: +421-54-949-8293 (M.S.)
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Abstract
Mastocytosis is a clonal hematopoietic disorder characterized by proliferation of abnormal mast cells in various organs including the skin, digestive system, lymph nodes, and bone marrow. We report on a 75-year-old woman presenting with abdominal pain, vomiting, diarrhoea, myalgia, and weight loss. Abdominal CT showed hepatosplenomegaly with heterogeneous splenic parenchyma, lymphadenopathy, and osteopenia with areas of osteosclerosis but no primary tumour. An 18F-FDG PET/CT revealed an overall low metabolic activity of the lesions with a diffuse bone marrow involvement raising suspicion of a haematological neoplasm. Subsequently, bone marrow and peripheral blood examinations confirmed the diagnosis of aggressive systemic mastocytosis.
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Affiliation(s)
- Renata Koukalová
- Department of Nuclear Medicine, PET centre, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiří Vašina
- Department of Nuclear Medicine, PET centre, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiří Štika
- Central European Institute of Technology (CEITEC), Brno, Czech Republic
| | - Michael Doubek
- Department of Internal Medicine, Haematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Szturz
- Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Lausanne, Switzerland
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