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van der Valk ES, Kleinendorst L, Delhanty PJD, van der Voorn B, Visser JA, van Haelst MM, de Graaff LCG, Huisman M, White A, Ito S, Wakamatsu K, de Rijke YB, van den Akker ELT, Iyer AM, van Rossum EFC. Obesity and Hyperphagia With Increased Defective ACTH: A Novel POMC Variant. J Clin Endocrinol Metab 2022; 107:e3699-e3704. [PMID: 35737586 PMCID: PMC9797039 DOI: 10.1210/clinem/dgac342] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Patients with pro-opiomelanocortin (POMC) defects generally present with early-onset obesity, hyperphagia, hypopigmentation and adrenocorticotropin (ACTH) deficiency. Rodent models suggest that adequate cleavage of ACTH to α-melanocortin-stimulating hormone (α-MSH) and desacetyl-α-melanocortin-stimulating hormone (d-α-MSH) by prohormone convertase 2 at the KKRR region is required for regulating food intake and energy balance. METHODS We present 2 sisters with a novel POMC gene variant, leading to an ACTH defect at the prohormone convertase 2 cleavage site, and performed functional studies of this variant. RESULTS The patients had obesity, hyperphagia and hypocortisolism, with markerly raised levels of ACTH but unaffected pigmentation. Their ACTH has reduced potency to stimulate the melanocortin (MC) 2 receptor, explaining their hypocortisolism. CONCLUSION The hyperphagia and obesity support evidence that adequate cleavage of ACTH to α-MSH and d-α-MSH is also required in humans for feeding control.
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Affiliation(s)
- Eline S van der Valk
- Obesity Centre CGG, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | | | | | - Bibian van der Voorn
- Obesity Centre CGG, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Jenny A Visser
- Obesity Centre CGG, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - M M van Haelst
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, the Netherlands
| | - Laura C G de Graaff
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Martin Huisman
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Anne White
- Divison of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Shosuke Ito
- Institute for Melanin Chemistry, Fujita Health University, Toyoake, 470-1192, Japan
| | - Kazumasa Wakamatsu
- Institute for Melanin Chemistry, Fujita Health University, Toyoake, 470-1192, Japan
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Erica L T van den Akker
- Obesity Centre CGG, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus University Medical Center, 3000 CA Rotterdam, the Netherlands
| | - Anand M Iyer
- Obesity Centre CGG, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Correspondence: Elisabeth F. C. van Rossum, MD, PhD, Obesity Center CGG (Centrum Gezond Gewicht), Erasmus MC, University Medical Center Rotterdam, the Netherlands, Rm Rg-5. P. O. Box 2400, 3000 CA Rotterdam, the Netherlands.
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van den Akker WMR, Brummelman I, Martis LM, Timmermans RN, Pfundt R, Kleefstra T, Willemsen MH, Gerkes EH, Herkert JC, van Essen AJ, Rump P, Vansenne F, Terhal PA, van Haelst MM, Cristian I, Turner CE, Cho MT, Begtrup A, Willaert R, Fassi E, van Gassen KLI, Stegmann APA, de Vries BBA, Schuurs-Hoeijmakers JHM. De novo variants in CDK13 associated with syndromic ID/DD: Molecular and clinical delineation of 15 individuals and a further review. Clin Genet 2019; 93:1000-1007. [PMID: 29393965 DOI: 10.1111/cge.13225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 09/27/2017] [Revised: 01/03/2018] [Accepted: 01/24/2018] [Indexed: 01/06/2023]
Abstract
De novo variants in the gene encoding cyclin-dependent kinase 13 (CDK13) have been associated with congenital heart defects and intellectual disability (ID). Here, we present the clinical assessment of 15 individuals and report novel de novo missense variants within the kinase domain of CDK13. Furthermore, we describe 2 nonsense variants and a recurrent frame-shift variant. We demonstrate the synthesis of 2 aberrant CDK13 transcripts in lymphoblastoid cells from an individual with a splice-site variant. Clinical characteristics of the individuals include mild to severe ID, developmental delay, behavioral problems, (neonatal) hypotonia and a variety of facial dysmorphism. Congenital heart defects were present in 2 individuals of the current cohort, but in at least 42% of all known individuals. An overview of all published cases is provided and does not demonstrate an obvious genotype-phenotype correlation, although 2 individuals harboring a stop codons at the end of the kinase domain might have a milder phenotype. Overall, there seems not to be a clinically recognizable facial appearance. The variability in the phenotypes impedes an à vue diagnosis of this syndrome and therefore genome-wide or gene-panel driven genetic testing is needed. Based on this overview, we provide suggestions for clinical work-up and management of this recently described ID syndrome.
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Affiliation(s)
- W M R van den Akker
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - I Brummelman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L M Martis
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R N Timmermans
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R Pfundt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T Kleefstra
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M H Willemsen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E H Gerkes
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C Herkert
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A J van Essen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P Rump
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F Vansenne
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P A Terhal
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - M M van Haelst
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Clinical Genetics, AMC/VUmc, Amsterdam, The Netherlands
| | - I Cristian
- Division of Genetics and Metabolism, Department of Pediatrics, Nemours Children's Hospital Orlando, Orlando, Florida
| | - C E Turner
- Department of Genetics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - M T Cho
- GeneDx, Gaithersburg, Maryland
| | | | | | - E Fassi
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - K L I van Gassen
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A P A Stegmann
- Department of Human Genetics, Maastricht University Hospital, Maastricht, The Netherlands
| | - B B A de Vries
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
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Walters RG, Jacquemont S, Valsesia A, de Smith AJ, Martinet D, Andersson J, Falchi M, Chen F, Andrieux J, Lobbens S, Delobel B, Stutzmann F, El-Sayed Moustafa JS, Chèvre JC, Lecoeur C, Vatin V, Bouquillon S, Buxton JL, Boute O, Holder-Espinasse M, Cuisset JM, Lemaitre MP, Ambresin AE, Brioschi A, Gaillard M, Giusti V, Fellmann F, Ferrarini A, Hadjikhani N, Campion D, Guilmatre A, Goldenberg A, Calmels N, Mandel JL, Le Caignec C, David A, Isidor B, Cordier MP, Dupuis-Girod S, Labalme A, Sanlaville D, Béri-Dexheimer M, Jonveaux P, Leheup B, Ounap K, Bochukova EG, Henning E, Keogh J, Ellis RJ, Macdermot KD, van Haelst MM, Vincent-Delorme C, Plessis G, Touraine R, Philippe A, Malan V, Mathieu-Dramard M, Chiesa J, Blaumeiser B, Kooy RF, Caiazzo R, Pigeyre M, Balkau B, Sladek R, Bergmann S, Mooser V, Waterworth D, Reymond A, Vollenweider P, Waeber G, Kurg A, Palta P, Esko T, Metspalu A, Nelis M, Elliott P, Hartikainen AL, McCarthy MI, Peltonen L, Carlsson L, Jacobson P, Sjöström L, Huang N, Hurles ME, O'Rahilly S, Farooqi IS, Männik K, Jarvelin MR, Pattou F, Meyre D, Walley AJ, Coin LJM, Blakemore AIF, Froguel P, Beckmann JS. A new highly penetrant form of obesity due to deletions on chromosome 16p11.2. Nature 2010; 463:671-5. [PMID: 20130649 PMCID: PMC2880448 DOI: 10.1038/nature08727] [Citation(s) in RCA: 345] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 12/01/2009] [Indexed: 01/04/2023]
Affiliation(s)
- R G Walters
- Section of Genomic Medicine, Imperial College London, London W12 0NN, UK
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van Haelst MM, Eussen HJFMM, Visscher F, de Ruijter JLM, Drop SLS, Lindhout D, Wouters CH, Govaerts LCP. Silver-Russell phenotype in a patient with pure trisomy 1q32.1-q42.1: further delineation of the pure 1q trisomy syndrome. J Med Genet 2002; 39:582-5. [PMID: 12161598 PMCID: PMC1735207 DOI: 10.1136/jmg.39.8.582] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
We report on ten pregnancies with trisomy 8 mosaicism. Nine cases were prenatally detected in chorionic villi (n=6), amniotic fluid (AF) cells (n=2) or fetal blood (FB) lymphocytes (n=1). Follow-up laboratory investigations showed confined placental mosaicism (CPM) or pseudomosaicism in eight cases. In one case with ultrasound abnormalities, trisomy 8 mosaicism was detected in FB cells although cultured AF cells showed normal cells only. Another case of mosaic trisomy 8 was prenatally missed; cytogenetic analysis of short-term cultured villi revealed a normal male karyotype, while postnatally, trisomy 8 mosaicism was detected in peripheral blood lymphocytes and skin fibroblasts of the affected child. These findings indicate the difficulties in the prenatal diagnosis of trisomy 8 mosaicism. When found in chorionic villi, it mostly represented CPM, while in a case of true fetal trisomy 8 mosaicism, the cytotrophoblast cells showed a normal karyotype. So, the cytotrophoblast compartment of chorionic villi is a poor indicator of the presence or absence of fetal trisomy 8 mosaicism. Follow-up investigations including amniocentesis and especially fetal blood sampling are required to come to a definite prenatal diagnosis of trisomy 8 mosaicism.
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Affiliation(s)
- M M van Haelst
- Department of Clinical Genetics, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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van Haelst MM, Hoogeboom J, Galjaard RJ, Kleijer WJ, den Hollander NS, de Krijger RR, Hennekam RC, Niermeijer MF. Lymphangiectasia with persistent Müllerian derivatives: confirmation of autosomal recessive Urioste syndrome. Am J Med Genet 2001; 104:65-8. [PMID: 11746030 DOI: 10.1002/ajmg.1518.abs] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We report on a sibship with protein-losing enteropathy related to intestinal lymphangiectasia, a peculiar face, and genital anomalies. The parents are distantly related and from Dutch ancestry. The first patient was born with a protein-losing enteropathy, craniofacial anomalies, and renal defects. At 1 year of age, she died of severe complications of the protein-losing enteropathy and respiratory distress. Her brother was a cytogenetically normal male fetus identified by prenatal ultrasound at 19 weeks with similar anomalies. The pregnancy was terminated at 20 weeks. Autopsy showed müllerian duct remnants. These cases seem to confirm the Urioste syndrome [Urioste et al., 1993: Am J Med Genet 47:494-503]. Although it was previously only reported in 46,XY individuals, this report of a consanguineous family with an affected sibship of both sexes suggests it to be an autosomal recessive entity.
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Affiliation(s)
- M M van Haelst
- Department of Clinical Genetics, University Hospital Dijkzigt, Erasmus University Rotterdam, Westzeedijk 112, 3015 AH Rotterdam, The Netherlands.
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van Haelst MM, Brooks AS, Hoogeboom J, Wessels MW, Tibboel D, de Jongste JC, den Hollander JC, Bongers-Schokking JJ, Niermeijer MF, Willems PJ. Unexpected life-threatening complications in Kabuki syndrome. Am J Med Genet 2000; 94:170-3. [PMID: 10982974 DOI: 10.1002/1096-8628(20000911)94:2<170::aid-ajmg10>3.0.co;2-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Kabuki syndrome is a rare multiple congenital anomalies/mental retardation syndrome comprising a distinct facial appearance and fetal fingertip pads. We observed two patients with Kabuki syndrome and describe unusual life-threatening complications, including stenosis of the central airways (not previously reported), extrahepatic biliary atresia, and congenital diaphragmatic hernia.
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Affiliation(s)
- M M van Haelst
- Department of Clinical Genetics, Erasmus University Rotterdam, The Netherlands.
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