Complex Phenotypic Presentation of Syndromic Hearing Loss Deciphered as Three Separate Clinical Entities: How Genetic Testing Guides Final Diagnosis

BACKGROUND

Genetically determined prelingual hearing loss (HL) may occur in an isolated or syndromic form.

OBJECTIVE

The aim of the study was to unravel the genetic cause of medical problems in a 21-year-old woman, whose phenotypic presentation extended beyond Stickler syndrome and included enlarged vestibular aqueduct (EVA) and persistent microhematuria.

METHODS AND RESULTS

After sequencing of clinical exome, a known de novo COL2A1 pathogenic variant (c.1833+1G>A, p.?) causative for Stickler syndrome and one paternally inherited pathogenic change in COL4A5 (c.1871G>A, p.Gly624Asp) causative for X-linked Alport syndrome were found. No pathogenic variants, including those within the SLC26A4 5' region (Caucasian EVA haplotype), explaining the development of EVA, were identified.

CONCLUSIONS

The study reveals a multilocus genomic variation in one individual and provides a molecular diagnosis of two HL syndromes that co-occur in the proband independent of each other. For the third entity, EVA, no etiological factor was identified. Our data emphasize the relevance of detailed clinical phenotyping for accurate genotype interpretation. Focus on broadening the phenotypic spectrum of known genetic syndromes may actually obscure patients with multiple molecular diagnoses.

Sequence analyses of RT-PCR products obtained from seven infected leaf samples revealed existence of three potyvirus species in Indian narcissus (Narcissus tazetta L.)

Potyvirus species associated with yellow leaf stripe disease of Indian narcissus (Narcissus tazetta L.) var. Paperwhite has been studied by sequence analyses of ~ 1.5 kb genomic fragments obtained from seven RT-PCR amplifications of infected samples. Sequence analysis revealed the occurrence of three potyvirus species: cyrtanthus elatus virus-A (CEVA: KF430815, KF430816, KM066973, KM066974); narcissus yellow stripe virus (NYSV: KM066972, JQ686724) and narcissus degeneration virus (NDV: MK572806). The existence of three potyvirus species: CEVA, NYSV and NDV are being reported in Indian narcissus.