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Shalata A, Lauhasurayotin S, Leibovitz Z, Li H, Hebert D, Dhanraj S, Hadid Y, Mahroum M, Bajar J, Egenburg S, Arad A, Shohat M, Haddad S, Bakry H, Moshiri H, Scherer SW, Tzur S, Dror Y. Biallelic mutations in EXOC3L2 cause a novel syndrome that affects the brain, kidney and blood. J Med Genet 2018; 56:340-346. [PMID: 30327448 DOI: 10.1136/jmedgenet-2018-105421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/18/2018] [Accepted: 08/17/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Dandy-Walker malformation features agenesis/hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle and enlargement of posterior fossa. Although Dandy-Walker malformation is relatively common and several genes were linked to the syndrome, the genetic cause in the majority of cases is unknown. OBJECTIVE To identify the mutated gene responsible for Dandy-Walker malformation, kidney disease and bone marrow failure in four patients from two unrelated families. METHODS Medical assessment, sonographic, MRI and pathological studies were used to define phenotype. Chromosomal microarray analysis and whole-exome sequence were performed to unravel the genotype. RESULTS We report four subjects from two unrelated families with homozygous mutations in the Exocyst Complex Component 3-Like-2 gene (EXOC3L2).EXOC3L2 functions in trafficking of post-Golgi vesicles to the plasma membrane. In the first family a missense mutation in a highly conserved amino acid, p.Leu41Gln, was found in three fetuses; all had severe forms of Dandy-Walker malformation that was detectable by prenatal ultrasonography and confirmed by autopsy. In the second family, the affected child carried a nonsense mutation, p.Arg72*, and no detected protein. He had peritrigonal and cerebellar white matter abnormalities with enlargement of the ventricular trigones, developmental delay, pituitary hypoplasia, severe renal dysplasia and bone marrow failure. CONCLUSION We propose that biallelic EXOC3L2 mutations lead to a novel syndrome that affects hindbrain development, kidney and possibly the bone marrow.
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Affiliation(s)
- Adel Shalata
- Pediatrics and Medical Genetics and The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, Haifa, Israel
| | - Supanun Lauhasurayotin
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Marrow Failure and Myelodysplasia Program, Division of Hematology/ Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Israel
| | - Zvi Leibovitz
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center and Rappaport Faculty of Medicine, The Technion, Haifa, Israel
| | - Hongbing Li
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Marrow Failure and Myelodysplasia Program, Division of Hematology/ Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Israel
| | - Diane Hebert
- Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Santhosh Dhanraj
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Marrow Failure and Myelodysplasia Program, Division of Hematology/ Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Israel
| | - Yarin Hadid
- Pediatrics and Medical Genetics and The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, Haifa, Israel
| | - Mohammed Mahroum
- Pediatrics and Medical Genetics and The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, Haifa, Israel
| | - Jacob Bajar
- Department of Pathology, Bnai Zion Medical Center, Haifa, Israel
| | - Sandro Egenburg
- Department of Pathology, Bnai Zion Medical Center, Haifa, Israel
| | - Ayala Arad
- Department of Pathology, Bnai Zion Medical Center, Haifa, Israel
| | - Mordechai Shohat
- Sheba Cancer Research Center, Sackler School of Medicine, Tel Aviva University, Maccabi Genetic Institute, Tel Aviv, Israel
| | - Sami Haddad
- Ultrasound unit, Obstetrics-Gynecology Department, Baruch Padeh Peoria Hospital, Tiberias, Israel
| | - Hassan Bakry
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center and Rappaport Faculty of Medicine, The Technion, Haifa, Israel
| | - Houtan Moshiri
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen W Scherer
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shay Tzur
- Laboratory of Molecular Medicine, Rappaport Faculty of Medicine and Research Institute, Technion - Israel Institute of Technology, Haifa, Israel
- Genomic Research Department, Emedgene Technologies, Tel Aviv, Israel
| | - Yigal Dror
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
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