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Du R, Tian H, Zhao B, Shi X, Sun Y, Qiu B, Li Y. A de novo homozygous missense mutation of the GUSB gene leads to mucopolysaccharidosis type VII identification in a family with twice adverse pregnancy outcomes due to non-immune hydrops fetalis. Mol Genet Metab Rep 2024; 38:101033. [PMID: 38149215 PMCID: PMC10750109 DOI: 10.1016/j.ymgmr.2023.101033] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Non-immune hydrops fetalis (NIHF) is a common and severe manifestation of many genetic disorders. The ultrasound is an ideal method for diagnosing hydrops fetalis during pregnancy. Since most NIHFs do not have an identifiable cause, determining the underlying etiology remains a challenge for prenatal counseling. Due to advancements in exome sequencing, the diagnostic rates of NIHF have recently increased. As reported here, DNA was extracted from the amniotic fluid of a pregnant woman who was prenatally diagnosed with a NIHF type of unclear origin. Amniocentesis sampling demonstrated a normal female karyotype and copy number variation(CNVs) without alterations. Tri-whole exome sequencing (WES) was conducted to identify possible causative variants. In the fetus, a de novo genetic mutation was identified as a homozygous form. The mutation was located on the glucuronidase beta (GUSB) gene: NM_000181.3: c.1324G > A; p. Ala442Thr; Chr7:65439349, which leads to mucopolysaccharidosis type VII. This mutation was inherited from the parents and was first reported to be related to NIHF. We conclude that the use of WES is beneficial for NIHF cases whose prognosis has not been explained by standard genetic testing.
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Affiliation(s)
- Runxuan Du
- Department of Reproduction and Genetics, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
| | - Haishen Tian
- Department of Reproduction and Genetics, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
| | - Bingyi Zhao
- Department of Reproduction and Genetics, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
| | - Xuedong Shi
- Department of Reproduction and Genetics, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
| | - Yanmei Sun
- Department of Reproduction and Genetics, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
| | - Bo Qiu
- Department of pharmacy, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
| | - Yali Li
- Department of Reproduction and Genetics, Hebei General Hospital, Hebei Provincial, Shijiazhuang, China
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Hizem S, Elaribi Y, Ben Slama S, Dimassi K, Jilani H, Rejeb I, Sebaï M, Bekri S, Ben Jemaa L. Mucopolysaccharidosis type VII as a cause of recurrent Non-Immune Hydrops Fetalis: The first Tunisian case confirmed by Next-Generation Sequencing. Clin Chim Acta 2020; 513:68-70. [PMID: 33382994 DOI: 10.1016/j.cca.2020.12.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/11/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 11/29/2022]
Abstract
Non-Immune Hydrops Fetalis (NIHF) is an intrauterine condition characterized by excessive fluid accumulation in at least two fetal compartments in the absence of maternal circulating red cell antibodies. It is associated with a poor prognosis and a wide etiological spectrum. Among the metabolic causes, Mucopolysaccharidosis type VII depicts the most frequent type of lysosomal storage disorders in the cause of NIHF. Nonetheless, it remains an ultra-rare disorder, as less than 150 cases have been reported in the literature. This rarity seems to be related to misdiagnosis since the underlying etiology remains unelusive in most cases of NIHF. In this report, we describe the first Tunisian case of Mucopolysaccharidosis type VII caused by a homozygous mutation in the GUSB gene confirmed by a Next-Generation Sequencing gene panel in a patient with recurrent NIHF.
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Affiliation(s)
- Syrine Hizem
- Department of Congenital and Hereditary Diseases, Mongi Slim Hospital, Tunis, Tunisia.
| | - Yasmina Elaribi
- Department of Congenital and Hereditary Diseases, Mongi Slim Hospital, Tunis, Tunisia
| | - Sana Ben Slama
- Department of Pathology, Mongi Slim Hospital, Tunis, Tunisia
| | - Kawther Dimassi
- Department of Obstetrics and Gynecology, Mongi Slim Hospital, Tunis, Tunisia
| | - Houweyda Jilani
- Department of Congenital and Hereditary Diseases, Mongi Slim Hospital, Tunis, Tunisia
| | - Imen Rejeb
- Department of Congenital and Hereditary Diseases, Mongi Slim Hospital, Tunis, Tunisia
| | - Molka Sebaï
- Department of Congenital and Hereditary Diseases, Mongi Slim Hospital, Tunis, Tunisia
| | - Soumeya Bekri
- Department of Metabolic Biochemistry, Rouen University Hospital, Rouen, France
| | - Lamia Ben Jemaa
- Department of Congenital and Hereditary Diseases, Mongi Slim Hospital, Tunis, Tunisia
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Furlan F, Rovelli A, Rigoldi M, Filocamo M, Tappino B, Friday D, Gasperini S, Mariani S, Izzi C, Bondioni MP, Gellera C, Venerando A, Villa N, Del Carmen Rodriguez Perez M, Pavan F, Biondi A, Parini R. A new case report of severe mucopolysaccharidosis type VII: diagnosis, treatment with haematopoietic cell transplantation and prenatal diagnosis in a second pregnancy. Ital J Pediatr 2018; 44:128. [PMID: 30442200 PMCID: PMC6238262 DOI: 10.1186/s13052-018-0566-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A new patient with severe mucopolysaccharidosis (MPS) type VII is reported. Non-immune hydrops fetalis (NIHF) was diagnosed during pregnancy. At birth, he showed generalized hydrops and dysmorphic features typical of MPS. Many diagnoses were excluded before reaching the diagnosis of MPS VII at 8 months of life. During the first year of life he had frequent respiratory infections associated with restrictive and obstructive bronchopneumopathy and underwent three surgical interventions: decompression of the spinal cord at the craniocervical junction, bilateral inguinal hernia, and bilateral clubfoot. At 14 months of life he underwent successful haematopoietic cell transplantation (HCT). During the following 10 months, his bronchopneumopathy progressively worsened, needing chronic pharmacological treatment and O2 administration. The patient died of respiratory insufficiency during a respiratory syncytial virus infection at 25 months of age. Molecular analysis showed the homozygous variant c.1617C > T, leading to the synonymous mutation p.Ser539=. This caused aberrant splicing with partial skipping of exon 10 (r.1616_1653del38) and complete skipping of exon 9 (r.1392_1476del85; r.1616_1653del38). No transcript of normal size was evident. The parents were both confirmed to be carriers. In a subsequent pregnancy, a prenatal diagnosis showed an affected fetus. Ultrasound examination before abortion showed NIHF. The skin and placenta examination by electron microscopy showed foamy intracytoplasmic vacuoles with a weakly electron-dense substrate. MPS VII is a very rare disease but it is possible that some cases go undiagnosed for several reasons, including that MPS VII, and other lysosomal storage diseases, are not included in the work-up for NIHF in many institutions, and the presence of anasarca at birth may be confounding for the recognition of the typical facial characteristics of the disease. This is the eighth patient affected by MPS VII who has undergone HCT. It is not possible to draw conclusions about the efficacy of HCT in MPS VII. Treatment with enzyme replacement is now available and will probably be beneficial for the patients who have a milder form with no or little cognitive involvement. Increased awareness among clinicians is needed for prompt diagnosis and to offer the correct treatment as early as possible.
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Affiliation(s)
- Francesca Furlan
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Clinica Pediatrica, Fondazione MBBM, Università Milano-Bicocca, Monza, Italy
| | - Attilio Rovelli
- Clinica Pediatrica, Fondazione MBBM, Università Milano-Bicocca, Monza, Italy
| | - Miriam Rigoldi
- Medical Genetics Unit S Gerardo Hospital, ASST Monza, Monza, Italy
| | - Mirella Filocamo
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto Giannina Gaslini, Genoa, Italy
| | - Barbara Tappino
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche, Istituto Giannina Gaslini, Genoa, Italy
| | - Douglas Friday
- Diagenom GmbH Robert-Koch-Str. 10, D-18059, Rostock, Germany
| | - Serena Gasperini
- Clinica Pediatrica, Fondazione MBBM, Università Milano-Bicocca, Monza, Italy
| | - Silvana Mariani
- Clinica Ostetrica Fondazione MBBM Università Milano Bicocca, Monza, Italy
| | - Claudia Izzi
- Prenatal Diagnosis Unit, Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Maria Pia Bondioni
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Cinzia Gellera
- Unit of Genetics of Neurodegenerative and Metabolic Diseases,- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Venerando
- Unit of Genetics of Neurodegenerative and Metabolic Diseases,- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Nicoletta Villa
- Medical Genetics Unit S Gerardo Hospital, ASST Monza, Monza, Italy
| | | | - Fabio Pavan
- Clinica Pediatrica, Fondazione MBBM, Università Milano-Bicocca, Monza, Italy
| | - Andrea Biondi
- Clinica Pediatrica, Fondazione MBBM, Università Milano-Bicocca, Monza, Italy
| | - Rossella Parini
- Clinica Pediatrica, Fondazione MBBM, Università Milano-Bicocca, Monza, Italy. .,Fondazione MBBM, AST San Gerardo, via Pergolesi 33, 20900, Monza, Italy.
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