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Walne AJ, Collopy L, Cardoso S, Ellison A, Plagnol V, Albayrak C, Albayrak D, Kilic SS, Patıroglu T, Akar H, Godfrey K, Carter T, Marafie M, Vora A, Sundin M, Vulliamy T, Tummala H, Dokal I. Marked overlap of four genetic syndromes with dyskeratosis congenita confounds clinical diagnosis. Haematologica 2016; 101:1180-1189. [PMID: 27612988 DOI: 10.3324/haematol.2016.147769] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/21/2016] [Indexed: 11/09/2022] Open
Abstract
Dyskeratosis congenita is a highly pleotropic genetic disorder. This heterogeneity can lead to difficulties in making an accurate diagnosis and delays in appropriate management. The aim of this study was to determine the underlying genetic basis in patients presenting with features of dyskeratosis congenita and who were negative for mutations in the classical dyskeratosis congenita genes. By whole exome and targeted sequencing, we identified biallelic variants in genes that are not associated with dyskeratosis congenita in 17 individuals from 12 families. Specifically, these were homozygous variants in USB1 (8 families), homozygous missense variants in GRHL2 (2 families) and identical compound heterozygous variants in LIG4 (2 families). All patients had multiple somatic features of dyskeratosis congenita but not the characteristic short telomeres. Our case series shows that biallelic variants in USB1, LIG4 and GRHL2, the genes mutated in poikiloderma with neutropenia, LIG4/Dubowitz syndrome and the recently recognized ectodermal dysplasia/short stature syndrome, respectively, cause features that overlap with dyskeratosis congenita. Strikingly, these genes also overlap in their biological function with the known dyskeratosis congenita genes that are implicated in telomere maintenance and DNA repair pathways. Collectively, these observations demonstrate the marked overlap of dyskeratosis congenita with four other genetic syndromes, confounding accurate diagnosis and subsequent management. This has important implications for establishing a genetic diagnosis when a new patient presents in the clinic. Patients with clinical features of dyskeratosis congenita need to have genetic analysis of USB1, LIG4 and GRHL2 in addition to the classical dyskeratosis congenita genes and telomere length measurements.
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Affiliation(s)
- Amanda J Walne
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Laura Collopy
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Shirleny Cardoso
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Alicia Ellison
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | | | - Canan Albayrak
- Department of Pediatric Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology, Ondokuz Mayis University, Samsun, Turkey
| | | | - Turkan Patıroglu
- Department of Pediatric Immunology Erciyes University Medical Facility, Kayseri, Turkey
| | - Haluk Akar
- Department of Pediatric Immunology Erciyes University Medical Facility, Kayseri, Turkey
| | - Keith Godfrey
- Department of Pediatric Dermatology and NIHR Southampton Biomedical Research Center, University Hospital, Southampton and University of Southampton, UK
| | - Tina Carter
- Department of Oncology and Haematology, Princess Margaret Hospital, Perth, WA, Australia
| | - Makia Marafie
- Clinical Cancer and Community Genetics, Kuwait Medical Genetics Center, Al-Sabah Medical area, Kuwait
| | - Ajay Vora
- Department of Haematology, Sheffield Children's NHS foundation Trust, Sheffield, UK
| | - Mikael Sundin
- Section of Pediatric Hematology/Immunology/SCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Division of Pediatrics, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Vulliamy
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Hemanth Tummala
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Inderjeet Dokal
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
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Fusaro M, Fusaro M, Noale M, Tripepi G, D'angelo A, Miozzo D, Gallieni M, Study Group PV, Tsamelesvili M, Dimitriadis C, Papagianni A, Raidis C, Efstratiadis G, Memmos D, Mutluay R, Konca Degertekin C, Derici U, Deger SM, Akkiyal F, Gultekin S, Gonen S, Tacoy G, Arinsoy T, Sindel S, Sanchez-Perales C, Vazquez E, Merino E, Perez Del Barrio P, Borrego FJ, Borrego MJ, Liebana A, Krzanowski M, Janda K, Dumnicka P, Krasniak A, Sulowicz W, Kim YO, Yoon SA, Yun YS, Song HC, Kim BS, Cheong MA, Pasch A, Farese S, Floege J, Jahnen-Dechent W, Ohtake T, Ohtake T, Furuya R, Iwagami M, Tsutsumi D, Mochida Y, Ishioka K, Oka M, Maesato K, Moriya H, Hidaka S, Kobayashi S, Guedes A, Malho Guedes A, Pinho A, Fragoso A, Cruz A, Mendes P, Morgado E, Bexiga I, Silva AP, Neves P, Oyake N, Suzuki K, Itoh S, Yano S, Turkmen K, Kayikcioglu H, Ozbek O, Saglam M, Toker A, Tonbul HZ, Gelev S, Trajceska L, Srbinovska E, Pavleska S, Amitov V, Selim G, Dzekova P, Sikole A, Bouarich H, Lopez S, Alvarez C, Arribas I, DE Sequera P, Rodriguez D, Fusaro M, Fusaro M, Noale M, Tripepi G, D'angelo A, Miozzo D, Gallieni M, Study Group PV, Tanaka S, Kanemitsu T, Sugahara M, Kobayashi M, Uchida L, Ishimoto Y, Kotera N, Tanimoto S, Tanabe K, Hara K, Sugimoto T, Mise N, Goldstein B, Turakhia M, Arce C, Winkelmayer W, Zayed BED, Said K, Nishimura M, Nishimura M, Okamoto Y, Tokoro T, Nishida M, Hashimoto T, Iwamoto N, Takahashi H, Ono T, Nishimura M, Okamoto Y, Tokoro T, Sato N, Nishida M, Hashimoto T, Iwamoto N, Takahashi H, Ono T, Guedes A, Malho Guedes A, Cruz A, Morgado E, Pinho A, Fragoso A, Mendes P, Bexiga I, Silva AP, Neves P, Raimann J, Usvyat LA, Sands J, Levin NW, Kotanko P, Iwasaki M, Joki N, Tanaka Y, Ikeda N, Hayashi T, Kubo S, Imamura TA, Takahashi Y, Hirahata K, Imamura Y, Hase H, Claes K, Meijers B, Bammens B, Kuypers D, Naesens M, Vanrenterghem Y, Evenepoel P, Boscutti G, Calabresi L, Bosco M, Simonelli S, Boer E, Vitali C, Martone M, Mattei PL, Franceschini G, Baligh E, Zayed BED, Said K, El-Shafey E, Ezaat A, Zawada A, Rogacev K, Hummel B, Grun O, Friedrich A, Rotter B, Winter P, Geisel J, Fliser D, Heine GH, Makino JI, Makino KS, Ito T, Genovesi S, Santoro A, Fabbrini P, Rossi E, Pogliani D, Stella A, Bonforte G, Remuzzi G, Bertoli S, Pozzi C, Gallieni M, Pasquali S, Cagnoli L, Conte F, Santoro A, Buzadzic I, Tosic J, Dimkovic N, Djuric Z, Popovic J, Pejin Grubisa I, Barjaktarevic N, DI Napoli A, DI Lallo D, Salvatori MF, Franco F, Chicca S, Guasticchi G, Onofriescu M, Hogas S, Luminita V, Mugurel A, Gabriel V, Laura F, Irina M, Adrian C, Bosch E, Baamonde E, Culebras C, Perez G, El Hayek B, Ramirez JI, Ramirez A, Garcia C, Lago M, Toledo A, Checa MD, Taira T, Hirano T, Nohtomi K, Hyodo T, Chiba T, Saito A, Kim YK, Song HC, Choi EJ, Yang CW, Kim YS, Lim PS, Ming Ying W, Ya-Chung J, Zaripova I, Kayukov I, Essaian A, Nimgirova A, Young H, Dungey M, Watson EL, Baines R, Burton JO, Smith AC, Joki N, Iwasaki M, Tanaka Y, Kubo S, Hayashi T, Ikeda N, Yamazaki K, Hase H, 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Ryuzaki M, Nakamoto H, Kinoshita S, Kobayashi E, Takimoto C, Shishido T, Enia G, Torino C, Tripepi R, Panuccio V, Postorino M, Clementi A, Garozzo M, Bonanno G, Boito R, Natale G, Cicchetti T, Chippari A, Logozzo D, Alati G, Cassani S, Sellaro A, Zoccali C, Quiroga B, Verde E, Abad S, Vega A, Goicoechea M, Reque J, Lopez-Gomez JM, Luno J, Cabre Menendez C, Moles V, Vives JP, Villa D, Vinas J, Compte T, Arruche M, Diaz C, Soler J, Aguilera J, Martinez Vea A, De Mauri A, David P, Conte MM, Chiarinotti D, Ruva CE, De Leo M, Bargnoux AS, Morena M, Jaussent I, Chalabi L, Bories P, Dion JJ, Henri P, Delage M, Dupuy AM, Badiou S, Canaud B, Cristol JP, Fabbrini P, Sironi E, Pieruzzi F, Galbiati E, Vigano MR, Stella A, Genovesi S, Anpalakhan S, Anpalakhan S, Rocha S, Chitalia N, Sharma R, Kaski JC, Chambers J, Goldsmith D, Banerjee D, Cernaro V, Lacquaniti A, Lupica R, Lucisano S, Fazio MR, Donato V, Buemi M, Segalen I, Segalen I, Vinsonneau U, Tanquerel T, Quiniou G, Le Meur Y, Seibert E, Girndt M, Zohles K, Ulrich C, Kluttig A, Nuding S, Swenne C, Kors J, Werdan K, Fiedler R, Van der Weerd NC, Grooteman MP, Bots M, Van den Dorpel MA, Den Hoedt C, Nube MJ, Wetzels J, Swinkels DW, Blankestijn P, Ter Wee PM, Khandekar A, Khandge J, Lee JE, Moon SJ, Choi KH, Lee HY, Kim BS, Morena M, Tuaillon E, Jaussent I, Rodriguez A, Chenine L, Vendrell JP, Cristol JP, Canaud B, Sue YM, Tang CH, Chen YC, Sanchez-Perales C, Vazquez E, Segura P, Garcia Cortes MJ, Gil JM, Biechy MM, Liebana A, Poulikakos D, Shah A, Persson M, Banerjee D, Dattolo P, Amidone M, Amidone M, Michelassi S, Moriconi L, Betti G, Conti P, Rosati A, Mannarino A, Panichi V, Pizzarelli F, Klejna K, Naumnik B, Koc-Zorawska E, Mysliwiec M, Dimitrie S, Simona H, Mihaela O, Mugurel A, Gabriela O, Radu S, Octavian P, Adrian C, Akdam H, Akar H, Yenicerioglu Y, Kucuk O, Kurt Omurlu I, Goldsmith D, Thambiah S, Roplekar R, Manghat P, Manghat P, Fogelman I, Fraser W, Hampson G, Likaj E, Likaj E, Caco G, Seferi S, Rroji M, Barbullushi M, Thereska N, Onofriescu M, Hogas S, Luminita V, Mugurel A, Serban A, Carmen V, Cristian S, Silvia L, Covic A. Cardiovascular complications in CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Loh ZY, Yap CW, Anantharaman V, How P, Hirata M, Aizawa K, Yogo K, Tashiro Y, Takeda S, Endo K, Fukagawa M, Serizawa KI, Fujii H, Fujii H, Kono K, Nakai K, Goto S, Hirata M, Shinohara M, Kitazawa R, Kitazawa S, Fukagawa M, Nishi S, Oruc A, Korkmaz S, Bal O, Yilmaztepe Oral A, Ersoy A, Gullulu M, Ketteler M, Martin K, Amdahl M, Cozzolino M, Goldsmith D, Sharma A, Khan S, Ketteler M, Martin K, Amdahl M, Cozzolino M, Goldsmith D, Sharma A, Khan S, Chitalia N, Afzali B, Edozie F, Manghat P, Wierzbicki A, Hampson G, Goldsmith D, Corradini M, Iannuzzella F, Manenti L, Ciarrocchi A, Albertazzi L, Somenzi D, Pasquali S, Calabria Baxmann A, Barcellos Menon V, Froeder L, Medina-Pestana JO, Barbosa Carvalho A, Pfeferman Heilberg I, Sola L, De Souza N, Flores J, Perico N, Yuste C, Garcia DE Vinuesa MS, Luno J, Goicoechea MA, Barraca D, Panizo N, Quiroga B, Kim SM, Kwon SK, Kim HY, Cournoyer S, Bell R, Berbiche D, Menard L, Viaene L, Evenepoel P, Meijers B, Overbergh L, Mathieu C, Pasquali M, Rotondi S, Conte C, Pirro G, Mazzaferro S, Frasheri A, Marangella M, Tartaglione L, Park JS, Koo TY, Kim GH, Kang CM, Lee CH, Hiemstra TF, Casian A, Boraks P, Jayne D, Schoenmakers I, Schmiedeke B, Niemann M, Schmiedeke D, Davydenko I, Emmert A, Pilz S, Obermayer-Pietsch B, Weidemann F, Breunig F, Wanner C, Drechsler C, Shiizaki K, Ito C, Onishi A, Nakazawa E, Ogura M, Kusano E, Ermolenko V, Mikhaylova N, Mikhaylova N, Vartanjan K, Levchuk D, Dobrina E, Capusa C, Stancu S, Maria D, Vladu I, Barsan L, Garneata L, Mota E, Mircescu G, Capusa C, Stancu S, Barsan L, Ilyes A, Dorobantu N, Petrescu L, Mircescu G, Martinez-Gallardo R, Martinez-Gallardo R, Ferreira F, Garcia-Pino G, Luna E, Caravaca F, De Jager DJ, Grootendorst DC, Postmus I, De Goeij MCM, Boeschoten EW, Sijpkens YWJ, Dekker FW, Halbesma N, Wuthrich RP, Covic A, Gaillard S, Rakov V, Louvet L, Buchel J, Steppan S, Passlick-Deetjen J, Massy ZA, Akalin N, Akalin N, Altiparmak MR, Trabulus S, Yalin AS, Seyahi N, Ataman R, Serdengecti K, Donate-Correa J, Martinez-Sanz R, Muros-de-Fuentes M, Garcia J, Garcia P, Cazana V, Mora-Fernandez C, Navarro-Gonzalez JF, Chitalia N, Afzali B, Edozie F, Manghat P, Wierzbicki A, Hampson G, Goldsmith D, Berutti S, Marranca D, Soragna G, Erroi L, Migliardi M, Marangella M, Corradini M, Iannuzzella F, Belloni L, Somenzi D, Parmeggiani M, Pasquali S, Camerini C, Pezzotta M, Zani R, Movilli E, Cancarini G, Anwar S, Pruthi R, Kenchayikoppad S, Reyes J, Dasilva I, Furlano M, Calero F, Montanes R, Ayasreh N, Del Pozo M, Estorch M, Rousaud F, Ballarin JA, Bover J, Resende A, Dias CB, Dos Reis L, Jorgetti V, Woronik V, Panuccio V, Panuccio V, Enia G, Tripepi R, Cutrupi S, Pizzini P, Aliotta R, Zoccali C, Yildiz I, Sagliker Y, Demirhan O, Tunc E, Inandiklioglu N, Tasdemir D, Acharya V, Zhang L, Golea O, Sabry A, Ookalkar D, Capusa C, Radulescu D, Garneata L, Mircescu G, Ben Maiz H, Chen CH, Rome JP, Benzegoutta M, Paylar N, Eyupoglu K, Karatepe E, Esenturk M, Yavascan O, Grzegorzevska A, Shilo V, M-Mazdeh M, Francesco RC, Gouda Z, Adam SM, Emir I, Ocal F, Usta E, Kiralp N, Sagliker C, S Ozkaynak P, Sagliker HS, Bassuoni M, El-Wakil HS, Akar H, Yenicerioglu Y, Kose E, Sekin O. Mineral and bone disease - CKD 1-5. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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