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Acevedo AC, Poulter JA, Alves PG, de Lima CL, Castro LC, Yamaguti PM, Paula LM, Parry DA, Logan CV, Smith CEL, Johnson CA, Inglehearn CF, Mighell AJ. Variability of systemic and oro-dental phenotype in two families with non-lethal Raine syndrome with FAM20C mutations. BMC Med Genet 2015; 16:8. [PMID: 25928877 PMCID: PMC4422040 DOI: 10.1186/s12881-015-0154-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/06/2015] [Indexed: 12/30/2022]
Abstract
Background Raine syndrome (RS) is a rare autosomal recessive bone dysplasia typified by osteosclerosis and dysmorphic facies due to FAM20C mutations. Initially reported as lethal in infancy, survival is possible into adulthood. We describe the molecular analysis and clinical phenotypes of five individuals from two consanguineous Brazilian families with attenuated Raine Syndrome with previously unreported features. Methods The medical and dental clinical records were reviewed. Extracted deciduous and permanent teeth as well as oral soft tissues were analysed. Whole exome sequencing was undertaken and FAM20C cDNA sequenced in family 1. Results Family 1 included 3 siblings with hypoplastic Amelogenesis Imperfecta (AI) (inherited abnormal dental enamel formation). Mild facial dysmorphism was noted in the absence of other obvious skeletal or growth abnormalities. A mild hypophosphataemia and soft tissue ectopic mineralization were present. A homozygous FAM20C donor splice site mutation (c.784 + 5 g > c) was identified which led to abnormal cDNA sequence. Family 2 included 2 siblings with hypoplastic AI and tooth dentine abnormalities as part of a more obvious syndrome with facial dysmorphism. There was hypophosphataemia, soft tissue ectopic mineralization, but no osteosclerosis. A homozygous missense mutation in FAM20C (c.1487C > T; p.P496L) was identified. Conclusions The clinical phenotype of non-lethal Raine Syndrome is more variable, including between affected siblings, than previously described and an adverse impact on bone growth and health may not be a prominent feature. By contrast, a profound failure of dental enamel formation leading to a distinctive hypoplastic AI in all teeth should alert clinicians to the possibility of FAM20C mutations. Electronic supplementary material The online version of this article (doi:10.1186/s12881-015-0154-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ana Carolina Acevedo
- Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Department of Dentistry, Health Sciences School, University of Brasilia, Brasilia, Brazil.
| | - James A Poulter
- Section of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK.
| | - Priscila Gomes Alves
- Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Department of Dentistry, Health Sciences School, University of Brasilia, Brasilia, Brazil.
| | - Caroline Lourenço de Lima
- Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Department of Dentistry, Health Sciences School, University of Brasilia, Brasilia, Brazil.
| | - Luiz Claudio Castro
- Department of Pediatrics, School of Medicine, University of Brasilia, Brasilia, Brazil.
| | - Paulo Marcio Yamaguti
- Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Department of Dentistry, Health Sciences School, University of Brasilia, Brasilia, Brazil.
| | - Lilian M Paula
- Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Department of Dentistry, Health Sciences School, University of Brasilia, Brasilia, Brazil.
| | - David A Parry
- Section of Genetics, School of Medicine, University of Leeds, Leeds, UK.
| | - Clare V Logan
- Section of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK.
| | - Claire E L Smith
- Section of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK.
| | - Colin A Johnson
- Section of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK.
| | - Chris F Inglehearn
- Section of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK.
| | - Alan J Mighell
- Section of Ophthalmology and Neuroscience, University of Leeds, Leeds, UK. .,Department of Oral Medicine, School of Dentistry, University of Leeds, Leeds, UK.
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