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Kozma K, Bembea M, Jurca CM, Ioana M, Streață I, Şoşoi SŞ, Pirvu A, Petchesi CD, Szilágyi A, Sava CN, Jurca A, Ujfalusi A, Szűcs Z, Szakszon K. Greig Cephalopolysyndactyly Contiguous Gene Syndrome: Case Report and Literature Review. Genes (Basel) 2021; 12:genes12111674. [PMID: 34828280 PMCID: PMC8623992 DOI: 10.3390/genes12111674] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Greig cephalopolysyndactyly syndrome (GCPS) is a rare genetic disorder (about 200 cases reported), characterized by macrocephaly, hypertelorism, and polysyndactyly. Most of the reported GCPS cases are the results of heterozygous loss of function mutations affecting the GLI3 gene (OMIM# 175700), while a small proportion of cases arise from large deletions on chromosome 7p14 encompassing the GLI3 gene. To our knowledge, only 6 patients have been reported to have a deletion with an exact size (given by genomic coordinates) and a gene content larger than 1 Mb involving the GLI3 gene. This report presents a patient with Greig cephalopolysyndactyly contiguous gene syndrome (GCP-CGS) diagnosed with a large, 18 Mb deletion on chromosome 7p14.2-p11.2. Similar cases are reviewed in the literature for a more accurate comparison between genotype and phenotype.
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Affiliation(s)
- Kinga Kozma
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
- Regional Center of Medical Genetics Bihor, 410445 Oradea, Romania
- Municipal Clinical Hospital “Dr. Gavril Curteanu”, 410469 Oradea, Romania
- Correspondence: (K.K.); (C.D.P.); Tel.: +40-744-708-777 (K.K.)
| | - Marius Bembea
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
- Regional Center of Medical Genetics Bihor, 410445 Oradea, Romania
- Municipal Clinical Hospital “Dr. Gavril Curteanu”, 410469 Oradea, Romania
| | - Claudia M. Jurca
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
- Regional Center of Medical Genetics Bihor, 410445 Oradea, Romania
- Municipal Clinical Hospital “Dr. Gavril Curteanu”, 410469 Oradea, Romania
| | - Mihai Ioana
- Regional Center of Medical Genetics Dolj, 200349 Craiova, Romania; (M.I.); (I.S.); (S.Ş.Ş.); (A.P.)
- Human Genomics Laboratory, Faculty of Medicine, University of Medicine and Pharmacy Craiova, 200642 Craiova, Romania
| | - Ioana Streață
- Regional Center of Medical Genetics Dolj, 200349 Craiova, Romania; (M.I.); (I.S.); (S.Ş.Ş.); (A.P.)
- Human Genomics Laboratory, Faculty of Medicine, University of Medicine and Pharmacy Craiova, 200642 Craiova, Romania
| | - Simona Ş. Şoşoi
- Regional Center of Medical Genetics Dolj, 200349 Craiova, Romania; (M.I.); (I.S.); (S.Ş.Ş.); (A.P.)
- Human Genomics Laboratory, Faculty of Medicine, University of Medicine and Pharmacy Craiova, 200642 Craiova, Romania
| | - Andrei Pirvu
- Regional Center of Medical Genetics Dolj, 200349 Craiova, Romania; (M.I.); (I.S.); (S.Ş.Ş.); (A.P.)
- Human Genomics Laboratory, Faculty of Medicine, University of Medicine and Pharmacy Craiova, 200642 Craiova, Romania
| | - Codruța D. Petchesi
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
- Correspondence: (K.K.); (C.D.P.); Tel.: +40-744-708-777 (K.K.)
| | - Ariana Szilágyi
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
- Municipal Clinical Hospital “Dr. Gavril Curteanu”, 410469 Oradea, Romania
| | - Cristian N. Sava
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
- Municipal Clinical Hospital “Dr. Gavril Curteanu”, 410469 Oradea, Romania
| | - Alexandru Jurca
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.B.); (C.M.J.); (A.S.); (C.N.S.); (A.J.)
| | - Anikó Ujfalusi
- Division of Clinical Genetics, Faculty of Medicine, Departament of Laboratory Medicine, University of Debrecen, 4032 Debrecen, Hungary; (A.U.); (Z.S.)
| | - Zsuzsanna Szűcs
- Division of Clinical Genetics, Faculty of Medicine, Departament of Laboratory Medicine, University of Debrecen, 4032 Debrecen, Hungary; (A.U.); (Z.S.)
| | - Katalin Szakszon
- Faculty of Medicine, Departament of Pediatrics, University of Debrecen, 4032 Debrecen, Hungary;
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El Mouatani A, Van Winckel G, Zaafrane-Khachnaoui K, Whalen S, Achaiaa A, Kaltenbach S, Superti-Furga A, Vekemans M, Fodstad H, Giuliano F, Attie-Bitach T. Homozygous GLI3 variants observed in three unrelated patients presenting with syndromic polydactyly. Am J Med Genet A 2021; 185:3831-3837. [PMID: 34296525 DOI: 10.1002/ajmg.a.62426] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/01/2021] [Accepted: 06/12/2021] [Indexed: 11/08/2022]
Abstract
Polydactyly is a hallmark of GLI3 pathogenic variants, with Greig cephalopolysyndactyly syndrome and Pallister-Hall syndrome being the two main associated clinical presentations. Homozygous GLI3 variants are rare instances in the literature, and mendelian dominance is the accepted framework for GLI3-related diseases. Herein, we report three unrelated probands, presenting with polydactyly, and homozygous variants in the GLI3 gene. First, a 10-year-old girl, whose parents were first-degree cousins, presented with bilateral postaxial polydactyly of the hands, developmental delay and multiple malformations. Second, a male newborn, whose parents were first-degree cousins, presented with isolated bilateral postaxial polysyndactyly of the hands and the feet. Third, an adult male, whose parents were first-degree cousins, had bilateral mesoaxial polydactyly of the hands, with severe intellectual disability and multiple malformations. All three probands carried homozygous GLI3 variants. Strikingly, the parents also carried the child's variant, in the heterozygous state, without any clinical sign of GLI3 disease. Given the clinical presentation of our patients, the rarity and predicted high pathogenicity of the variants observed, and the absence of other pathogenic variants, we suggest that these GLI3 homozygous variants are causal. Moreover, the parents were heterozygous for the observed variants, but were clinically unremarkable, suggesting that these variants are hypomorphic alleles.
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Affiliation(s)
- Ahmed El Mouatani
- Service Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Géraldine Van Winckel
- Service de Médecine Génétique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | | | - Sandra Whalen
- Unité Fonctionnelle de Génétique Clinique, Centre de Référence Maladies Rares Anomalies du développement et syndromes malformatifs, Hôpital Armand Trousseau, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Amale Achaiaa
- Service Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Sophie Kaltenbach
- Service Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.,INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France
| | - Andrea Superti-Furga
- Service de Médecine Génétique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Michel Vekemans
- Service Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Heidi Fodstad
- Service de Médecine Génétique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Fabienne Giuliano
- Service de Médecine Génétique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Tania Attie-Bitach
- Service Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.,INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France
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Al-Qattan MM, Shamseldin HE, Salih MA, Alkuraya FS. GLI3-related polydactyly: a review. Clin Genet 2017; 92:457-466. [PMID: 28224613 DOI: 10.1111/cge.12952] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 09/19/2016] [Revised: 10/28/2016] [Accepted: 12/06/2016] [Indexed: 12/20/2022]
Abstract
GLI3 mutations are known to be associated with nine syndromes/conditions in which polydactyly is a feature. In this review, the embryology, pathogenesis, and animal models of GLI3-related polydactyly are discussed first. This is followed by a detailed review of the genotype-phenotype correlations. Based on our review of the literature and our clinical experiences, we recommend viewing GLI3-related syndromes/conditions as four separate entities; each characterized by a specific pattern of polydactyly. These four entities are: the preaxial polydactyly type IV-Greig-acrocallosal spectrum, postaxial polydactyly types A/B, Pallister-Hall syndrome (PHS), and oral-facial-digital overlap syndrome. We also provide illustrative clinical examples from our practice including a family with a novel GLI3 mutation causing PHS. The review also introduces the term 'Forme Fruste' preaxial polydactyly and gives several conclusions/recommendations including the recommendation to revise the current criteria for the clinical diagnosis of PHS.
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Affiliation(s)
- M M Al-Qattan
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - H E Shamseldin
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - M A Salih
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - F S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.,Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Tabler JM, Rice CP, Liu KJ, Wallingford JB. A novel ciliopathic skull defect arising from excess neural crest. Dev Biol 2016; 417:4-10. [PMID: 27395007 DOI: 10.1016/j.ydbio.2016.07.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 01/17/2023]
Abstract
The skull is essential for protecting the brain from damage, and birth defects involving disorganization of skull bones are common. However, the developmental trajectories and molecular etiologies by which many craniofacial phenotypes arise remain poorly understood. Here, we report a novel skull defect in ciliopathic Fuz mutant mice in which only a single bone pair encases the forebrain, instead of the usual paired frontal and parietal bones. Through genetic lineage analysis, we show that this defect stems from a massive expansion of the neural crest-derived frontal bone. This expansion occurs at the expense of the mesodermally-derived parietal bones, which are either severely reduced or absent. A similar, though less severe, phenotype was observed in Gli3 mutant mice, consistent with a role for Gli3 in cilia-mediated signaling. Excess crest has also been shown to drive defective palate morphogenesis in ciliopathic mice, and that defect is ameliorated by reduction of Fgf8 gene dosage. Strikingly, skull defects in Fuz mutant mice are also rescued by loss of one allele of fgf8, suggesting a potential route to therapy. In sum, this work is significant for revealing a novel skull defect with a previously un-described developmental etiology and for suggesting a common developmental origin for skull and palate defects in ciliopathies.
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Affiliation(s)
- Jacqueline M Tabler
- Department of Molecular Biosciences, University of Texas at Austin, United States
| | - Christopher P Rice
- Department of Molecular Biosciences, University of Texas at Austin, United States
| | - Karen J Liu
- Department of Craniofacial Development and Stem Cell Biology, King's College London, UK.
| | - John B Wallingford
- Department of Molecular Biosciences, University of Texas at Austin, United States.
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