1
|
Cerminara M, Spirito G, Pisciotta L, Squillario M, Servetti M, Divizia MT, Lerone M, Berloco B, Boeri S, Nobili L, Vozzi D, Sanges R, Gustincich S, Puliti A. Case Report: Whole Exome Sequencing Revealed Disease-Causing Variants in Two Genes in a Patient With Autism Spectrum Disorder, Intellectual Disability, Hyperactivity, Sleep and Gastrointestinal Disturbances. Front Genet 2021; 12:625564. [PMID: 33679889 PMCID: PMC7930735 DOI: 10.3389/fgene.2021.625564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/03/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Autism Spectrum Disorder (ASD) refers to a broad range of conditions characterized by difficulties in communication, social interaction and behavior, and may be accompanied by other medical or psychiatric conditions. Patients with ASD and comorbidities are often difficult to diagnose because of the tendency to consider the multiple symptoms as the presentation of a complicated syndromic form. This view influences variant filtering which might ignore causative variants for specific clinical features shown by the patient. Here we report on a male child diagnosed with ASD, showing cognitive and motor impairments, stereotypies, hyperactivity, sleep, and gastrointestinal disturbances. The analysis of whole exome sequencing (WES) data with bioinformatic tools for oligogenic diseases helped us to identify two major previously unreported pathogenetic variants: a maternally inherited missense variant (p.R4122H) in HUWE1, an ubiquitin protein ligase associated to X-linked intellectual disability and ASD; and a de novo stop variant (p.Q259X) in TPH2, encoding the tryptophan hydroxylase 2 enzyme involved in serotonin synthesis and associated with susceptibility to attention deficit-hyperactivity disorder (ADHD). TPH2, expressed in central and peripheral nervous tissues, modulates various physiological functions, including gut motility and sleep. To the best of our knowledge, this is the first case presenting with ASD, cognitive impairment, sleep, and gastrointestinal disturbances linked to both HUWE1 and TPH2 genes. Our findings could contribute to the existing knowledge on clinical and genetic diagnosis of patients with ASD presentation with comorbidities.
Collapse
Affiliation(s)
- Maria Cerminara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Giovanni Spirito
- Neuroscience Area, International School for Advanced Studies (SISSA), Trieste, Italy
| | - Livia Pisciotta
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco (ASST Fbf Sacco), Milan, Italy
| | - Margherita Squillario
- Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Martina Servetti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Teresa Divizia
- Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Margherita Lerone
- Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Bianca Berloco
- Child Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Silvia Boeri
- Child Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Lino Nobili
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Diego Vozzi
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Remo Sanges
- Neuroscience Area, International School for Advanced Studies (SISSA), Trieste, Italy.,Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Stefano Gustincich
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Aldamaria Puliti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Medical Genetics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| |
Collapse
|
2
|
Fernández MA, Morillo MD, Gilibert N, Carvalho C, Bello S. [The technological tools of the diagnosis and treatment of attention deficit disorder and hyperactivity]. Medicina (B Aires) 2020; 80 Suppl 2:67-71. [PMID: 32150717] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Attention deficit disorder and hyperactivity (ADHD) is the main reason for consultation in most Pediatric Neurology units in Spain. The new technologies also associate benefits for both patients and professionals and the health system itself, which makes its rational implementation essential. Genetics, neuroimaging or virtual reality, for example, are clear exponents of the results that can be achieved by optimizing traditional processes. The different technologies that we collect in this article are fully operational and have thousands of experience in patients. The incorporation of them to the usual clinical practice is in our hands.
Collapse
Affiliation(s)
| | | | | | - Carla Carvalho
- Instituto Andaluz de Neurología Pediátrica, Sevilla, España
| | - Sabina Bello
- Instituto Andaluz de Neurología Pediátrica, Sevilla, España
| |
Collapse
|
3
|
Altay MA, Görker I. Assessment of Psychiatric Comorbidity and WISC-R Profiles in Cases Diagnosed with Specific Learning Disorder According to DSM-5 Criteria. Noro Psikiyatr Ars 2018; 55:127-134. [PMID: 30057453 DOI: 10.5152/npa.2017.18123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 05/10/2016] [Accepted: 01/18/2017] [Indexed: 01/28/2023] Open
Abstract
Introduction In this study, the frequency of psychiatric comorbidity in children and adolescents who were diagnosed with specific learning disorder, the factors that affect the frequency of comorbidity, the subtypes of specific learning disorder and the effects on cognitive profile have been investigated. Methods Our study was performed among 80 cases with the age range 6-15 years who diagnosed with specific learning disorder Child and Adolescent Psychiatry Department between January and June 2015. In the study, DSM-IV Based Screening and Evaluation Scale for Child and Adolescent Behavioral Disorders, Specific Learning Disability Evaluation Scale and the WISC-R test were performed. During the interview, reading-writing-math abilities evaluation list (error analysis) was performed in order to define the specific learning disorder subgroup and to evaluate the detailed error profile of the specific learning disorder subgroup. Kiddie Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime Turkish Version (KSADS) was performed to detect psychiatric comorbidity diagnoses. Results 92.5% of the cases have a comorbid psychiatric disorder. The most frequent psychiatric comorbidity was attention deficit hyperactivity disorder (82.3%), followed by specific phobia (46.3%), oppositional defiant disorder (26.3%), enuresis (25%) and tic disorders (22.5%). Psychiatric comorbidity is detected more often in patients with specific learning disorder accompanied by attention deficit and hyperactivity disorder. The most frequent subtype of specific learning disorder is combined type disorder consisting of reading, writing and math disorder (37.5%). The WISC-R score of the patients who had math disorder were found to be lower than the others, and also it was detected that they learned reading and writing later, and have more comorbid psychiatric disorders. Conclusion The results of our study indicate that associated psychiatric disorders are frequent with specific learning disorder. Specific learning disorder should not be considered as a single disorder, but should be assessed and treated with comorbid psychiatric disorders.
Collapse
Affiliation(s)
- Mengühan Araz Altay
- Department of Child and Adolescent Psychiatry, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey
| | - Işık Görker
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine, Edirne, Turkey
| |
Collapse
|