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MacCarrick G, Aradhya S, Bailey M, Chu D, Hunt A, Izzo E, Krakow D, Mackenzie W, Poll S, Raggio C, Shediac R, White KK, McLaughlin HM, Seratti G. Clinical utility of comprehensive gene panel testing for common and rare causes of skeletal dysplasia and other skeletal disorders: Results from the largest cohort to date. Am J Med Genet A 2024:e63646. [PMID: 38702915 DOI: 10.1002/ajmg.a.63646] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 04/03/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
Molecular genetics enables more precise diagnoses of skeletal dysplasia and other skeletal disorders (SDs). We investigated the clinical utility of multigene panel testing for 5011 unrelated individuals with SD in the United States (December 2019-April 2022). Median (range) age was 8 (0-90) years, 70.5% had short stature and/or disproportionate growth, 27.4% had a positive molecular diagnosis (MDx), and 30 individuals received two MDx. Genes most commonly contributing to MDx were FGFR3 (16.9%), ALPL (13.0%), and COL1A1 (10.3%). Most of the 112 genes associated with ≥1 MDx were primarily involved in signal transduction (n = 35), metabolism (n = 23), or extracellular matrix organization (n = 17). There were implications associated with specific care/treatment options for 84.4% (1158/1372) of MDx-positive individuals; >50% were linked to conditions with targeted therapy approved or in clinical development, including osteogenesis imperfecta, achondroplasia, hypophosphatasia, and mucopolysaccharidosis. Forty individuals with initially inconclusive results became MDx-positive following family testing. Follow-up mucopolysaccharidosis enzyme activity testing was positive in 14 individuals (10 of these were not MDx-positive). Our findings showed that inclusion of metabolic genes associated with SD increased the clinical utility of a gene panel and confirmed that integrated use of comprehensive gene panel testing with orthogonal testing reduced the burden of inconclusive results.
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Affiliation(s)
- Gretchen MacCarrick
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Mitch Bailey
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Dorna Chu
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Abigail Hunt
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Emanuela Izzo
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Deborah Krakow
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - William Mackenzie
- Department of Orthopaedic Surgery, Nemours Children's Hospital, Wilmington, Delaware, USA
| | - Sarah Poll
- Invitae Corporation, San Francisco, California, USA
| | - Cathleen Raggio
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Renée Shediac
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Klane K White
- Department of Pediatric Orthopedic Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
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de Souza Lima T, Ferreira BG, Loureiro Souza CW, Batista IBC, Araujo Júnior E, Galvão Petrini C, Paschoini MC, Peixoto AB. Prenatal diagnosis of diastrophic dysplasia in the second trimester of pregnancy: Two- and three- dimensional ultrasonographic findings. Turk J Obstet Gynecol 2021; 18:258-263. [PMID: 34581174 PMCID: PMC8480210 DOI: 10.4274/tjod.galenos.2021.35033] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
To present a prenatal diagnosis of diastrophic dysplasia in the second trimester of pregnancy using two- (2D) and three-dimensional (3D) ultrasonography. The mother was primigravida and aged 12 years. She underwent the first 2D obstetric ultrasound examination at 27 weeks, showing bilaterally upper and lower limb micromelia, thumb and hallux in bilateral abduction, bilateral talipes equinovarus; hyperlordosis of the lumbar spine, cervical, lumbar, and sacral scoliosis; cervical hyperkyphosis with the misalignment of cervical vertebrae, and straight clavicles. 3D ultrasonography in conventional and HDlive rendering modes confirmed the changes observed in 2D ultrasonography and allowed improved understanding by the parents. At birth, the newborn presented transient respiratory distress and neonatal sepsis. At the time of writing, the child is aged 31 months and under follow-up by the pediatrics department. 3D ultrasound allowed the parents to understand the fetal malformations better, and they received adequate counseling.
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Affiliation(s)
- Thaísa de Souza Lima
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil
| | - Bárbara Ghannam Ferreira
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil
| | | | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil,Medical course, Municipal University of São Caetano do Sul (USCS), São Paulo-SP, Brazil
| | - Caetano Galvão Petrini
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil,Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba-MG, Brazil
| | - Marina Carvalho Paschoini
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil
| | - Alberto Borges Peixoto
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil,Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba-MG, Brazil
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Sierrasesúmaga Martín P, Berrade Zubiri S, Chueca Guindulain MJ, Viguria N, Moreno-Galarraga L. [Respiratory impairment in a patient with acrodysostosis: A rare association of an uncommon pathology]. ARCH ARGENT PEDIATR 2021; 119:e340-e344. [PMID: 34309314 DOI: 10.5546/aap.2021.e340] [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: 08/29/2020] [Accepted: 01/25/2021] [Indexed: 11/12/2022]
Abstract
Acrodysostosis is a rare skeletal displasia, of autosomal dominant inheritance, characterized by the presence of facial and peripheral dysostosis, short stature and obesity. Type 1 acrodysostosis is secondary to a mutation in the PRKAR1A (17q24.2) gene, which results in multi hormonal resistance and skeletal anomalities. This syndrome is under-diagnosed as it shares analytical and clinical characteristics with other entities, such as pseudohypoparathyroidism. We report the case of an eight-year-old girl with genetically confirmed type 1 acrodysostosis. In addition to the characteristic phenotype described, the short stature and the hormonal resistance, the Afectación respiratoria en paciente con acrodisostosis: una asociación infrecuente de una enfermedad rara Respiratory impairment in a patient with acrodysostosis: A rare association of an uncommon pathology patient suffered a progressive lung function deterioration: an irreversible pulmonary obstructive pattern. We have not found in previous literature cases reporting an association between acrodysostosis and lung function impairement.
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Affiliation(s)
| | - Sara Berrade Zubiri
- Endocrinología Infantil, Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, España
| | | | - Natividad Viguria
- Neumología Infantil, Servicio de Pediatría, Complejo Hospitalario de Navarra. IdisNa, Instituto de investigación sanitaria de Navarra, España
| | - Laura Moreno-Galarraga
- Neumología Infantil, Servicio de Pediatría, Complejo Hospitalario de Navarra. IdisNa, Instituto de investigación sanitaria de Navarra, España.
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Raggio CL, Yonko EA, Khan SI, Carter EM, Citron KP, Bostrom MPG, Figgie MP. Joint Replacements in Individuals With Skeletal Dysplasias: One Institution's Experience and Response to Operative Complications. J Arthroplasty 2020; 35:1993-2001. [PMID: 32386881 DOI: 10.1016/j.arth.2020.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/14/2020] [Accepted: 04/03/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Skeletal dysplasias are a heterogeneous group of >400 genetic disorders characterized by abnormal bone growth. Many individuals experience joint pain and limitation, coming to require joint replacement much earlier than the average-statured population. In addition, prosthesis survival rate is less in the dysplastic population. The purpose of this study is to identify risk factors for surgery and provide recommendations to improve surgical outcomes. METHODS This a retrospective review of 29 individuals with a skeletal dysplasia who had 64 joint replacements between April 1985 and January 2019 at a single institution. We collected demographics, physical examination, medical history, imaging studies, surgical indication, and complications. RESULTS Spondyloepiphyseal dysplasia was the most common skeletal dysplasia (7), followed by pseudoachondroplasia (4) and multiple epiphyseal dysplasia (4). Average age of the cohort was 40.6 years (range 14-64). Hip arthroplasty (34) was the most commonly performed surgery. The majority of arthroplasties (75%) required custom components. Complication rate was 37.3%, most commonly pulmonary embolism (3) and pneumonia (3). Most complications (81.8%) occurred in individuals with either a pre-existing cardiopulmonary comorbidity or lumbar/sacral deformity. Body mass index did not correlate with complication severity (R = -0.042, P = .752) or rate (R = 0.006, P = .963). CONCLUSION Surgical complications are highest in patients with pre-existing cardiopulmonary conditions. Body mass index does not predict complications in this cohort. Preoperative evaluations for individuals with skeletal dysplasias should include comprehensive work-up of spine issues and extraskeletal systems that present an operative risk. Intraoperative protocol should include special consideration for placement on the table, airway maintenance, and spinal cord monitoring in select cases.
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Affiliation(s)
- Cathleen L Raggio
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Elizabeth A Yonko
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Sobiah I Khan
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Erin M Carter
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Kate P Citron
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Mathias P G Bostrom
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Mark P Figgie
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
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Affiliation(s)
- Beatrice Cockbain
- Department of Immunology and Infection, Barts Health NHS Trust, London, United Kingdom (B.C.)
| | - Laura C Price
- National Pulmonary Hypertension Service (L.C.P.), Royal Brompton Hospital, London, United Kingdom
| | - Matthew Hind
- Department of Respiratory Medicine (M.H.), Royal Brompton Hospital, London, United Kingdom
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Hurd LM, Thacker MM, Okenfuss E, Duker AL, Lou Y, Harty MP, Conard K, Lian JB, Bober MB. Aneurysmal bone cysts and pathologic fracture associated with supernumerary ring chromosome 6 in two unrelated patients. Am J Med Genet A 2017; 173:3205-3210. [PMID: 29080333 DOI: 10.1002/ajmg.a.38498] [Citation(s) in RCA: 2] [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: 08/09/2016] [Revised: 08/07/2017] [Accepted: 09/15/2017] [Indexed: 11/08/2022]
Abstract
Small supernumerary ring chromosome 6 (sSRC[6]) is a rare chromosomal abnormality characterized by a broad clinical phenotype. The spectrum of this disorder can range from phenotypically normal to severe developmental delay and congenital anomalies. We describe two unrelated patients with small SRCs derived from chromosome 6 with a novel bone phenotype. Both patients presented with a complex bone disorder characterized by severe osteopenia, pathologic fractures, and cyst-like lesions within the bone. Imaging revealed decreased bone mineral density, mutiple multiloculated cysts and cortical thinning. Lesion pathology in both patients demonstrated a bland cyst wall with woven dysplastic appearing bone entrapped within it. In patient 1, array comparative genomic hybridization (CGH) detected a tandem duplication of region 6p12.3 to 6q12 per marker chromosome. Cytogenetic analysis further revealed a complex patient of mosaicism with some cell lines displaying either one or two copies of the marker indicative of both tetrasomy and hexasomy of this region. Patient 2 was mosaic for a sSRC that encompassed a 26.8 Mb gain from 6p21.2 to 6q12. We performed an in-depth clinical analysis of a phenotype not previously observed in sSRC(6) patients and discuss the potential influence of genes located within this region on the skeletal presentation observed.
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Affiliation(s)
- Lauren M Hurd
- Department of Biomedical Research, Nemours-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Mihir M Thacker
- Department of Orthopaedic Surgery, Nemours-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Ericka Okenfuss
- Department of Genetics, Skeletal Dysplasia Program, Kaiser Permanente, Oakland, California
| | - Angela L Duker
- Division of Medical Genetics, Nemours-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Yang Lou
- Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts.,Yurogen Biosystems LLC., Worcester, Massachusetts
| | - Mary P Harty
- Department of Medical Imaging, Nemours-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Katrina Conard
- Department of Pathology, Nemours-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Jane B Lian
- Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts.,Department of Biochemistry, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Michael B Bober
- Division of Medical Genetics, Nemours-Alfred I. duPont Hospital for Children, Wilmington, Delaware
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7
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Oostra RJ, Boer L, van der Merwe AE. Paleodysmorphology and paleoteratology: Diagnosing and interpreting congenital conditions of the skeleton in anthropological contexts. Clin Anat 2016; 29:878-91. [PMID: 27554863 DOI: 10.1002/ca.22769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/09/2016] [Revised: 08/10/2016] [Accepted: 08/19/2016] [Indexed: 11/08/2022]
Abstract
Most congenital conditions have low prevalence, but collectively they occur in a few percent of all live births. Congenital conditions are rarely encountered in anthropological studies, not least because many of them have no obvious effect on the skeleton. Here, we discuss two groups of congenital conditions that specifically affect the skeleton, either qualitatively or quantitatively. Skeletal dysplasias (osteochondrodysplasias) interfere with the histological formation, growth and maturation of skeletal tissues leading to diminished postural length, but the building plan of the body is unaffected. Well- known skeletal dysplasias represented in the archeological record include osteogenesis imperfecta and achondroplasia. Dysostoses, in contrast, interfere with the building plan of the body, leading to e.g. missing or extraskeletal elements, but the histology of the skeletal tissues is unaffected. Dysostoses can concern the extremities (e.g., oligodactyly and polydactyly), the vertebral column (e.g., homeotic and meristic anomalies), or the craniofacial region. Conditions pertaining to the cranial sutures, i.e., craniosynostoses, can be either skeletal dysplasias or dysostoses. Congenital conditions that are not harmful to the individual are known as anatomical variations, several of which have a high and population-specific prevalence that could potentially make them useful for determining ethnic origins. In individual cases, specific congenital conditions could be determinative in establishing identity, provided that ante-mortem registration of those conditions was ensured. Clin. Anat. 29:878-891, 2016. © 2016 The Authors Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.
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Affiliation(s)
- Roelof-Jan Oostra
- Department of Anatomy, Embryology and Physiology, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.
| | - Lucas Boer
- Department of Anatomy and Museum for Anatomy and Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Alie E van der Merwe
- Department of Anatomy, Embryology and Physiology, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
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Waryah AM, Shahzad M, Shaikh H, Sheikh SA, Channa NA, Hufnagel RB, Makhdoom A, Riazuddin S, Ahmed ZM. A novel CHST3 allele associated with spondyloepiphyseal dysplasia and hearing loss in Pakistani kindred. Clin Genet 2016; 90:90-5. [PMID: 26572954 PMCID: PMC4870159 DOI: 10.1111/cge.12694] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 11/03/2015] [Accepted: 11/05/2015] [Indexed: 01/07/2023]
Abstract
Skeletal dysplasias (SDs) are highly heterogeneous disorders composed of 40 clinical sub-types that are part of 456 well-delineated syndromes in humans. Here, we enrolled consanguineous kindred from a remote area of Sindh province of Pakistan, with 14 affected individuals suffering with short stature, kyphoscoliosis, joint dislocations, clubfoot, heart valve anomalies and progressive bilateral mixed hearing loss. To identify pathogenic variants in this family, whole exome sequencing (WES) was performed in one affected and one normal individual, which revealed a novel transversion mutation (c.802G>T; p.Glu268*) in CHST3 associated with the phenotype. CHST3 encodes a chondroitin 6-O-sulfotransferase-1 (C6ST-1) enzyme that is essential for the sulfation of proteoglycans found in cartilages. Previously, mutations in CHST3 have largely been reported in sporadic cases of SD, primarily with severe spinal abnormalities, joint dislocations, joint contractures, and clubfoot. Clinical and radiological examination of the affected individuals in this family provides new insights into phenotypic spectrum of CHST3 alleles and disease progression with age.
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Affiliation(s)
- Ali M. Waryah
- Molecular Biology & Genetics Department, Medical Research Center, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan
| | - Mohsin Shahzad
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Hina Shaikh
- Molecular Biology & Genetics Department, Medical Research Center, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan
| | - Shakeel A. Sheikh
- Molecular Biology & Genetics Department, Medical Research Center, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan
| | - Naseem A. Channa
- Institute of Biochemistry, University of Sindh, Jamshoro, Pakistan
| | - Robert B. Hufnagel
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Unit on Pediatric, Developmental & Genetic Ophthalmology, Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Asadullah Makhdoom
- Department of Orthopedic Surgery, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan
| | - Saima Riazuddin
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Zubair M. Ahmed
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
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Mattos EP, Sanseverino MTV, Magalhães JAA, Leite JCL, Félix TM, Todeschini LA, Cavalcanti DP, Schüler-Faccini L. Clinical and molecular characterization of a Brazilian cohort of campomelic dysplasia patients, and identification of seven new SOX9 mutations. Genet Mol Biol 2014; 38:14-20. [PMID: 25983619 PMCID: PMC4415563 DOI: 10.1590/s1415-475738120140147] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 05/08/2014] [Accepted: 08/19/2014] [Indexed: 11/21/2022] Open
Abstract
Campomelic dysplasia (CD) is an autosomal, dominantly inherited, skeletal abnormality
belonging to the subgroup of bent bone dysplasias. In addition to bowed lower limbs,
CD typically includes the following: disproportionate short stature, flat face,
micrognathia, cleft palate, bell-shaped thorax, and club feet. Up to three quarters
of 46, XY individuals may be sex-reversed. Radiological signs include scapular and
pubic hypoplasia, narrow iliac wings, spaced ischia, and bowed femora and tibiae.
Lethal CD is usually due to heterozygous mutations in SOX9, a major regulator of
chondrocytic development. We present a detailed clinical and molecular
characterization of nine Brazilian CD patients. Infants were either stillborn (n = 2)
or died shortly after birth and presented similar phenotypes. Sex-reversal was
observed in one of three chromosomally male patients. Sequencing of SOX9 revealed new
heterozygous mutations in seven individuals. Six patients had mutations that resulted
in premature transcriptional termination, while one infant had a single-nucleotide
substitution at the conserved splice-site acceptor of intron 1. No clear
genotype-phenotype correlations were observed. This study highlights the diversity of
SOX9 mutations leading to lethal CD, and expands the group of known genetic
alterations associated with this skeletal dysplasia.
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Affiliation(s)
- Eduardo P Mattos
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil . ; Departamento de Genética, Universidade Federal de Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Júlio César L Leite
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Temis Maria Félix
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Denise P Cavalcanti
- Grupo de Displasias Esqueléticas, Departamento de Genética Médica, Faculdade de Medicina, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Lavinia Schüler-Faccini
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil . ; Departamento de Genética, Universidade Federal de Rio Grande do Sul, Porto Alegre, RS, Brazil
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Honório JC, Bruns RF, Gründtner LF, Raskin S, Ferrari LP, Araujo E, Nardozza LMM. Diastrophic dysplasia: prenatal diagnosis and review of the literature. SAO PAULO MED J 2013; 131:127-32. [PMID: 23657516 PMCID: PMC10871734 DOI: 10.1590/s1516-31802013000100024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 04/02/2011] [Accepted: 04/19/2012] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Diastrophic dysplasia is a type of osteochondrodysplasia caused by homozygous mutation in the gene DTDST (diastrophic dysplasia sulfate transporter gene). Abnormalities occurring particularly in the skeletal and cartilaginous system are typical of the disease, which has an incidence of 1 in 100,000 live births. CASE REPORT The case of a pregnant woman, without any consanguineous relationship with her husband, whose fetus was diagnosed with skeletal dysplasia based on ultrasound findings and DNA tests, is described. An obstetric ultrasound scan produced in the 16th week of gestation revealed characteristics that guided the clinical diagnosis. Prominent among these characteristics were rhizomelia of the lower and upper limbs (shortening of the proximal portions) and mesomelia (shortening of the intermediate portions). Both upper limbs showed marked curvature, with the first finger of the upper limbs in abduction and clinodactyly of the fifth finger. Molecular analysis using the polymerase chain reaction (PCR) and gene sequencing detected mutations that had already been described in the literature for the gene DTDST, named c.862C > T and c.2147_2148insCT. Therefore, the fetus was a compound heterozygote, carrying two different mutations. CONCLUSIONS Prenatal diagnosis of this condition allowed a more realistic interpretation of the prognosis, and of the couple's reproductive future. This case report shows the contribution of molecular genetics towards the prenatal diagnosis, for which there are few descriptions in the literature.
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Affiliation(s)
- Jonathan Celli Honório
- Undergraduate Pharmacy Student, Faculdades Integradas do Brasil (UniBrasil), Curitiba, Paraná, Brazil.
| | - Rafael Frederico Bruns
- MD, PhD. Adjunct Professor, Department of Gynecology and Obstetrics, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | | | - Salmo Raskin
- PhD. Associate Professor, Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Science (PPGCS), Health and Biosciences School (ESB), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil.
| | - Lilian Pereira Ferrari
- PhD. Collaborating Professor, Biomedicine Course, Faculdades Integradas do Brasil (UniBrasil), Curitiba, Paraná, Brazil.
| | - Edward Araujo
- MD, PhD. Adjunct Professor, Department of Obstetrics, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
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Kang SS, Shin SH, Auh CK, Chun J. Human skeletal dysplasia caused by a constitutive activated transient receptor potential vanilloid 4 (TRPV4) cation channel mutation. Exp Mol Med 2012; 44:707-22. [PMID: 23143559 PMCID: PMC3538978 DOI: 10.3858/emm.2012.44.12.080] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [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] [Accepted: 09/29/2012] [Indexed: 12/23/2022] Open
Abstract
The transient receptor potential vanilloid 4 (TRPV4) cation channel, a member of the TRP vanilloid subfamily, is expressed in a broad range of tissues where it participates in the generation of Ca²⁺ signals and/or depolarization of the membrane potential. Regulation of TRPV4 abundance at the cell surface is critical for osmo- and mechanotransduction. Defects in TRPV4 are the cause of several human diseases, including brachyolmia type 3 (MIM:113500) (also known as brachyrachia or spondylometaphyseal dysplasia Kozlowski type [MIM:118452]), and metatropic dysplasia (MIM:156530) (also called metatropic dwarfism or parastremmatic dwarfism [MIM:168400]). These bone dysplasia mutants are characterized by severe dwarfism, kyphoscoliosis, distortion and bowing of the extremities, and contractures of the large joints. These diseases are characterized by a combination of decreased bone density, bowing of the long bones, platyspondyly, and striking irregularities of endochondral ossification with areas of calcific stippling and streaking in radiolucent epiphyses, metaphyses, and apophyses. In this review, we discuss the potential effect of the mutation on the regulation of TRPV4 functions, which are related to human diseases through deviated function. In particular, we emphasize how the constitutive active TRPV4 mutant affects endochondral ossification with a reduced number of hypertrophic chondrocytes and the presence of cartilage islands within the zone of primary mineralization. In addition, we summarize current knowledge about the role of TRPV4 in the pathogenesis of several diseases.
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Affiliation(s)
- Sang Sun Kang
- Department of Biology Education Chungbuk National University Cheongju 361-763, Korea.
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