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Tedesco MG, Lonardo F, Ceccarini C, Cesarano C, Digilio MC, Magliozzi M, Rogaia D, Mencarelli A, Leoni C, Piscopo C, Imperatore V, Falco MT, Fontana P, Nardone AM, Novelli A, Troiani S, Seri M, Prontera P. Clinical and molecular characterizations of 11 new patients with type 1 Feingold syndrome: Proposal for selecting diagnostic criteria and further genetic testing in patients with severe phenotype. Am J Med Genet A 2021; 185:1204-1210. [PMID: 33442900 DOI: 10.1002/ajmg.a.62068] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 11/07/2022]
Abstract
Feingold Syndrome type 1 (FS1) is an autosomal dominant disorder due to a loss of function mutations in the MYCN gene. FS1 is generally clinically characterized by mild learning disability, microcephaly, short palpebral fissures, short stature, brachymesophalangy, hypoplastic thumbs, as well as syndactyly of toes, variably associated with organ abnormalities, the most common being gastrointestinal atresia. In current literature, more than 120 FS1 patients have been described, but diagnostic criteria are not well agreed upon, likewise the genotype-phenotype correlations are not well understood. Here, we describe 11 FS1 patients, belonging to six distinct families, where we have identified three novel MYCN mutations along with three pathogenetic variants, the latter which have already been reported. Several patients presented a mild phenotype of the condition and they have been diagnosed as being affected only after segregation analyses of the MYCN mutation identified in the propositus. We also describe here the first ever FS1 patient with severe intellectual disability having a maternally inherited MYCN variant together with an additional GNAO1 mutation inherited paternally. Mutations in the GNAO1 gene are associated with a specific form of intellectual disability and epilepsy, thus the finding of two different rare diseases in the same patient could explain his severe phenotype. Therein, a thorough investigation is merited into the possibility that additional variants in patients with a MYCN mutation and severe phenotype do exist. Finally, in order to guarantee a more reliable diagnosis of FS1, we suggest using both major and minor clinical-molecular diagnostic criteria.
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Affiliation(s)
- Maria Giovanna Tedesco
- Medical Genetics Unit, Santa Maria della Misericordia Hospital and University of Perugia, Perugia, Italy.,Genetics Unit, "Mauro Baschirotto" Institute for Rare Diseases (B.I.R.D.), Vicenza, Italy
| | | | - Caterina Ceccarini
- Cytogenetics Unit, Policlinico Riuniti, University Hospitals Foggia, Foggia, Italy
| | - Carla Cesarano
- Cytogenetics Unit, Policlinico Riuniti, University Hospitals Foggia, Foggia, Italy
| | - Maria Cristina Digilio
- Laboratory of Medical Genetics, Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monia Magliozzi
- Laboratory of Medical Genetics, Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Daniela Rogaia
- Medical Genetics Unit, Santa Maria della Misericordia Hospital and University of Perugia, Perugia, Italy
| | - Amedea Mencarelli
- Medical Genetics Unit, Santa Maria della Misericordia Hospital and University of Perugia, Perugia, Italy
| | - Chiara Leoni
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carmelo Piscopo
- U.O.S.C. Medical Genetics, A.O.R.N. "A. Cardarelli", Naples, Italy
| | - Valentina Imperatore
- Medical Genetics Unit, Santa Maria della Misericordia Hospital and University of Perugia, Perugia, Italy
| | | | - Paolo Fontana
- Medical Genetics Unit, "San Pio" Hospital, Benevento, Italy
| | - Anna Maria Nardone
- Medical Genetics Laboratory, "Policlinico Tor Vergata" Hospital, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefania Troiani
- Medical Genetics Unit, Santa Maria della Misericordia Hospital and University of Perugia, Perugia, Italy.,Division of Neonatology and Neonatal Intensive Care Unit, Santa Maria della Misericordia Hospital of Perugia, Perugia, Italy
| | - Marco Seri
- Medical Genetics Unit, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Paolo Prontera
- Medical Genetics Unit, Santa Maria della Misericordia Hospital and University of Perugia, Perugia, Italy
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Grote LE, Repnikova EA, Amudhavalli SM. Expanding the phenotype of feingold syndrome-2. Am J Med Genet A 2015; 167A:3219-25. [PMID: 26360630 DOI: 10.1002/ajmg.a.37368] [Citation(s) in RCA: 11] [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: 12/31/2014] [Accepted: 08/24/2015] [Indexed: 12/16/2022]
Abstract
Feingold syndrome-2 has been recently shown to be caused by germline heterozygous deletions of MIR17HG with 10 reported patients to date. Manifestations common to both Feingold syndrome-1 and Feingold syndrome-2 include microcephaly, short stature, and brachymesophalangy; but those with Feingold syndrome-2 lack gastrointestinal atresias. Here we describe a 14-year-old male patient who presented to our Cardiovascular Genetics Clinic with a history of a bicuspid aortic valve with aortic stenosis, short stature, hearing loss, and mild learning disabilities. Upon examination he was noted to have dysmorphic features and brachydactyly of his fingers and toes. His head circumference was 54.5 cm (25th-50th centile) and his height was 161.3 cm (31st centile) after growth hormone therapy. A skeletal survey noted numerous abnormalities prompting suspicion for Feingold syndrome. A comparative genomic hybridization microarray was completed and a ∼3.6 Mb interstitial heterozygous deletion at 13q31.3 including MIR17HG was found consistent with Feingold syndrome-2. Clinically, this patient has the characteristic digital anomalies and short stature often seen in Feingold syndrome-2 with less common features of a congenital heart defect and hearing loss. Although non-skeletal features have been occasionally reported in Feingold syndrome-1, only one other patient with a 13q31 microdeletion including MIR17HG has had non-skeletal manifestations. Additionally, our patient does not have microcephaly and, to our knowledge, is the first reported pediatric patient with Feingold syndrome-2 without this feature. This report illustrates significant phenotypic variability within the clinical presentation of Feingold syndrome-2 and highlights considerable overlap with Feingold syndrome-1.
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Affiliation(s)
- Lauren E Grote
- Division of Clinical Genetics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Elena A Repnikova
- Cytogenetics and Molecular Genetics Laboratories, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Shivarajan M Amudhavalli
- Division of Clinical Genetics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
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Goyal K, Imbriglia J. Metacarpophalangeal joint locking in 3 family members with brachymesophalangy: case report. J Hand Surg Am 2014; 39:1094-7. [PMID: 24793228 DOI: 10.1016/j.jhsa.2014.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/30/2014] [Revised: 03/06/2014] [Accepted: 03/07/2014] [Indexed: 02/02/2023]
Abstract
We report painful locking of the metacarpophalangeal joint in a man, his mother, and his sister, all of whom have brachymesophalangy. Surgical excision of loose osteocartilaginous fragments relieved their symptoms. The fragments appeared to be unfused ossicles of the metacarpal head, unique to patients with brachymesophalangy.
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Affiliation(s)
- Kanu Goyal
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA; Western Pennsylvania Hand and UpperEx Center, Wexford, PA.
| | - Joseph Imbriglia
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA; Western Pennsylvania Hand and UpperEx Center, Wexford, PA
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