Primary ciliary dyskinesia: Kartagener syndrome in a family with a novel DNAH5 gene mutation and variable phenotypes

Primary ciliary dyskinesia is a genetically heterogeneous autosomal recessive disorder with variable clinical manifestations, including chronic rhinosinusitis, otitis media, bronchitis, pneumonia, bronchiectasis, situs inversus totalis, reduced fertility in female patients and male infertility. The condition occurs as a result of abnormal ciliary structure and function. It is presented in early life with an estimated incidence of approximately 1/16,000-20,000. About 50% of the affected patients have situs inversus totalis leading to Kartagener syndrome [MIM: 244400]. So far more than 19 causative genes have been associated with primary ciliary dyskinesia dyskinesia. Here we are presenting Kartagener syndrome in a consanguineous Kuwaiti family with a novel pathogenic DNAH5 gene mutation; namely c.9864dupA; [p.Pro3289ThrfsStop52], which is predicted to result in protein truncation. In this family several homozygous individuals showed variable disease manifestations. Molecular test helped in confirmation of the clinical diagnosis and in providing better management of the affected family members, which in turn could significantly improve overall quality of their life. Consequently, preimplantation genetic diagnosis, which is the most acceptable procedure in the Islamic countries, was offered to the heterozygous-carrier couple in order to prevent recurrence of the disease in their future generations

Senior-Loken syndrome: a novel NPHP5 gene mutation in a family from Kuwait

Rare autosomal recessive disorders of variable severity are segregating in many highly consanguineous families from the Arab population. One of these deleterious diseases is Senior-Loken syndrome, a hereditary heterogeneous multiorgan disorder, which combines nephronophthisis with retinal dystrophy, leading to blindness and eventually end stage renal failure. This disorder has been reported in many cases worldwide, including two unrelated families from Arabian Gulf countries, which share the gene pool with Kuwait. Here, we are reporting two children from an Arab family with a novel frameshift mutation found in IQCB1/NPHP5 gene; c.1241-1242delTC, predicted to cause protein termination p.Leu414HisfsStop4, and describing the associated clinical features. Identification of this pathogenic mutation helped in confirmation of the clinical diagnosis and in providing a proper pre-marital genetic counselling and testing for a couple embarking on marriage from this highly consanguineous high-risk family

Baraitser-winter syndrome: an additional Arab patient

An Arab child is presented herein with a phenotype that fits the rare Baraitser-Winter syndrome. Her clinical features included a unilateral iris coloboma, ptosis, hypertelorism, epicanthic folds, broad nasal bridge, full cheeks, pointed chin, low set abnormal ears and short neck. In addition, she had cardiac defect, previously undescribed brain anomaly, seizures, hypotonia and developmental delay. Chromosomal analysis of the peripheral lymphocytes and FISH study revealed a normal 46, XX karyotype. To date, Baraitser-Winter syndrome has only been reported in 19 patients of different ethnic families. The present case adds a new finding to the spectrum of malformations published before

Partial duplication of chromosome 8p: Report of 5 patients and review of literature

The partial chromosome 8p duplication is a rare syndrome and is associated with a characteristic phenotype, including multiple congenital anomalies and mental retardation of various degrees. However, different outcomes depend on the size and location of the duplicated area. We present clinical and cytogenetic data of 5 Arab patients with de novo inversion duplication of 8p. This report provides additional cases to the growing literature

Partial Monosomy of 21q22.13-q22.2 in an Egyptian boy

A rare case of de novo interstitial deletion of the long arm of chromosome 21 involving 21q22.13-q22.22 is described here. This finding was detected by high resolution banding techniques and then confirmed by FISH study. The phenotypic abnormality was to some extent similar to that previously found in cases reported with deletion of 21q, spanning the long arm of chromosome 21 from the centromere to 21q22. This is the first reported case at Kuwait Medical Genetics Centre with abrasion involving this region. It supports what was previously suggested that the critical region for full phenotype expression lies distal to 21q21, within 21q22.1-q22.2