Clinical and genetic analysis of a child with Alazami syndrome due to compound heterozygous variants of LARP7 gene / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical phenotype and genetic basis of a child with Alazami syndrome (AS).@*METHODS@#A child who presented at Tianjin Children's Hospital on June 13, 2021 was selected as the study subject. The child was subjected to whole exome sequencing (WES), and candidate variants were verified by Sanger sequencing.@*RESULTS@#WES revealed that the child has harbored two frameshifting variants of the LARP7 gene, namely c.429_430delAG (p.Arg143Serfs*17) and c.1056_1057delCT (p.Leu353Glufs*7), which were verified by Sanger sequencing to be respectively inherited from his father and mother.@*CONCLUSION@#The compound heterozygous variants of the LARP7 gene probably underlay the pathogenesis in this child.

Clinical characteristics of four children with 3M syndrome and a literature review / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical features of 3M syndrome and effect of growth hormone therapy.@*METHODS@#Clinical data of four children diagnosed with 3M syndrome by whole exome sequencing at Hunan Children's Hospital from January 2014 to February 2022 were retrospectively analyzed, which included clinical manifestation, results of genetic testing and recombinant human growth hormone (rhGH) therapy. A literature review was also carried our for Chinese patients with 3M syndrome.@*RESULTS@#The clinical manifestations of the 4 patients included severe growth retardation, facial dysmorphism and skeletal malformations. Two patients were found to harbor homozygous variants of CUL7 gene, namely c.4717C>T (p.R1573*) and c.967_993delinsCAGCTGG (p.S323Qfs*33). Two patients were found to harbor 3 heterozygous variants of the OBSL1 gene including c.1118G>A (p.W373*), c.458dupG (p.L154Pfs*1002) and c.690dupC (p.E231Rfs*23), among which c.967_993delinsCAGCTGG and c.1118G>A were unreported previously. Eighteen Chinese patients with 3M syndrome were identified through the literature review, including 11 cases (11/18, 61.1%) carrying CUL7 gene variants and 7 cases (7/18, 38.9%) carrying OBSL1 gene variants. The main clinical manifestations were in keeping with previously reported. Four patients were treated with growth hormone, 3 showed obvious growth acceleration, and no adverse reaction was noted.@*CONCLUSION@#3M syndrome has a typical appearance and obvious short stature. To attain accurate diagnosis, genetic testing should be recommended for children with a stature of less than -3 SD and facial dysmorphism. The long-term efficacy of growth hormone therapy for patients with 3M syndrome remains to be observed.

Analysis of a Chinese pedigree affected with familial short stature due to 15q25.3q26.1 deletion involving the ACAN gene / 中华医学遗传学杂志

OBJECTIVE@#To analyze the genetic etiology of a Chinese pedigree affected with short stature.@*METHODS@#A child with familial short stature (FSS) who had presented at the Ningbo Women and Children's Hospital in July 2020 and his parents and paternal and maternal grandparents were selected as the study subject. Clinical data of the pedigree was collected, and the proband was subjected to routine growth and development assessment. Peripheral blood samples were collected. The proband was subjected to whole exome sequencing (WES), and the proband, his parents and grandparents were subjected to chromosomal microarray analysis (CMA).@*RESULTS@#The height of the proband and his father was 87.7cm (-3 s) and 152 cm (-3.39 s) respectively. Both of them were found to harbor a 15q25.3-q26.1 microdeletion, which has encompassed the whole of the ACAN gene which is closely associated with short stature. The CMA results of his mother and grandparents were all negative, and above deletion has not been included in population database and related literature, and was rated as pathogenic based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). After 14 months of rhGH treatment, the height of the proband has increased to 98.5 cm (-2.07 s).@*CONCLUSION@#The 15q25.3-q26.1 microdeletion probably underlay the FSS, in this pedigree. Short-term rhGH treatment can effectively improve the height of the affected individuals.

Clinical and genetic analysis of a Chinese pedigree affected with Dyggve-Melchior-Clausen syndrome due to a novel frameshift variant of DYM gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis of a Chinese pedigree affected with Dyggve-Melchior-Clausen syndrome.@*METHODS@#Whole exome sequencing and Sanger sequencing were carried out to detect potential pathogenic variants associated with the syndrome. The function of candidate variant was verified by Western blotting.@*RESULTS@#A novel homozygous variant, c.1222delG of the DYM gene was detected in the two affected siblings, for which both parents were heterozygous carriers. The variant has caused replacement of Asp by Met at amino acid 408 and generate a premature stop codon p.Asp408Metfs*10. Western blotting confirmed that the variant can result in degradation of the mutant DYM protein, suggesting that it is a loss of function variant.@*CONCLUSION@#The homozygous c.1222delG frameshift variant of the DYM probably underlay the Dyggve-Melchior-Clausen syndrome in the two affected siblings. Above findings has enabled clinical diagnosis and genetic counseling for the family.

Siblings Seckel's syndrome 1 caused by ATR gene variants in a sibpair / 中华医学遗传学杂志

OBJECTIVE@#Two brothes with Seckel's syndrome 1(SCKL1) were reported and a literature review was carried to provide clinical and genetic information of this rare disease.@*METHODS@#Clinical data of the two children were collected, and the peripheral blood was extracted for whole exome sequencing. Literature of the disease were reviewed.@*RESULTS@#The two patients were 11 years and 9.5 years old when examined for short stature. They presented with intrauterine growth retardation, intellectual disability, microcephaly, birdhead-like face and coffee au lait spots. The bone age was more than 2 years behind the chronical age and the growth hormone levels were normal. Whole exome sequencing revealed novel compound heterozygous variants c.1A>G (p.M1?) and c.4853-18A>G of ART gene in both children.@*CONCLUSION@#Children with prenatal onset short stature, developmental delay, microcephaly and special facial featuresshould be considered for the possibility of Seckel's syndrome, whole exome sequencing could help to confirm the clinical diagnosis.

Mutações em heterozigose no gene do receptor tipo B dos peptídeos natriuréticos (NPR2) são causa de baixa estatura inicialmente classificada como idiopática / Heterozygous mutations in natriuretic peptide receptor-B gene (NPR2) are cause of short stature initially classified as idiopathic

Nos últimos anos, o sistema do peptídeo natriurético do tipo C (CNP) e seu receptor (NPR-B) foi apontado como um importante regulador do processo de ossificação endocondral. Vários estudos em animais evidenciam o seu papel de estímulo à proliferação e diferenciação de condrócitos e secreção de matriz extracelular. Mutações bialélicas com perda de função do gene do NPR-B (NPR2) levam a uma doença denominada displasia acromesomélica do tipo Maroteaux (AMDM), uma displasia esquelética caracterizada por baixa estatura extrema. Observa-se que familiares de pacientes com AMDM carreadores de mutação no NPR2 têm estatura abaixo da média da população a qual pertencem, sugerindo um papel de mutações em heterozigose do NPR2 como causadoras de baixa estatura idiopática (BEI). Os objetivos deste estudo foram avaliar a presença de mutações no gene NPR2 em um grupo de pacientes com BEI e correlacionar os achados moleculares com o fenótipo dos pacientes e familiares. A região codificadora do gene NPR2 foi sequenciada pelo método de Sanger em 60 pacientes com diagnóstico de BEI. Foram identificadas cinco diferentes variantes alélicas missense em heterozigose no NPR2, cada uma em um único paciente. Essas variantes foram submetidas à análise funcional in vitro para avaliação da atividade da guanililciclase e microscopia confocal para localização intracelular dos receptores NPR-B. As variantes c.226T > C / p.Ser76Pro, c.788G > C / p.Arg263Pro e c.2455C > T / p.Arg819Cys segregam com o fenótipo de baixa estatura dentro das famílias e determinam um prejuízo funcional ao NPR-B. As três variantes geram proteínas que exercem efeito dominante negativo e os receptores NPR-B com as mutações p.Ser76Pro e p.Arg263Pro não se localizam na membrana celular. As variantes c.491C > G / p.Ala164Gly e c.1636A > T / p.Asn546Tyr não segregam com o fenótipo de baixa estatura nas famílias e não se evidenciou um efeito dominante negativo. O escore-Z da altura dos indivíduos carreadores das variantes...

Over the past several years, C-type natriuretic peptide (CNP) and its receptor (NPR-B) system has emerged as an important regulator of endochondral bone growth. Animal models showed a CNP/NPR-B role in promoting chondrocyte proliferation and differentiation and matrix synthesis. Biallelic loss-of-function mutations in NPR-B gene (NPR2) cause acromesomelic dysplasia type Maroteux (AMDM), a skeletal dysplasia with extreme short stature. Relatives of patients with AMDM, heterozygous for NPR2 mutations, were noted to be shorter than expected for their population of origin, suggesting that heterozygous mutations in NPR2 could be a cause of idiopathic short stature (ISS). The objective of this study was to investigate the presence of NPR2 mutations in a group of patients with ISS and to correlate molecular findings with phenotype. The NPR2 coding region was sequenced by Sanger's method in 60 patients with ISS. Five different heterozygous missense variants in NPR2 were identified in five patients. The functional consequences of those variants were established using in vitro cell-based assay to determine guanylate cyclase activity and confocal microscopy to determine intracellular localization of NPR-B. The variants c.226T > C / p.Ser76Pro, c.788G > C / p.Arg263Pro and c.2455C > T / p.Arg819Cys segregated with short stature phenotype and were functionally deleterious. NPR-B receptors with these three variants have a dominantnegative effect and p.Ser76Pro and p.Arg263Pro NPR-B were not localized in the cell membrane. Cosegregation analysis of the variants c.491C > G / p.Ala164Gly and c.1636A > T / p.Asn546Tyr was inconclusive and they did not have a dominant negative effect. Carriers of functionally deleterious variants have a height SD score that ranged from -4.5 to -1.7. One of these patients and two relatives have disproportionate short stature and one has shortened metacarpal. In conclusion, heterozygous mutations in NPR2 gene are cause of short stature in...

Single-nucleotide polymorphism analysis of GH, GHR, and IGF-1 genes in minipigs

Tibetan (TB) and Bama (BM) miniature pigs are two popular pig breeds that are used as experimental animals in China due to their small body size. Here, we analyzed single-nucleotide polymorphisms (SNPs) in gene fragments that are closely related to growth traits [growth hormone (GH), growth hormone receptor (GHR), and insulin-like growth factor (IGF)-1)] in these pig breeds and a large white (LW) control pig breed. On the basis of the analysis of 100 BMs, 108 TBs, and 50 LWs, the polymorphic distribution levels of GH, GHR, and IGF-1 were significantly different among these three pig breeds. According to correlation analyses between SNPs and five growth traits - body weight (BW), body length (BL), withers height (WH), chest circumference (CC), and abdomen circumference (AC) - three SNP loci in BMs and four SNP loci in TBs significantly affected growth traits. Three SNP sites in BMs and four SNP sites in TBs significantly affected growth traits. SNPs located in the GH gene fragment significantly affected BL and CC at locus 12 and BL at locus 45 in BMs, and also BW, WH, CC, and AC at locus 45 and WH and CC at locus 93 in TBs. One SNP at locus 85 in the BM GHR gene fragment significantly affected all growth traits. All indices were significantly reduced with a mixture of alleles at locus 85. These results provide more information regarding the genetic background of these minipig species and indicate useful selection markers for pig breeding programs.

Association of Polymorphisms in the Vitamin D Receptor Promoter with Idiopathic Short Stature

The genetic alterations of vitamin D receptor (VDR) are related with the growth of long bone. There were a lot of reports regarding an association of polymorphisms in the VDR promoter with many disorders, but not with idiopathic short stature (ISS). We investigated the association of them with ISS. A total of 50 subjects, including 29 ISS patients and 21 healthy controls with their heights within the normal range was recruited. We selected two single nucleotide polymorphisms (SNPs) from VDR promoter (rs11568820 at the Cdx-2 binding site upstream of exon 1e and rs4516035 at -1012 upstream of exon 1a) as candidates, respectively. In genotype analysis, the frequency of A/A genotype at the Cdx-2 binding site locus (rs11568820) upstream of exon 1e of VDR was decreased to 6.9% in ISS patients (28.6% in controls) (P = 0.027). The genetic variation at the Cdx-2 binding site of VDR promoter can be a contributing factor of growth of height.

A recurrent mutation in Moroccan patients with Dyggve-Melchior-Clausen syndrome: Report of a new case and review.

Dyggve-Melchior-Clausen (DMC) syndrome is a rare autosomal recessive disorder. It is a spondyloepimetaphyseal dysplasia associated with mental retardation. Clinical manifestations include coarse facies, microcephaly, short trunk dwarfism, and mental retardation. Mutations in Dymeclin gene (DYM), mapped to chromosome 18q21.1, is responsible for DMC. We report here the observation of a consanguineous Moroccan patient having DMC syndrome. The molecular studies showed a previously reported homozygous mutation at c.1878delA of DYM gene. We discuss this recurrent mutation in Moroccan patients with DMC syndrome with a review.

Síndrome de Seckel, dos casos en una familia colombiana / Seckel syndrome: report of two cases in a Colombian family

Seckel syndrome is an infrequent autosomic recessive genetic disorder. It is characterized by short stature, mental retardation and a typical facies. Nearly 10 families have been reported with two or more affected members. This paper reports two sisters, daughters of non-related parents. The mother presented bilateral fissurate lip. The main traits of this syndrome are highlighted through a literature review.

El síndrome de Seckel es una enfermedad genética de herencia autosómica recesiva de baja ocurrencia, caracterizado por la asociación de talla baja, retardo mental y facies especial, se han reportado cerca de 10 familias con dos o más miembros afectados. Nosotros reportamos dos hermanas hijas de padres no consanguíneas, la madre presenta labio fisurado bilateral. Se describen las características más importantes del síndrome y se hace una revisión de la literatura.

Seckel syndrome with chromosomal 18 deletion.

Four case records of patients with Seckel Syndrome (SS) were retrieved. Typical of bird headed dwarfism was seen in all. Chromosome 18 deletion was seen in one child with SS. MRI abnormalities were detected in 3 patients. Cytogenetic studies and neuroimaging is likely to provide important diagnostic and prognostic information.

Identification of alternate dwarfing gene sources to widely used Dee-Gee-Woo-Gen allele of sd1 gene by molecular and biochemical assays in rice ( Oryza sativa L. )

After the success of IR8 and TN1, breeders depended heavily on these two rice cultivars for source of short stature led to the narrow genetic base to majority of present day rice varieties, as far as sd1 (semi-dwarf1) gene is concerned. In addition, analysis of genetic lineage of the majority of the cultivated rice varieties in tropical Asia reveals that sd1 from DGWG (Dee-Gee-Woo-Gen) is the major source of dwarfing gene. Such high amount of genetic homogeneity renders rice plants vulnerable to epidemic of diseases and insect pests. In the current study, we made an attempt to identify the alternate sources of DGWG allele of sd1 gene by characterizing 29 induced and 3 spontaneous dwarf accessions employing marker for DGWG allele of sd1 gene and exogenous application of gibberellic acid (GA3). When occurrence of DGWG allele of sd1 gene and GA3 response were analyzed together, existence of two kinds of dwarfs was noticed viz., dwarf accessions with DGWG allele and dwarf accessions without DGWG allele of sd1 allele exhibiting varying responses to GA3. As many as 22 of 32 dwarf accessions showed absence of DGWG allele of sd1 gene with varying response to GA3 could be used as excellent alternate sources for DGWG allele of sd1 gene. These dwarf accessions could be used for broadening the genetic base for the plant height and thereby minimize the risk of genetic vulnerability. Our strategy of combining molecular and biochemical assays can be efficiently used for identifying alternate dwarfing gene sources to the Green Revolution gene sd1.

Uso de GH em pacientes com baixa estatura idiopática: [revisão] / GH treatment in patients with idiopathic short stature: [review]

Pacientes com baixa estatura idiopática podem ser tratados com GH. Os critérios clínicos e laboratoriais utilizados na decisão do uso do GH, bem como no reconhecimento da responsividade dos indivíduos ao tratamento, são discutidos. Não apenas os resultados antropométricos, mas também os aspectos éticos e psicossociais devem ser considerados na avaliação dos custos/benefícios envolvidos no tratamento com GH em pacientes com baixa estatura idiopática.

Growth hormone has been used in the treatment of patients with idiopathic short stature. Clinical and laboratorial criteria are discussed, taking into consideration the indication of GH and the evaluation of its efficacy and individual responsiveness. Anthropometric, psychosocial, ethical, and also cost/benefit aspects must be considered before GH prescription in idiopathic short stature patients.

O hormônio de crescimento na síndrome de Turner: dados e reflexões: [revisão] / Growth hormone treatment inTurner syndrome: data and reflections: [review]

A baixa estatura é a principal característica na síndrome de Turner (ST). O agravo estatural na ST é precoce e torna-se mais evidente na puberdade. A haploinsuficiência do gene SHOX tem sido implicada como principal fator na definição da estatura de mulheres, no entanto, ainda que a maioria das pacientes não tenha deficiência do hormônio de crescimento, a terapia com GHr melhora a altura final. Recentemente, tem-se chamado a atenção para a associação entre GH e câncer. O risco de câncer nessas pacientes está associado à presença de fragmentos do cromossomo Y que pode levar ao desenvolvimento de gonadoblastoma. Dessa forma, a administração de GHr na ST deve ser feita com cautela. A investigação de seqüências do cromossomo Y deve ser realizada, bem como a gonadectomia profilática nos casos positivos, conferindo maior segurança ao tratamento.

Short stature is the major characteristic of Turner syndrome. The statural appeal is premature and become evident in the puberty. Haploinsuficiency of SHOX gene has been related as main factor on final height of these patients. Despite the majority of the patients are not growth hormone deficient, the GHr therapy improves the final height. Recently, a great number of publications have described the association between GH and cancer. The cancer risk, in these patients, is mainly associated with the presence of Y chromosome sequences that can lead to the gonadoblastoma development. In conclusion, the GHr therapy in ST patients deserves caution. The investigation of Y chromosome sequences should be performed as well as the prophylactic gonadectomy in the positive cases conferring confidence to the treatment.

Baixa estatura por haploinsuficiência do gene SHOX: do diagnóstico ao tratamento / Short stature caused by SHOX gene haploinsufficiency: from diagnosis to treatment

Estudos realizados em pacientes portadores de deleções parciais dos cromossomos sexuais permitiram a caracterização do SHOX, gene localizado na região pseudoautossômica no braço curto dos cromossomos sexuais, fundamental na determinação da altura normal. A perda de uma cópia deste gene na síndrome de Turner (ST) explica dois terços da baixa estatura observada nesta síndrome. A haploinsuficiência do SHOX é detectada em 77 por cento dos pacientes com discondrosteose de Leri-Weill, uma forma comum de displasia esquelética de herança autossômica dominante e em 3 por cento das crianças com baixa estatura idiopática (BEI), tornando os defeitos neste gene a principal causa monogênica de baixa estatura. A medida da altura sentada em relação à altura total (Z da AS/AT para idade e sexo) é uma forma simples de identificar a desproporção corpórea e, associada ao exame cuidadoso do paciente e de outros membros da família, auxilia na seleção de pacientes para o estudo molecular do SHOX. O uso de hormônio de crescimento (GH) está bem estabelecido na ST e em razão da causa comum da baixa estatura com o de crianças com defeitos isolados do SHOX o tratamento destes pacientes com GH é também proposto. Neste artigo será revisado os aspectos clínicos, moleculares e terapêuticos da haploinsuficiência do SHOX.

Studies involving patients with short stature and partial deletion of sex chromosomes identified SHOX gene in the pseudoautosomal region of the X and Y chromosomes. SHOX haploinsufficiency is an important cause of short stature in a diversity of clinical conditions. It explains 2/3 of short stature observed in Turner syndrome (TS) patients. Heterozygous mutations in SHOX are observed in 77 percent of patients with Leri-Weill dyschondrosteosis, a common dominant inherited skeletal dysplasia and in 3 percent of children with idiopathic short stature, indicating that SHOX defects are the most frequent monogenetic cause of short stature. The sitting height/height ratio (SH/H) standard deviation score is a simple way to assess body proportions and together with a careful exam of other family members, effectively selected a group of patients that presented a high frequency of SHOX mutations. Growth hormone treatment of short stature due to TS is well established and considering the common etiology of short stature in patients with isolated defects of SHOX gene, this treatment is also proposed for these patients. Here, we review clinical, molecular and therapeutic aspects of SHOX haploinsufficiency.

A Case of Weill-Marchesani Syndrome with Inversion of Chromosome 15

PURPOSE: To present a case of Weill-Marchesani syndrome with corneal endothelial dysfunction due to anterior dislocation of a spherophakic lens and corneolenticular contact. METHODS: A 17-year-old woman presented with high myopia and progressive visual disturbance. She was of short stature and had brachydactyly. Her initial Snellen best corrected visual acuity (BCVA) was 20/50 (-sph 20.50 -cyl 3.00 Ax 180) in her right eye and 20/40 (-sph 16.00 -cyl 6.00 Ax 30) in her left eye. Slit lamp examination revealed a dislocated spherophakic lens touching corenal endothelium. A microspherophakic lens, hypoplastic ciliary body, and elongated zonules were confirmed on rotating Scheimpflug camera (Pentacam(R)) and on ultrasound biomicroscopy. Specular microscopy showed corneal endothealial dysfunction. Systemic evaluation was performed, and chromosomal study showed 46, XX, inv (15) (q13qter). The patient was diagnosed with Weill-Marchesani syndrome. RESULTS: Due to impending corneal decompensation, phacoemulsification and suture fixation of the intraocular lens were performed. The operation and postoperative course were uneventful. Three months postoperatively, the visual acuity was 20/30 (OD) and 20/40 (OS) without correction, and BCVA was 20/20 (+sph 0.50 -cyl 2.00 Ax 160 : OD) and 20/25 (+sph 1.50 -cyl 3.00 Ax 30 : OS). During the follow-up period, increased corneal endothelial counts, hexagonality, and decreased corneal thickness were achieved. CONCLUSIONS: In Weill-Marchesani syndrome with a chromosomal anomaly, a dislocated spherophakic lens may cause severe corneal endothelial dysfunction due to corneolenticular contact, and prompt lensectomy is important to prevent such complications.

Síndrome de seckel: a propósito de un caso: Centro de Recuperación Nutricional Infantil "Dr. Pastor Oropeza "San Cristobal Estado Táchira Venezuela noviembre 2004 / Syndrome of seckel: a purpose of a case: Centro de Recuperacion Nutricional Infantil Dr. Pastor Oropeza San Cristóbal state Táchira noviembre 2004

El Síndrome de Seckel es una enfermedad congénita, un trastorno autosónico recesivo y la forma más frecuente de enanismo osteodisplásico microcefálico. Fue descrita por primera vez como "enanismo de cabeza de pájaro" por Rudolf Virchow en 1982, posteriormente en 1960 Helmut Seckel caracterizó el síndrome tal como conocemos en la actualidad (1), con retraso del crecimiento intrauterino, microcefalia, dwarfismo (forma de enanismo proporcionado), y facie peculiar (4).

Seckel syndrome with polyarteritis nodosa.

Seckel syndrome is a rare genetic disorder with a typical "bird-headed" appearance. It could affect many organ systems but renal involvement is uncommon. Polyarteritis nodosa is systemic vasculitic disorder which also involves kidneys. We report a case of Seckel syndrome in a 9 year-old boy with renal involvement due to polyarteritis nodosa. According to the literature, this is the first report of polyarteritis nodosa in Seckel syndrome.