scholarly journals A Novel Frameshift Homozygous Mutation in DHCR7 with a Known Missense Homozygous Mutation in the PROC in a 6-Year-Old Boy: A Child with Two Rare Genetic Diseases

2019 ◽  
Vol 08 (03) ◽  
pp. 168-171
Author(s):  
Evren Gumus

AbstractIn the present case report, we described a 6-year-old-boy with developmental delay, mental retardation, lack of speech, skin scars, and 2 to 3 toe syndactyly from healthy consanguineous Turkish parents. The whole exome sequencing (WES) analysis of this patient showed homozygous variant c.418T > C p.(Cys140Arg) in PROC gene and novel homozygous variant c.57dupC p.(Asn20Glnfs*2) in the DHCR7 gene. This finding demonstrated that WES is of great value for the diagnosis of two separate genetic disorders in a patient with multiple dysmorphic and other clinical features. It should also be kept in mind that the coexistence of two autosomal recessive diseases could be observed in highly related consanguineous marriages. The combined evaluation of clinical and laboratory data provided extremely valuable insight into the diagnosis of this unique case.

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 33-34
Author(s):  
Marwan Elbagoury ◽  
Ohoud F. Kashari

Rationale Around the globe, it is now understood that individuals with Rare genetic Diseases routinely face limitations to getting access to diagnosis. Plans have been created to improve the requirements of the patient's communities, including access to multidisciplinary care, and proposing new corrections or amendments to existing strategies. In the gulf region, numerous proposals have been established to tackle the diagnosis and management Rare genetic Diseases. Introduction and Background Rare genetic diseases are characterized as life-long, serious conditions that debilitate or compromise life. Almost 80% of Rare genetic diseases are diagnosed during the childhood. Absence of access to these assets affect patients and their families living with complex needs that may incorporate day in and day out observing, continuous serious physical and formative medicines, remaining in the training framework, and now and then costly strength meds1. The underlying etiology may stay obscure for many patients with rare genetic diseases despite multiple investigations. patients may be assigned an incorrect diagnosis and be referred to several specialties until a correct diagnosis can be made. A correct diagnosis of rare genetic diseases may impact not only the patient's care but may have further implications for management and/or counselling of family members as well2. Also, Early diagnosis leading to early treatment to prevent long-term damage. Global Landscape3 Rarity of diseases is most commonly defined based on prevalence and incidence within a jurisdiction, or in some cases by a combination of factors based on severity and the existence or feasibility of alternative therapeutic options. Globally, the following areas of focus aimed at improving the delivery of health care for the rare disease population: - Improve access to early diagnosis, timely intervention, coordinated care for rare genetic disease patients and developing referral pathways for rare genetic disease patients to facilitate efficient care deliver - Provide educational resources and knowledge exchange opportunities to health professionals to allow them to better identify, manage and treat rare disea - support integrated peer networks, patient organizations to ensure that rare disease patients, their family/caregivers and support them to make informed decisions about their condition. The importance of having working groups for Rare genetic Diseases in Gulf region 4 - Encourage improved coordination of care and access to particular information for rare genetic diseaseses. - Create a complete system services suppliers over Gulf states. Assets and Gaps analysis 1- Early Detection and Diagnostics 5 There are resources that assist the diagnostic capacity and early detection for rare genetic diseases. · Whole Exome sequencing are used mainly for research purposes, despite the fact that their use will reduced diagnostic odyssey. · Lack of the availability of testing is dependent on budget support in some hospitals. - Timely Access to Evidence-based care 6 - Family doctors may not be well equipped to meet the needs of patients with rare hematological genetic diseases, even after diagnosis. - Poor access supportive services for adult care. - Access to genetic counseling for patients and families outside major academic hospitals7. References 1. Sawyer, S. L. et al. Utility of whole-exome sequencing for those near the end of the diagnostic odyssey: time to address gaps in care. Clin. Genet.89, 275-284 (2016). 2. Undiagnosed Diseases Network Manual of Operations. (2018). 3. Richter, T. et al. Rare Disease Terminology and Definitions-A Systematic Global Review: Report of the ISPOR Rare Disease Special Interest Group. (2015). doi:10.1016/j.jval.2015.05.008 4. International Rare Disease Research Consortium& GUIDELINES Long version. (2013). 5. Clinical Handbook for Sickle Cell Disease Vaso-occlusive Crisis Provincial Council for Maternal and Child Health & Ministry of Health and Long-Term Care. (2017). 6. Therrell, B. L. et al. Current status of newborn screening worldwide: 2015. Seminars in Perinatology39, 171-187 (2015). 7. Stille, C. J. & Antonelli, R. C. Coordination of care for children with special health care needs. Current Opinion in Pediatrics16, 700-705 (2004). Figure Disclosures No relevant conflicts of interest to declare.


2012 ◽  
Vol 45 (4) ◽  
pp. 461-470 ◽  
Author(s):  
T. M. B. MACHADO ◽  
T. F. BOMFIM ◽  
L. V. SOUZA ◽  
N. SOARES ◽  
F. L. SANTOS ◽  
...  

SummaryA high occurrence rate of consanguineous marriages may favour the onset and increased frequency of autosomal recessive diseases in a population. The population of Monte Santo, Bahia, Brazil, has a high frequency of rare genetic diseases such as mucopolysaccharidosis type VI, whose observed frequency in this population is 1:5000, while the incidence of this disease recorded in other regions of the world varies from 1:43,261 in Turkey to 1:1,505,160 in Switzerland. To verify the influence of consanguineous marriage on the increased frequency of observed genetic diseases in this population, the population structure and frequency of different types of marriage during different time periods were evaluated. A total of 9765 marriages were found in an analysis of parish marriage records from the city. Over three periods, 1860–1895, 1950–1961 and 1975–2010, the inbreeding rates were 37.1%, 13.2% and 4.2% respectively. Although there was a high rate of inbreeding, endogamic marriages were the dominant marriage type in all three periods. In the most recent period, there was an increase in the number of exogamous marriages and those among immigrants, but most of these occurred among individuals from cities that neighbour Monte Santo. The low rate of migration and high frequency of endogamic and consanguineous marriages show that growth of this population is predominantly internal and could explain the occurrence, and increase in frequency, of recessive genetic diseases in the city.


2021 ◽  
Author(s):  
Rachna Shanbhag Mohite ◽  
Rajeshwari Kempireddygaripalli Gangulappa ◽  
Vidya Manur Narasimhamurthy ◽  
Sagar Bhattad

Abstract Mendelian susceptibility to mycobacterial disease (MSMD) is a group of genetic disorders characterized by a defect in interferon γ (IFN γ)–mediated immunity, with predisposition to infections caused by atypical and low virulent mycobacteria and other intra-macrophagic organisms like Salmonella, Klebsiella, Listeria etc. A 10-year-old boy, second born of a consanguineously (third-degree) married Indian couple, presented with left inguinal and submandibular lymphadenopathy with low grade fever for 10 days. Past history was significant as the child had been unwell from infancy. At the age of 4 months and 5 years, he was diagnosed to have tubercular axillary lymphadenitis and was treated with anti-tubercular drugs on each occasion and he responded to the same. On examination, he had left submandibular and inguinal lymphadenopathy and mild splenomegaly. Chest radiograph showed enlarged mediastinal nodes. He underwent left inguinal lymph node biopsy that reported granulomatous lymphadenitis. However, culture from the biopsy showed a growth of Salmonella enterica sensitive to ceftriaxone. Genetic evaluation showed pathogenic homozygous mutation c.1791 + 2T > G in exon 15 of IL12Rß1 gene by whole exome sequencing. A diagnosis of Mendelian Susceptibility to Mycobacterial Disease (MSMD) was established and he was treated with intravenous ceftriaxone followed by oral cefixime. He responded promptly and lymphadenopathy resolved. He is currently being maintained on azithromycin prophylaxis. Children and adults presenting with disseminated infections with atypical mycobacteria and salmonella must be evaluated for MSMD. Disseminated salmonellosis is a peculiar manifestation in IL12Rß1 deficiency. A detailed review of literature on IL12RB1 deficiency was performed. Index case has been discussed in light of the previously published literature.


2019 ◽  
Author(s):  
Go Hun Seo ◽  
Taeho Kim ◽  
Jung-young Park ◽  
Jungsul Lee ◽  
Sehwan Kim ◽  
...  

AbstractPurposeEVIDENCE, an automated interpretation system, has been developed to facilitate the entire process of whole exome sequencing (WES) analyses. This study investigated the diagnostic yield of EVIDENCE in patients suspected genetic disorders.MethodsDNA from 330 probands (age range, 0–68 years) with suspected genetic disorders were subjected to WES. Candidate variants were identified by EVIDENCE and confirmed by testing family members and/or clinical reassessments.ResultsThe average number of overlapping organ categories per patient was 4.5 ± 5.0. EVIDENCE reported a total 244 variants in 215 (65.1%) of the 330 probands. After clinical reassessment and/or family member testing, 196 variants were identified in 171 probands (51.8%), including 115 novel variants. These variants were confirmed as being responsible for 146 genetic disorders. One hundred-seven (54.6%) of the 196 variants were categorized as pathogenic or likely pathogenic before, and 146 (74.6%) after, clinical assessment and/or family member testing. Factors associated with a variant being confirmed as causative include rules, such as PVS1, PS1, PM1, PM5, and PP5, and similar symptom scores between that variant and a patient’s phenotype.ConclusionThis new, automated variant interpretation system facilitated the diagnosis of various genetic diseases with a 51% improvement in diagnostic yield.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Hosneara Akter ◽  
Mohammad Shahnoor Hossain ◽  
Nushrat Jahan Dity ◽  
Md. Atikur Rahaman ◽  
K. M. Furkan Uddin ◽  
...  

AbstractCollectively, rare genetic diseases affect a significant number of individuals worldwide. In this study, we have conducted whole-exome sequencing (WES) and identified underlying pathogenic or likely pathogenic variants in five children with rare genetic diseases. We present evidence for disease-causing autosomal recessive variants in a range of disease-associated genes such as DHH-associated 46,XY gonadal dysgenesis (GD) or 46,XY sex reversal 7, GNPTAB-associated mucolipidosis II alpha/beta (ML II), BBS1-associated Bardet–Biedl Syndrome (BBS), SURF1-associated Leigh Syndrome (LS) and AP4B1-associated spastic paraplegia-47 (SPG47) in unrelated affected members from Bangladesh. Our analysis pipeline detected three homozygous mutations, including a novel c. 863 G > C (p.Pro288Arg) variant in DHH, and two compound heterozygous variants, including two novel variants: c.2972dupT (p.Met991Ilefs*) in GNPTAB and c.229 G > C (p.Gly77Arg) in SURF1. All mutations were validated by Sanger sequencing. Collectively, this study adds to the genetic heterogeneity of rare genetic diseases and is the first report elucidating the genetic profile of (consanguineous and nonconsanguineous) rare genetic diseases in the Bangladesh population.


Author(s):  
Ahmad Almatrafi ◽  
Jamil A. Hashmi ◽  
Fatima Fadhli ◽  
Asma Alharbi ◽  
Sibtain Afzal ◽  
...  

AbstractEhlers–Danlos syndrome (EDS) is a group of clinically and genetically heterogeneous disorder of soft connective tissues. The hallmark clinical features of the EDS are hyperextensible skin, hypermobile joints, and fragile vessels. It exhibits associated symptoms including contractures of muscles, kyphoscoliosis, spondylodysplasia, dermatosparaxis, periodontitis, and arthrochalasia. The aim of this study is to determine the exact subtype of EDS by molecular genetic testing in a family segregating EDS in an autosomal recessive manner. Herein, we describe a family with two individuals afflicted with EDS. Whole exome sequencing identified a homozygous missense mutation (c.2050G > A; p.Glu684Lys) in the COL1A1 gene in both affected individuals, although heterozygous variants in the COL1A1 are known to cause EDS. Recently, only one report showed homozygous variant as an underlying cause of the EDS in two Saudi families. This is the second report of a homozygous variant in the COL1A1 gene in a family of Saudi origin. Heterozygous carriers of COL1A1 variant are asymptomatic. Interestingly, the homozygous variant identified previously and the one identified in this study are same (c.2050G > A). The identification of a unique homozygous mutation (c.2050G > A) in three Saudi families argues in favor of a founder effect.


2021 ◽  
Vol 86 (1-4) ◽  
pp. 28-33
Author(s):  
Karishma Mahtani ◽  
Diana Park ◽  
Jessica Abbott ◽  
Pavalan Panneer Selvam ◽  
Paldeep S. Atwal

Multiple familial diseases in a single patient often present with overlapping symptomatology that confers difficulty in delineating a clinical diagnosis. Pedigree analysis has been a long-standing practice in the field of medical genetics to discover familial diseases. In recent years, whole exome sequencing (WES) has proven to be a useful tool for aiding physicians in diagnosing and understanding disease etiology. This report shows that pedigree analysis and WES are co-dependent processes in establishing diagnoses in a family with 4 different genetic disorders: Birt-Hogg-Dubé Syndrome, <i>RRM2B</i>-related mitochondrial disease, <i>CDC73</i>-related primary hyperparathyroidism, and familial prostate cancer.


2021 ◽  
pp. 1-6
Author(s):  
Antonio Gennaro Nicotera ◽  
Giulia Spoto ◽  
Francesco Calì ◽  
Giusi Romeo ◽  
Antonino Musumeci ◽  
...  

Congenital disorders of glycosylation (CDG) are a group of rare genetic diseases caused by the deficiency of enzymes involved in the biosynthesis or remodeling of the glycan moieties of glycoconjugates. Most of CDG are autosomal recessive; however, few of them show autosomal dominant or X-linked inheritance. ALG12-CDG is an autosomal recessive inherited defect caused by a deficiency in the α-mannosyltransferase, dolichyl-P-mannose: Man7-GlcNAc-2-PP-dolichyl-alpha-6-mannosyltransferase (mannosyltransferase 8), which determines Man7GlcNAc2-PP-dolichol accumulation in tissues including fibroblasts. The clinical features of ALG12-CDG include dysmorphic features, developmental delay, hypotonia, progressive microcephaly, hypogammaglobulinemia, coagulopathies, and failure to thrive. Herein, we describe the case of a Sicilian patient with a milder phenotype bearing an <i>ALG12</i> homozygous mutation. To date, including this patient, only 16 cases have been described with this form of CDG. Furthermore, our study contributes to understanding the milder ALG12-CDG cases and to further expanding the genotype-phenotype spectrum.


Author(s):  
J Francis Borgio

More than 25 million DNA variations were discovered as novel including major alleles from Arab population. Exome studies on Arabs discovered >3000 novel nucleotide variants associated with >1200 rare genetic disorders. Reclassification of many pathogenic variant into benign through the Arab database enhance building a detailed and comprehensive map of Arab morbid genome. Intellectual disability stands first with the combined and observed carrier frequency. Genome studies and advanced computational biology discovered interesting novel candidate disease marker variations in many genes from consanguineous families with intellectual disability, neurogenetic disorders, blood and bleeding disorder and rare genetic diseases. Pathogenic variants in C12orf57 gene are prominently associated with the etiology of developmental delay/intellectual impairment. Arab mitogenome exposed hundreds of variations in mtDNA genome and its association with obesity. Further study is needed in genomics to fully comprehend the molecular abnormalities and associated pathogenesis that cause inherited disorders in Arab ancestries.


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