scholarly journals Familial juvenile polyposis syndrome with a de novo germline missense variant in BMPR1A gene: a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Liu ◽  
Mengling Liu ◽  
Tianshu Liu ◽  
Yiyi Yu

Abstract Background Juvenile polyposis syndrome (JPS) is a rare autosomal dominant hereditary disorder characterized by the development of multiple distinct juvenile polyps in the gastrointestinal tract with an increased risk of colorectal cancer. Germline mutations in two genes, SMAD4 and BMPR1A, have been identified to cause JPS. Case presentation Here, we report a germline heterozygous missense variant (c.299G > A) in exon 3 BMPR1A gene in a family with juvenile polyposis. This variant was absent from the population database, and concluded as de novo compared with the parental sequencing. Further sequencing of the proband’s children confirmed the segregation of this variant with the disease, while the variant was also predicted to have damaging effect based on online prediction tools. Therefore, this variant was classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Conclusions Germline genetic testing revealed a de novo germline missense variant in BMPR1A gene in a family with juvenile polyposis. Identification of the pathogenic variant facilitates the cancer risk management of at-risk family members, and endoscopic surveillance is recommended for mutation carriers.

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Jay Lodhia ◽  
David Msuya ◽  
Abdallah Msemo ◽  
Huda Akrabi ◽  
Patrick Amsi ◽  
...  

Introduction. Juvenile polyposis syndrome is a rare autosomal dominant disorder in children characterized by multiple polyps in the gastrointestinal tract. A variety of clinical features manifest, including prolapse of a polyp or entire rectum, gastrointestinal bleeding, anaemia, and intussusception. This condition if left unmanaged promptly leads to fatal complications including the development of cancer of the bowel. Case Presentation. A 13-year-old girl with a history of mass protrusion per anus associated with bloody diarrhea. Colonoscopy showed multiple polyps in her large bowel. She underwent total colectomy with ileorectal anastomosis and did clinically well post surgery with no complications. Conclusion. Juvenile polyposis syndrome is an inherited condition with significant morbidity and a high risk of colon malignancy. It is important for early screening and diagnosis and hence management in its early stages as there are no specific standard guidelines for children.


2019 ◽  
Vol 57 (04) ◽  
pp. 497-500
Author(s):  
Moritz Schiemer ◽  
Annette Schmitt-Graeff ◽  
Volker Brass ◽  
Peter Hasselblatt

AbstractJuvenile polyposis syndrome is a rare autosomal-dominant disorder characterized by multiple hamartomatous polyps in the gastrointestinal tract. It is associated with an increased risk of gastrointestinal cancer. We report the case of a 49-year-old woman presenting with proximal muscle weakness, weight loss, severe anemia, and melena. One year before, the diagnosis of a “fundic gland polyposis” was presumed after endoscopic evaluation for iron deficiency anemia had shown numerous polyps limited to the gastric mucosa. On admission, the diagnosis of dermatomyositis was made based on laboratory results with a marked elevated creatine kinase as well as the presence of characteristic clinical findings and muscle histology. Upper endoscopy revealed multiple pedunculated, edematous polyps in the stomach without apparent cancerous lesions intraluminally. Infiltration of the muscular layer was not detectable on endoscopic ultrasound. Histopathological examination of the polyps showed smooth outer surfaces and multiple dilated cystic glands, consistent with hamartomatous juvenile-type polyps. Magnetic resonance imaging revealed a peritoneal mass close to the greater curvature of the stomach, which was identified as a poorly differentiated adenocarcinoma by laparoscopic sampling. Immunohistochemical analysis of resected polyps was remarkable for a loss of SMAD4 expression, a finding that is very commonly observed in patients with gastric juvenile polyposis syndrome. Despite initial treatment response to glucocorticoids and chemotherapy, the patient died 5 months later due to progressive illness. Patients with gastric juvenile polyposis and SMAD4 mutations are at a high risk of developing gastric cancer; hence, early gastrectomy should be considered.


2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Amna Ahmed ◽  
Badr Alsaleem

Juvenile polyposis syndrome (JPS) is a rare autosomal dominant hereditary disorder, characterized by multiple juvenile polyps in the gastrointestinal tract and an increased risk of colorectal cancer. JPS is most frequently caused by mutations in the SMAD4 or BMPR1A genes. Herein, we report a child with juvenile polyposis syndrome (JPS) with a novel mutation in the SMAD4 gene. An 8-year-old boy presented with recurrent rectal bleeding and was found to have multiple polyps in the entire colon. The histology of the resected polyps was consistent with juvenile polyps. Subsequent genetic screening revealed a novel mutation in SMAD4, exon 5 (p.Ser144Stop). To the best of our knowledge, this mutation has not been reported before. Offering genotypic diagnosis for patients with JPS is an important step for strategic plan of management.


2016 ◽  
Author(s):  
Sahar Nissim ◽  
Ramona M. Lim

Although sporadic polyps in the gastrointestinal tract are common with increasing age, the finding of a large number of polyps raises suspicion for a hereditary polyposis syndrome associated with a germline genetic mutation. Because many of these hereditary polyposis syndromes also confer an increased risk of gastrointestinal and extraintestincal cancers, implicated in approximately 1% of all colorectal cancers, recognition of these syndromes is critical to offer preventive screening measures. A key distinguishing feature is polyp histologic type, ranging from adenomatous, to serrated, to hamartomatous. A clinical diagnosis can be confirmed by genetic testing for a germline mutation in known cancer susceptibility genes, although in many polyposis families, a genetic etiology has not yet been identified. This review covers familial adenomatous polyposis, MUTYH-associated polyposis, polyposis associated with polymerase proofreading, juvenile polyposis syndrome, PTEN hamartoma tumor syndromes, hereditary mixed polyposis syndrome, and serrated polyposis. The figures shows the spectrum of histologic types and genetic etiologies of hereditary polyposis syndromes. Tables list polyposis syndromes, American College of Gastroenterology surveillance guidelines for hereditary polyposis syndromes, diagnostic criteria for juvenile polyposis syndrome, diagnostic criteria for PTEN hamartoma tumor syndrome, and World Health Organization diagnostic criteria for serrated polyposis syndrome.   This review contains 1 highly rendered figure, 5 tables, and 172 references Key words: Familial adenomatous polyposis; Polyposis syndromes; Gastrointestinal polyps; Hereditary polyposis syndromes


2020 ◽  
Vol 13 (12) ◽  
pp. e236855
Author(s):  
Wendy Chang ◽  
Patricia Renaut ◽  
Casper Pretorius

Juvenile polyposis syndrome (JPS) and hereditary haemorrhagic telangiectasia (HHT) are rare autosomal dominant diseases, where symptoms manifest at childhood. A 32-year-old man with no family history of JPS or HHT with SMAD4 gene mutation who developed signs and symptoms only at the age of 32, when he was an adult. In this article, we highlight the steps taken to diagnose this rare pathology, explain its pathophysiology and management.


2001 ◽  
Vol 69 (4) ◽  
pp. 704-711 ◽  
Author(s):  
Xiao-Ping Zhou ◽  
Kelly Woodford-Richens ◽  
Rainer Lehtonen ◽  
Keisuke Kurose ◽  
Micheala Aldred ◽  
...  

2012 ◽  
Vol 55 (8) ◽  
pp. 886-892 ◽  
Author(s):  
Margaret O’Malley ◽  
Lisa LaGuardia ◽  
Matthew F. Kalady ◽  
Joseph Parambil ◽  
Brandie Heald ◽  
...  

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