Case Report: Contiguous Xq22.3 Deletion Associated with ATS-ID Syndrome: From Genotype to Further Delineation of the Phenotype

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Authors

SMETANA Jan VALLOVÁ Vladimíra WAYHELOVÁ Markéta HLADÍLKOVÁ Eva FILKOVÁ Hana HOŘÍNOVÁ Věra BROŽ Petr MIKULÁŠOVÁ Aneta GAILLYOVÁ Renata KUGLÍK Petr

Year of publication 2021
Type Article in Periodical
Magazine / Source Frontiers in Genetics
MU Faculty or unit

Faculty of Science

Citation
Web https://doi.org/10.3389/fgene.2021.750110
Doi http://dx.doi.org/10.3389/fgene.2021.750110
Keywords ATS-MR syndrome; trio-based whole exome sequencing; genotype-phenotype analysis; neurodevelopmental disorders; Xq22.3q23 deletions
Description Alport syndrome with intellectual disability (ATS-ID, AMME complex; OMIM #300194) is an X-linked contiguous gene deletion syndrome associated with an Xq22.3 locus mainly characterized by hematuria, renal failure, hearing loss/deafness, neurodevelopmental disorder (NDD), midface retrusion, and elliptocytosis. It is thought that ATS-ID is caused by the loss of function of COL4A5 (ATS) and FACL4 (ACSL4) genes through the interstitial (micro)deletion of chromosomal band Xq22.3. We report detailed phenotypic description and results from genome-wide screening of a Czech family with diagnosis ATS-ID (proband, maternal uncle, and two female carriers). Female carriers showed mild clinical features of microscopic hematuria only, while affected males displayed several novel clinical features associated with ATS-ID. Utilization of whole-exome sequencing discovered the presence of approximately 3 Mb of deletion in the Xq23 area, which affected 19 genes from TSC22D3 to CHRDL1. We compared the clinical phenotype with previously reported three ATS-ID families worldwide and correlated their clinical manifestations with the incidence of genes in both telomeric and centromeric regions of the deleted chromosomal area. In addition to previously described phenotypes associated with aberrations in AMMECR1 and FACL4, we identified two genes, members of tripartite motif family MID2 and subunit of the proteasome PA700/19S complex (PSMD10), respectively, as prime candidate genes responsible for additional clinical features observed in our patients with ATS-ID. Overall, our findings further improve the knowledge about the clinical impact of Xq23 deletions and bring novel information about phenotype/genotype association of this chromosomal aberration.
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