Olavarrieta L, Morales-Angulo C, del Castillo I, Moreno F, Moreno-Pelayo M A
Unidad de Genética Molecular, Hospital Ramón y Cajal, 28034 Madrid, Spain.
Clin Genet. 2008 Mar;73(3):262-7. doi: 10.1111/j.1399-0004.2007.00947.x. Epub 2007 Dec 29.
Branchio-oto-renal (BOR) and Stickler (STL) syndromes are disorders that include hearing loss among their clinical features. STL syndrome type I (STL1) is a combination of ophthalmic, orofacial, articular, and auditory manifestations, caused by mutations in the COL2A1. BOR syndrome is an autosomal dominant trait encompassing branchial, otic and renal anomalies because of mutations in EYA1, SIX1 and SIX5. In this study, we have clinically and genetically diagnosed a proband that displayed STL1 and BOR syndromes. This patient and his younger brother exhibited hearing loss and cleft palate. Both siblings and their mother also showed myopia, congenital non-progressive vitreous anomaly and a flat face. Taken together, these clinical features are consistent with the diagnosis of a familial case of STL. Sequence analysis revealed in the three patients a novel COL2A1 mutation (c.1468_1475delinsT) that accounted for a STL1 phenotype. The proband also displayed pre-auricular pits, branchial fistulae and renal agenesis that define BOR syndrome. Interestingly, this patient carries an EYA1 mutation, p.R328X, which was not present in the two other patients or in his healthy father, supporting that the mutation arose de novo. In conclusion, this report highlights the importance of molecular testing and detailed clinical evaluation for the diagnosis of syndromes with overlapping phenotypic features.
鳃-耳-肾(BOR)综合征和斯蒂克勒(STL)综合征是临床特征包括听力损失的疾病。I型STL综合征(STL1)是一种由COL2A1基因突变引起的,具有眼部、口面部、关节和听觉表现的综合征。BOR综合征是一种常染色体显性性状,由于EYA1、SIX1和SIX5基因突变,表现为鳃、耳和肾的异常。在本研究中,我们对一名表现出STL1和BOR综合征的先证者进行了临床和基因诊断。该患者及其弟弟表现出听力损失和腭裂。这对兄弟及其母亲还表现出近视、先天性非进行性玻璃体异常和平脸。综合来看,这些临床特征与STL家族病例的诊断一致。序列分析在这三名患者中发现了一种新的COL2A1突变(c.1468_1475delinsT),该突变导致了STL1表型。先证者还表现出耳前凹、鳃瘘和肾发育不全,这些特征符合BOR综合征。有趣的是,该患者携带一种EYA1突变,p.R328X,另外两名患者及其健康父亲均未出现该突变,这支持该突变是新发的。总之,本报告强调了分子检测和详细临床评估对于诊断具有重叠表型特征综合征的重要性。