Shen Wei, Heeley Jennifer M, Carlston Colleen M, Acuna-Hidalgo Rocio, Nillesen Willy M, Dent Karin M, Douglas Ganka V, Levine Kara L, Bayrak-Toydemir Pinar, Marcelis Carlo L, Shinawi Marwan, Carey John C
Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah.
ARUP Laboratories, Salt Lake City, Utah.
Am J Med Genet A. 2017 Nov;173(11):3022-3028. doi: 10.1002/ajmg.a.38485. Epub 2017 Sep 21.
De novo, germline variants in DNMT3A cause Tatton-Brown-Rahman syndrome (TBRS). This condition is characterized by overgrowth, distinctive facial appearance, and intellectual disability. Somatic DNMT3A variants frequently occur in hematologic malignances, particularly acute myeloid leukemia. The Arg882 residue is the most common site of somatic DNMT3A variants, and has also been altered in patients with TBRS. Here we present three additional patients with this disorder attributed to DNMT3A germline variants that disrupt the Arg882 codon, suggesting that this codon may be a germline mutation hotspot in this disorder. Furthermore, based on the investigation of previously reported variants in patients with TBRS, we found overlap in the spectrum of DNMT3A variants observed in this disorder and somatic variants in hematological malignancies.
DNMT3A基因的新生种系变异会导致塔顿 - 布朗 - 拉赫曼综合征(TBRS)。这种病症的特征是生长过度、独特的面部外观和智力残疾。体细胞DNMT3A变异经常出现在血液系统恶性肿瘤中,尤其是急性髓系白血病。精氨酸882残基是体细胞DNMT3A变异最常见的位点,在TBRS患者中也发生了改变。在此,我们报告另外三名患有这种疾病的患者,其归因于DNMT3A种系变异破坏了精氨酸882密码子,这表明该密码子可能是这种疾病中的种系突变热点。此外,基于对先前报道的TBRS患者变异的研究,我们发现在这种疾病中观察到的DNMT3A变异谱与血液系统恶性肿瘤中的体细胞变异存在重叠。