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全外显子测序诊断首例表现为桥脑小脑发育不全 1 型的 Bainbridge-Ropers 综合征胎儿病例。

Whole exome sequencing diagnoses the first fetal case of Bainbridge-Ropers syndrome presenting as pontocerebellar hypoplasia type 1.

机构信息

Unité d'Embryofœtopathologie, Service d'Histologie Embryologie Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (APHP), Paris, France.

Service de Génétique, Centre hospitalier du Mans, Le Mans, France.

出版信息

Birth Defects Res. 2018 Apr 3;110(6):538-542. doi: 10.1002/bdr2.1191. Epub 2018 Jan 8.

Abstract

BACKGROUND

Bainbridge-Ropers syndrome (BRPS) is a recently identified severe disorder characterized by failure to thrive, facial dysmorphism, and severe developmental delay, caused by de novo dominant loss of function mutation in the ASXL3 gene.

CASE

We report here the first case of prenatal BRPS in a fetus presenting with arthrogryposis on ultrasound and for pontocerebellar hypoplasia type 1 (PCH1) following neuropathological examination. The diagnosis was done by whole exome sequencing that identified a novel de novo ASXL3 mutation. We review 29 previous published cases.

DISCUSSION

The fetopathological examination allowed to extend the phenotype to central nervous system and the genetic study highlights ASXL3 as a dominant gene responsible for PCH1 phenotype. Recognizing heterozygous ASXL3 mutation as a cause of prenatal PCH1 is essential for both large scale molecular analysis in the NGS era and genetic counseling.

摘要

背景

Bainbridge-Ropers 综合征(BRPS)是一种最近发现的严重疾病,其特征为生长不良、面部畸形和严重发育迟缓,由 ASXL3 基因的新生显性功能丧失突变引起。

病例

我们在此报告首例产前 BRPS 病例,该胎儿在超声检查中出现关节挛缩,神经病理学检查后发现为 1 型桥脑小脑发育不良(PCH1)。通过全外显子组测序进行诊断,发现了一种新的新生 ASXL3 突变。我们回顾了 29 例已发表的病例。

讨论

胎儿病理学检查将表型扩展到中枢神经系统,基因研究强调 ASXL3 是导致 PCH1 表型的显性基因。在 NGS 时代,对杂合 ASXL3 突变进行大规模分子分析以及遗传咨询,认识到其是导致产前 PCH1 的原因至关重要。

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