Zhang R, He X H, Lin H Y, Yang X H
Department of Prenatal Diagnosis, Bao'an Maternity and Child Health Hospital, Shenzhen 518133, China.
Zhonghua Er Ke Za Zhi. 2018 Feb 2;56(2):138-141. doi: 10.3760/cma.j.issn.0578-1310.2018.02.013.
To investigate the clinical manifestations and genetic features of a child with Bainbridge-Ropers syndrome caused by ASXL3 gene variation and review the literature. Clinical data and genetic features were collected and analyzed from a child with Bainbridge-Ropers syndrome who was diagnosed in Bao'an Maternity and Child Health Hospital in November 2016. "ASXL3" and "Bainbridge-Ropers" were used as key words to search at China National Knowledge Infrastructure, Wangfang Data Knowledge Service Platform, PubMed and Human Gene Mutation Database up to June 2017. A 2(9/12) years old girl was presented with psychomotor retardation, feeding difficulty, hypotonia and specific craniofacial phenotype. She showed severe growth retardation (height: 84 cm, body weight: 8.0 kg (both were less than 3(rd) percentile rank of the children at the same age) and head circumference: 46 cm(=3rd percentile rank)), without obvious abnormalities in laboratory tests and neuroimaging tests. A de novo heterozygous nonsense variation: c.3349C>T(p.R1117*) in ASXL3 gene was identified by the whole exome sequencing, and the novel variation was classified into pathologic variant based on Standards and guidelines for the interpretation of sequence variants from ACMG. According to literature retrieval, no Chinese cases with ASXL3 variation had been reported. Totally 28 cases including the present girl harboring ASXL3 variations with detailed clinical information were reported. Thirty-one variations in ASXL3 gene were involved, including 1 missense variation and 30 loss of function variations, which were all de novo variations. The clinical features of Bainbridge-Ropers syndrome include severe psychomotor retardation, feeding difficulties, hypotonia and specific facial features. The heterozygous nonsense variation in ASXL3 gene is the cause of the patient. All the pathogenic variations in ASXL3 gene are de novo and loss of function variations.
探讨1例因ASXL3基因变异导致的Bainbridge-Ropers综合征患儿的临床表现及遗传学特征,并进行文献复习。收集并分析2016年11月在深圳市宝安区妇幼保健院确诊的1例Bainbridge-Ropers综合征患儿的临床资料及遗传学特征。以“ASXL3”和“Bainbridge-Ropers”为关键词,检索中国知网、万方数据知识服务平台、PubMed及人类基因突变数据库,检索时间截至2017年6月。1例2(9/12)岁女童,表现为精神运动发育迟缓、喂养困难、肌张力低下及特殊颅面部表型。生长严重迟缓(身高:84 cm,体重:8.0 kg(均低于同年龄儿童第3百分位数),头围:46 cm(=第3百分位数)),实验室检查及神经影像学检查无明显异常。经全外显子测序发现ASXL3基因存在1个新发杂合无义变异:c.3349C>T(p.R1117*),根据美国医学遗传学与基因组学学会(ACMG)序列变异解读标准与指南,该新变异被分类为病理性变异。经文献检索,国内尚无ASXL3基因变异病例报道。共报道包括本例女童在内28例携带ASXL3基因变异且有详细临床资料的病例。涉及ASXL3基因变异31种,其中1种错义变异,30种功能缺失变异,均为新发变异。Bainbridge-Ropers综合征的临床特征包括严重精神运动发育迟缓、喂养困难、肌张力低下及特殊面容。ASXL3基因杂合无义变异是该患者致病原因。ASXL3基因所有致病变异均为新发的功能缺失变异。