Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA.
UC San Diego School of Medicine, La Jolla, California 92093, USA.
Cold Spring Harb Mol Case Stud. 2021 Jun 11;7(3). doi: 10.1101/mcs.a006085. Print 2021 Jun.
Visceral myopathies (VMs) encompass a spectrum of disorders characterized by chronic disruption of gastrointestinal function, with or without urinary system involvement. Pathogenic missense variation in smooth muscle γ-actin gene () is associated with autosomal dominant VM. Whole-genome sequencing of an infant presenting with chronic intestinal pseudo-obstruction revealed a homozygous 187 bp (c.589_613 + 163del188) deletion spanning the exon 6-intron 6 boundary within The patient's clinical course was marked by prolonged hospitalizations, multiple surgeries, and intermittent total parenteral nutrition dependence. This case supports the emerging understanding of allelic heterogeneity in -related VM, in which both biallelic and monoallelic variants in are associated with gastrointestinal dysfunction of similar severity and overlapped clinical presentation. Moreover, it illustrates the clinical utility of rapid whole-genome sequencing, which can comprehensively and precisely detect different types of genomic variants including small deletions, leading to guidance of clinical care decisions.
内脏肌病(VMs)是一组以胃肠道功能慢性紊乱为特征的疾病,伴有或不伴有泌尿系统受累。平滑肌γ-肌动蛋白基因()中的致病性错义变异与常染色体显性 VM 相关。对一名患有慢性肠假性梗阻的婴儿进行全基因组测序,发现一个纯合的 187bp(c.589_613+163del188)缺失跨越了 外显子 6-内含子 6 边界。该患者的临床病程以长时间住院、多次手术和间歇性全胃肠外营养依赖为特征。该病例支持在 相关 VM 中等位基因异质性的新认识,其中 中的双等位基因和单等位基因变异与相似严重程度的胃肠道功能障碍和重叠的临床表现相关。此外,它说明了快速全基因组测序的临床应用,它可以全面和精确地检测包括小缺失在内的不同类型的基因组变异,从而指导临床护理决策。