Division of Prenatal Diagnosis Center, P. Palagi Hospital, Florence, Italy.
Department of Genetic Diagnosis, Careggi Hospital, Florence, Italy.
Mol Genet Genomic Med. 2021 Aug;9(8):e1733. doi: 10.1002/mgg3.1733. Epub 2021 Jun 10.
Rhizomelic chondrodysplasia punctata (RCDP) is a clinical entity resulting from defects of peroxisomal metabolism whose clinical phenotype is characterized by rhizomelia, calcified foci in periarticular cartilage, coronal lesions of vertebral bodies, cataracts and severe cognitive delay. Usually, survival does not exceed the first decade of life. Transmission is autosomal recessive and is related to mutations in the PEX7, GNPAT or AGPS.
A detailed description of the prenatal ultrasound signs of RCDP found in two successive pregnancies in a consanguineous couple is reported. Molecular genetic investigations included the study of the coding regions and the exon-intron junctions of the GNPAT (high-throughput amplification and sequencing performed with Roche NimbleGen SeqCap Target kit on Illumina platform); the confirmation test was carried out by amplification and Sanger sequencing with automatic capillary sequencer.
In addition to the typical prenatal ultrasound signs described in the literature in association with RCDP, the presence of prefrontal oedema, never previously described, has been detected in both pregnancies. Moreover, genetic investigations have found a new splicing variant c.924+1G>A of the homozygous GNPAT.
The role of mutation in the GNPAT suggests a likely association with the clinical phenotype.
点状软骨发育不良(RCDP)是一种由过氧化物酶体代谢缺陷引起的临床实体,其临床表型的特征是肢端短小、关节周围软骨钙化灶、椎体冠状病变、白内障和严重的认知障碍。通常,患者的生存时间不会超过生命的第一个十年。这种疾病的遗传方式为常染色体隐性遗传,与 PEX7、GNPAT 或 AGPS 基因突变有关。
报告了一对近亲连续两次妊娠中发现的 RCDP 的产前超声特征的详细描述。分子遗传学研究包括 GNPAT 的编码区和外显子-内含子接头的研究(使用 Roche NimbleGen SeqCap Target 试剂盒在 Illumina 平台上进行高通量扩增和测序);确认测试是通过扩增和自动毛细管测序仪的 Sanger 测序进行的。
除了文献中描述的与 RCDP 相关的典型产前超声特征外,还在两次妊娠中发现了从未描述过的额前水肿。此外,遗传研究发现了 GNPAT 的一个新的剪接变异 c.924+1G>A,为纯合子。
GNPAT 突变的作用提示其可能与临床表型相关。