Department of Neurology, Children's Hospital of Shanghai, Shanghai JiaoTong University, China.
Division of Pediatric Neurology, Department of Pediatrics, University of Illinois and Children's Hospital of Illinois, USA.
Intern Med. 2021 Dec 1;60(23):3721-3728. doi: 10.2169/internalmedicine.6467-20. Epub 2021 Jun 19.
Objective Alström syndrome is an autosomal recessive genetic disease caused by a mutation in the ALMS1 gene. Alström syndrome is clinically characterized by multisystem involvement, including sensorineural deafness, cone-rod dystrophy, nystagmus, obesity, insulin resistance, type 2 diabetes and hypogonadism. The diagnosis is thus challenging for patients without this characteristic set of clinical symptoms. We explored the effectiveness of whole-exome sequencing in the diagnosis of Alström syndrome. Methods A girl with symptoms of Alström syndrome was tested and diagnosed with the disease by whole-exome sequencing. Results Whole-exome sequencing revealed two novel variants, c.6160_6161insAT: p.Lys2054Asnfs21 (exon 8) and c.10823_10824 delAG:p.Glu 3608Alafs9 (exon16) in the ALMS1 gene, leading to premature termination codons and the domain of ALMS1 protein. Blood sample testing of her asymptomatic parents revealed them to be heterozygous carriers of the same mutations. Assembly showed that the mutations on both alleles were located in conserved sequences. A review of the ALMS1 gene nonsense mutation status was performed. Conclusion We herein report two novel variants of the ALMS1 gene discovered in a Chinese Alström syndrome patient that expand the mutational spectrum of ALMS1 and provided new insight into the molecular mechanism underlying Alström syndrome. Our findings add to the current knowledge concerning the diagnosis and treatment of Alström syndrome.
Alström 综合征是一种常染色体隐性遗传疾病,由 ALMS1 基因突变引起。Alström 综合征的临床特征为多系统受累,包括感音神经性聋、圆锥-杆状细胞营养不良、眼球震颤、肥胖、胰岛素抵抗、2 型糖尿病和性腺功能减退症。因此,对于没有这种特征性临床症状的患者,诊断具有挑战性。我们探讨了全外显子组测序在 Alström 综合征诊断中的应用。
对一名具有 Alström 综合征症状的女孩进行全外显子组测序检测和诊断。
全外显子组测序发现 ALMS1 基因中的两个新变异,c.6160_6161insAT:p.Lys2054Asnfs21(外显子 8)和 c.10823_10824delAG:p.Glu3608Alafs9(外显子 16),导致提前终止密码子和 ALMS1 蛋白的结构域缺失。对其无症状的父母的血液样本进行检测,发现他们是相同突变的杂合携带者。组装表明,两个等位基因上的突变都位于保守序列中。对 ALMS1 基因无义突变状态进行了回顾性分析。
我们在此报告了一名中国 Alström 综合征患者中发现的 ALMS1 基因的两个新变异,扩展了 ALMS1 的突变谱,并为 Alström 综合征的分子机制提供了新的见解。我们的发现增加了当前对 Alström 综合征诊断和治疗的认识。