Wan Wei, Zeng Liang, Jiang Hongqun, Xia Yunyan, Xiong Yuanping
Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Nangchang University, Jiangxi, China.
Jiangxi Institute of Otorhinolaryngology-Head and Neck Surgery, Jiangxi, China.
Front Genet. 2022 Aug 23;13:947305. doi: 10.3389/fgene.2022.947305. eCollection 2022.
Mutations in PRKAR1A gene can lead to Carney complex (CNC), and most CNC patients develop cardiac and cutaneous myxomas. In particular, cardiac myxomas are a common cause of mortality in CNC patients. Cutaneous myxomas of the external ear are extremely rare, and do not have any specific clinical features In this retrospective study, we analyzed the clinical and genetic data of the proband and his family and fifty whole blood control samples selected from the molecular genetic database of our hospital. Whole exome DNA sequencing analysis was used to detect the mutation in the peripheral blood samples. The results of the clinical analysis showed the presence of spotty skin pigmentation and external auditory canal myxoma in the proband as well as in his sister and mother. Whole-exome DNA sequencing showed a novel heterozygous mutation in the PRKAR1A gene i.e., c.824_825delAG (p.Gln275Leufs*2), in the proband and his sister and mother. In conclusion, the family members had the same autosomal dominant PRKAR1A mutation. DNA sequencing revealed a novel c.824_825delAG in exon 9 of PRKAR1A. This pathogenic mutation has not been reported previously, and may be related to the occurrence of external auditory canal myxomas and spotty pigmentation. This study broadens the genotypic spectrum of PRKAR1A mutations in CNC.
PRKAR1A基因的突变可导致卡尼综合征(CNC),大多数CNC患者会出现心脏和皮肤黏液瘤。特别是心脏黏液瘤是CNC患者常见的死亡原因。外耳道皮肤黏液瘤极为罕见,且没有任何特定的临床特征。在这项回顾性研究中,我们分析了先证者及其家族的临床和遗传数据,以及从我院分子遗传数据库中选取的50份全血对照样本。采用全外显子组DNA测序分析检测外周血样本中的突变。临床分析结果显示,先证者及其姐姐和母亲均存在皮肤斑点状色素沉着和外耳道黏液瘤。全外显子组DNA测序显示,先证者及其姐姐和母亲的PRKAR1A基因存在一种新的杂合突变,即c.824_825delAG(p.Gln275Leufs*2)。总之,家庭成员具有相同的常染色体显性PRKAR1A突变。DNA测序显示PRKAR1A第9外显子有一个新的c.824_825delAG。这种致病突变此前尚未见报道,可能与外耳道黏液瘤和斑点状色素沉着的发生有关。本研究拓宽了CNC中PRKAR1A突变的基因型谱。