Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
The Chinese University of Hong Kong-Baylor College of Medicine Joint Center for Medical Genetics, Hong Kong SAR, China.
Fetal Diagn Ther. 2023;50(2):84-91. doi: 10.1159/000529504. Epub 2023 Feb 3.
Primary microcephaly (MCPH) is not an uncommon disorder with multiple etiologies. There are a growing number of MCPH-related genes discovered due to the extensive application of whole-exome sequencing (WES) in clinical and research settings. Biallelic mutations in the SASS6 gene cause an extremely rare MCPH, type 14. To date, only two families with SASS6 gene-related microcephaly have been reported.
We report a case of recurrent congenital microcephaly in a Chinese family. The two affected fetuses presented with microcephaly early in the second trimester with agenesis of the corpus callosum. In the first affected fetus, trio WES detected two compound heterozygous candidate variants c.1139T>C(p.L380P) and c.1223C>G (p.T408S) in the SASS6 gene. Another affected fetus also inherited both variants, while the normal child carried neither variant through Sanger sequencing analysis. Both variants were classified as a variant of uncertain significance according to the current American College of Medical Genetics and Genomics guidelines.
We reported novel biallelic variants in the SASS6 gene, encoding the SAS6 centriolar assembly protein, associated with prenatal onset of autosomal recessive microcephaly. We postulate that the pathomechanism of the compound heterozygous variants in close proximity could potentiate the overall coiled instability leading to the phenotypic features of our case.
原发性小头畸形(MCPH)是一种并不罕见的疾病,具有多种病因。由于全外显子组测序(WES)在临床和研究环境中的广泛应用,越来越多的与 MCPH 相关的基因被发现。SASS6 基因的双等位基因突变导致一种非常罕见的 MCPH 类型 14。迄今为止,仅有两例与 SASS6 基因相关的小头畸形的家族被报道过。
我们报告了一个中国家庭中复发性先天性小头畸形的病例。两名受影响的胎儿在妊娠中期早期出现小头畸形,伴有胼胝体发育不全。在第一个受影响的胎儿中,三重 WES 检测到 SASS6 基因中的两个复合杂合候选变体 c.1139T>C(p.L380P)和 c.1223C>G(p.T408S)。另一个受影响的胎儿也遗传了这两个变体,而正常孩子通过 Sanger 测序分析既没有携带这两个变体。根据美国医学遗传学与基因组学学院的现行指南,这两个变体均被归类为意义不明的变异。
我们报道了 SASS6 基因中与常染色体隐性小头畸形相关的新型双等位基因突变,该基因编码 SAS6 中心粒组装蛋白。我们推测,两个临近的杂合变体的致病机制可能会增强整体卷曲不稳定,导致我们病例的表型特征。