Case Reports in GeneticsPub Date : 2025-12-26eCollection Date: 2025-01-01DOI: 10.1155/crig/1587968
Laila Baker, Faisal Hadid, Sara Salahaldeen Irshaidat, Sondos Altaraqji, Ruba Benini, Farouq Thabet, Rana Al Shami, Husam Kayyali, Rehab Al Saleh, Tawfeg Ben Omran, Jehan Al Rayyahi, Ahmed El Beltagi, Baha Juma, Khalid Ibrahim
{"title":"Rare Presentation of Homozygous S<i>LC20A2</i> Mutations Causing Intra-Arterial Cerebral Vasculopathy and Stroke in Infancy: Case Report and Review of the Literature.","authors":"Laila Baker, Faisal Hadid, Sara Salahaldeen Irshaidat, Sondos Altaraqji, Ruba Benini, Farouq Thabet, Rana Al Shami, Husam Kayyali, Rehab Al Saleh, Tawfeg Ben Omran, Jehan Al Rayyahi, Ahmed El Beltagi, Baha Juma, Khalid Ibrahim","doi":"10.1155/crig/1587968","DOIUrl":"10.1155/crig/1587968","url":null,"abstract":"<p><p>Primary familial basal ganglia calcification (PFBC), also known as Fahr's disease, is a rare neurodegenerative condition characterized by bilateral calcifications in the basal ganglia and other brain regions. While it predominantly presents in adulthood and is commonly associated with heterozygous mutations, rare homozygous pathogenic variants may lead to severe early-onset manifestations. We present a unique case of PFBC in a 2-month-old female infant who exhibited focal motor seizures shortly after routine immunization. Neuroimaging revealed bilateral basal ganglia calcifications, multifocal cerebral infarcts, and evidence of significant intra-arterial cerebral vasculopathy. Genetic testing confirmed a homozygous pathogenic variant in the <i>SLC20A2</i> gene (<i>c.1399 C > T</i>) (<i>p.R467</i>∗). Notably, both consanguineous parents were heterozygous carriers of the same mutation. Other family members across two generations also harbored heterozygous variants but were asymptomatic. This case is one of the few reported instances of a homozygous <i>SLC20A2</i> pathogenic variant and the second to demonstrate intra-arterial vasculopathy in infancy. The clinical spectrum included seizures, hypotonia, poor feeding, and extensive ischemic changes. Despite supportive care and antiepileptic therapy, the patient remained neurologically impaired. This report underscores the importance of considering PFBC in the differential diagnosis of infantile seizures, especially in populations with high rates of consanguinity. It also expands the phenotypic spectrum of <i>SLC20A2</i>-related disease to include infantile stroke due to cerebral vasculopathy. Early diagnosis and genetic counseling are essential for management and family planning.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"1587968"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-12-15eCollection Date: 2025-01-01DOI: 10.1155/crig/5589985
Andrea A Arcari, María Eugenia Rodríguez, Romina Armando, María Sol Ayuso, Matias T De Iuliis La Torre, Marina Szlago
{"title":"MCT8 Deficiency in Two Brothers With a Novel Deletion Mutation in <i>SLC16A2</i>.","authors":"Andrea A Arcari, María Eugenia Rodríguez, Romina Armando, María Sol Ayuso, Matias T De Iuliis La Torre, Marina Szlago","doi":"10.1155/crig/5589985","DOIUrl":"10.1155/crig/5589985","url":null,"abstract":"<p><strong>Background: </strong>Monocarboxylate transporter 8 (MCT8) deficiency, also known as Allan-Herndon-Dudley syndrome, is a rare X-linked genetic disorder resulting from pathogenic mutations in the <i>SLC16A2</i> gene. MCT8 deficiency impacts the transport of thyroid hormone (TH) throughout the body. Symptoms are highly heterogeneous and often include severe neurodevelopmental delay, hypotonia in the limbs and trunk, and low body weight.</p><p><strong>Case presentation: </strong>This case report describes the diagnostic journey of two brothers born 1 year and 8 months apart to nonconsanguineous parents. Both exhibited severely limited motor development, quadriparesis, and an inability to sit independently or hold their head up. Despite their significant clinical presentations, the diagnoses were delayed: 12 years and 8 months for Case 1 and 8 years and 3 months for Case 2. Genetic testing revealed that both patients carry the same novel <i>SLC16A2</i> mutation, 960_995del (p.Tyr321_Ala332del). Although they displayed key clinical features of MCT8 deficiency, the TH profile of Case 1 was inconclusive, lacking the characteristic sustained elevation of triiodothyronine (T3) typically associated with MCT8 deficiency.</p><p><strong>Conclusions: </strong>Findings from this case report highlight the need for greater awareness of this disorder and underscore the clinical heterogeneity of MCT8 deficiency.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"5589985"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-12-15eCollection Date: 2025-01-01DOI: 10.1155/crig/6652420
Débora Romeo Bertola, Sofia de Oliveira Farias, Silvia Souza da Costa, Mara Maria Lisboa Santana Pinheiro, Maria Rita Dos Santos Passos-Bueno, Carla Rosenberg, Ana Cristina Victorino Krepischi
{"title":"A Complex Chromosome Rearrangement Disrupting <i>SYT1</i> Supports Haploinsufficiency as a Cause of Baker-Gordon Syndrome.","authors":"Débora Romeo Bertola, Sofia de Oliveira Farias, Silvia Souza da Costa, Mara Maria Lisboa Santana Pinheiro, Maria Rita Dos Santos Passos-Bueno, Carla Rosenberg, Ana Cristina Victorino Krepischi","doi":"10.1155/crig/6652420","DOIUrl":"10.1155/crig/6652420","url":null,"abstract":"<p><p>Baker-Gordon syndrome (BAGOS) is an autosomal dominant neurodevelopmental disorder caused by <i>de novo</i> heterozygous missense mutations in <i>SYT1</i>. The precise pathogenic mechanism of BAGOS is still unclear, with preliminary data favoring a dominant-negative effect, although a previous case presenting a reciprocal translocation disrupting <i>SYT1</i> supports haploinsufficiency as a possible mechanism. We report a child with a syndromic neurodevelopmental disorder compatible with BAGOS and carrying a t(5; 12)(q31; q21) by G-banded karyotype. Optical genome mapping (OGM) is based on ultrahigh molecular weight DNA molecules allowing the combined analyses of numerical and structural chromosome variants. The rearrangement was investigated using OGM, which revealed an additional structural variant, a paracentric inversion in the segment of Chromosome 12 translocated to der(5). The breakpoint of the paracentric inversion is mapped to Intron 9 of the <i>SYT1</i> gene, interrupting the C2B domain. This is the second BAGOS case reported in the literature caused by <i>SYT1</i> disruption, supporting that reduced amounts of functional SYT1, either by haploinsufficiency or dominant-negative effect, is responsible for <i>SYT1</i>-associated neurodevelopmental syndrome.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"6652420"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-11-27eCollection Date: 2025-01-01DOI: 10.1155/crig/5233998
Laven Anand, Michael J Munro, Ashalatha Shetty, John Dean, Judith Pagan, Jamie Campbell
{"title":"Diaphragmatic Hernia in a Newborn With COL1A1-Associated Classical Ehlers-Danlos Syndrome.","authors":"Laven Anand, Michael J Munro, Ashalatha Shetty, John Dean, Judith Pagan, Jamie Campbell","doi":"10.1155/crig/5233998","DOIUrl":"10.1155/crig/5233998","url":null,"abstract":"<p><p>Diaphragmatic rupture is an uncommonly seen complication of classical Ehlers-Danlos syndrome (cEDS). There have been no documented cases of diaphragmatic hernia in newborns having cEDS. This case study discusses a male infant delivered through spontaneous vertex delivery to a mother with cEDS. No evidence of a diaphragmatic hernia was found 6 days before delivery when an ultrasound scan to monitor a ventricular septal defect was carried out. Postnatally, the infant displayed signs of severe respiratory distress. A chest radiograph revealed a diaphragmatic hernia. The surgical team found and corrected a small posterolateral diaphragmatic defect on the third day of life. This resulted in a good recovery following management of a complication of chylothorax. The mother was known to have cEDS and bidirectional sequencing of the patient's lymphocyte DNA detected the heterozygous pathogenic familial variant <i>COL1A1</i> c.934C > T;p.(Arg312Cys). This variant has been previously reported in cases of cEDS. Other <i>COL1A1</i> variants are known to be associated with arthrochalasia-type EDS and osteogenesis imperfecta, but no <i>COL1A1</i> variants have been associated previously with congenital diaphragmatic hernia or diaphragmatic rupture. The familial variant impacts the highly conserved arginine residue in the Gly-X-Y triplet motif of the Type-I collagen protein. It has been reported in various families as a rare cause of autosomal-dominant cEDS. This case report details the patient's journey, including images of radiographs, highlighting a rare but important complication of spontaneous vertex delivery for individuals with cEDS. We also include a literature review on diaphragmatic hernia and rupture in classical EDS.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"5233998"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12677986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-11-26eCollection Date: 2025-01-01DOI: 10.1155/crig/5109434
Liora H Feshbach, Morgan Similuk, Laura M Amendola, Katie L Lewis, Magdalena A Walkiewicz, Mari Tokita, Rajarshi Ghosh, Andrew Lipton
{"title":"Long-Read Sequencing as a Diagnostic Tool for Primary Ciliary Dyskinesia.","authors":"Liora H Feshbach, Morgan Similuk, Laura M Amendola, Katie L Lewis, Magdalena A Walkiewicz, Mari Tokita, Rajarshi Ghosh, Andrew Lipton","doi":"10.1155/crig/5109434","DOIUrl":"10.1155/crig/5109434","url":null,"abstract":"<p><p>Primary ciliary dyskinesia (PCD) is a rare, inherited disease resulting from abnormal structure and/or function of cilia. To date, pathogenic variants in over 50 genes have been reported as causes of PCD. One of the genes, <i>HYDIN</i>, presents a diagnostic challenge due to the existence of <i>HYDIN2</i>, a highly homologous pseudogene that significantly complicates accurate molecular diagnosis. Here, we present a 43-year-old female with a clinical diagnosis of PCD seeking molecular diagnosis underlying her disease. Short-read genome sequencing detected two potentially pathogenic <i>HYDIN</i> variants (c.5416C > T and c.3786-1G > T), but clinical validation was hindered due to the pseudogene overlap. Using clinical long-read genome sequencing (lrGS), we confirmed the presence of both <i>HYDIN</i> pathogenic variants and a <i>trans</i> configuration, establishing the molecular diagnosis for this patient. This case highlights the promise of lrGS in diagnosing <i>HYDIN</i>-related PCD and demonstrates that offering lrGS to PCD patients, especially those with suspected <i>HYDIN</i> variants, could enhance diagnostics, disease management, and genetic counseling.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"5109434"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-11-18eCollection Date: 2025-01-01DOI: 10.1155/crig/6993134
Rebeca Méndez-Veras, Allan Urbizo, Julio Cabrera, Suzette Boburg
{"title":"Kufor-Rakeb Syndrome in a Guatemalan Patient With an <i>ATP13A2</i> Gene Pathogenic Variant: A Case Report.","authors":"Rebeca Méndez-Veras, Allan Urbizo, Julio Cabrera, Suzette Boburg","doi":"10.1155/crig/6993134","DOIUrl":"https://doi.org/10.1155/crig/6993134","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a neurodegenerative condition characterized by progressive loss of dopaminergic neurons and by heterogeneous etiologies and clinical manifestations. Juvenile-onset forms are rare and can be caused by biallelic mutations in several genes. Kufor-Rakeb syndrome (KRS) is an autosomal-recessive form of early-onset parkinsonism caused by pathogenic variants in the <i>ATP13A2</i> (<i>PARK9</i>) gene. This P5B-ATPase dysfunction impairs lysosomal processing, leading to the accumulation of <i>α</i>-synuclein. Here, we present the first documented Guatemalan case of KRS, a young woman with progressive motor and cognitive decline. Genetic testing identified a homozygous pathogenic variant in <i>ATP13A2</i>. This report underscores the importance of recognizing KRS in diverse populations and of using gene-based testing to guide diagnosis, counseling, and multidisciplinary supportive care.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"6993134"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-11-09eCollection Date: 2025-01-01DOI: 10.1155/crig/6578711
Kara Rogen, Lisa Boardman, Megan Bird
{"title":"Identification of a Mosaic <i>BMPR1A</i> Pathogenic Variant in Juvenile Polyposis Syndrome: A Case Study and Its Impact on Cancer Screening.","authors":"Kara Rogen, Lisa Boardman, Megan Bird","doi":"10.1155/crig/6578711","DOIUrl":"10.1155/crig/6578711","url":null,"abstract":"<p><p>Juvenile polyposis syndrome (JPS) (MIM: 174900) is a rare genetic disorder characterized by multiple benign, hamartomatous polyps, and an increased risk for colorectal and gastric cancer. It is caused by pathogenic variants in <i>SMAD4</i> and <i>BMPR1A</i>. We present the findings of a mosaic <i>BMPR1A</i> pathogenic variant in a 57-year-old patient with newly diagnosed colon cancer and a history of polyps, which were later discovered to be JPS polyps. The variant was first identified in a blood sample at approximately 15% allele frequency. Subsequent genetic testing performed on gDNA from cultured fibroblasts found this variant to be present at very low levels (< 10%). The finding of this <i>BMPR1A</i> variant in two sample types, as well as the history of JPS polyps, supports a diagnosis of JPS due to a mosaic <i>BMPR1A</i> pathogenic variant. This diagnosis affects cancer screening recommendations for our patient and his relatives. Our case highlights the need for recognition and workup of potentially mosaic cases and for universal germline genetic testing for patients with colorectal cancer.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"6578711"},"PeriodicalIF":0.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Identification of a Rare Variant in the <i>SRD5A2</i> Gene in Siblings With 46,XY Disorders of Sexual Development.","authors":"Leena Rawal, Deepak Panwar, Ravinder Kumar, Gaurav Sharma, Sumit Jangra, Reena Nakra, Vandana Lal, Vamshi Krishna Thamtam","doi":"10.1155/crig/5546459","DOIUrl":"10.1155/crig/5546459","url":null,"abstract":"<p><p>The <i>SRD5A2</i> gene encodes the steroid 5α-reductase-2 isozyme, which converts testosterone to dihydrotestosterone and plays a key role in sexual development and androgen physiology. Deficiency of this enzyme leads to an autosomal recessive sex-linked disorder associated with ambiguous genitalia and hypovirilization/complete feminization of external genitalia in individuals with a 46,XY karyotype. The present study emphasizes the indispensable role of molecular genetic testing in siblings (Probands 1 and 2) presented with disorders of sexual development (DSD). The biochemical, cytogenetics, and molecular testing, encompassing hormonal testing, chromosomal analysis, fluorescence in situ hybridization (FISH), and whole exome sequencing (WES), were carried out at our National Reference Laboratory. In addition, Sanger sequencing confirmed the identified variant, and bioinformatics tools were used to assess its impact on protein structure and stability, thereby assessing its pathogenic potential. The biochemical profile revealed highly elevated testosterone/dihydrotestosterone in Probands 1 and 2 as 45.4 and 43.2, respectively (biological reference range < 10). The cytogenetic analysis confirmed a 46,XY karyotype, and FISH validated the presence of the <i>SRY</i> gene. WES identified a pathogenic homozygous variant, c.737G > A(p.Arg246Gln) in the <i>SRD5A2</i> gene. Protein structure predictions and stability analyses indicated the variant's damaging effects. This study supports diagnosis through comprehensive molecular testing and highlights the significance of genetic insights in managing 46,XY DSD. This case highlights phenotypic variability in siblings with the same homozygous <i>SRD5A2</i> variant from a nonconsanguineous Indian family, underscoring the need for early genetic workup and multidisciplinary evaluation in 46,XY DSD.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"5546459"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-10-27eCollection Date: 2025-01-01DOI: 10.1155/crig/8822406
Nicole Nakousi C, Catalina Nakousi M, Gabriela Perez C
{"title":"Novel <i>SIAH1</i> Frameshift Variant in a Chilean Patient With Buratti-Harel Syndrome.","authors":"Nicole Nakousi C, Catalina Nakousi M, Gabriela Perez C","doi":"10.1155/crig/8822406","DOIUrl":"10.1155/crig/8822406","url":null,"abstract":"<p><p>Buratti-Harel syndrome (BURHAS) is a rare genetic condition caused by heterozygous pathogenic variants of the <i>SIAH1</i> gene, with only five unrelated cases included in a single report in 2019. BURHAS is characterized mainly by neurodevelopmental delay, infantile hypotonia, and dysmorphic features. We report the case of a 9-year-old Chilean female that matches this phenotype, with a heterozygous, <i>de novo</i> frameshift variant of the <i>SIAH1</i> gene.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"8822406"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12582652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Case Reports in GeneticsPub Date : 2025-10-20eCollection Date: 2025-01-01DOI: 10.1155/crig/1882021
Laura Keehan, Jennefer N Carter, Elijah Kravets, Matthew T Wheeler, Jonathan A Bernstein, Ricardo A Maselli, Jacinda B Sampson, Suha Bachir
{"title":"<i>RAPSN</i>-Associated Congenital Myasthenic Syndrome due to Biallelic Single Nucleotide Variants at the Same Position.","authors":"Laura Keehan, Jennefer N Carter, Elijah Kravets, Matthew T Wheeler, Jonathan A Bernstein, Ricardo A Maselli, Jacinda B Sampson, Suha Bachir","doi":"10.1155/crig/1882021","DOIUrl":"10.1155/crig/1882021","url":null,"abstract":"<p><p>Biallelic pathogenic variants in <i>RAPSN</i> cause a form of congenital myasthenic syndrome (CMS), which is typically characterized by fatiguable muscle weakness, hypotonia, and feeding difficulties that present in the neonatal period or early childhood. <i>RAPSN</i>-associated CMS can be treated with acetylcholinesterase inhibitors. Here, we present a 4-year-old male with a history of neonatal respiratory distress, hypotonia, and muscle weakness exacerbated by illness who underwent trio genome sequencing and was found to have biallelic single nucleotide variants at the same position in <i>RAPSN</i>, encoding NM_005055.5:c.264C > A p.(N88K) and NM_005055.5:c.264C > G p.(N88K). The paternally inherited c.264C > G variant has not been previously reported. Interestingly, only the maternally inherited c.264C > A variant was reported on the patient's prior clinical exome sequencing, which delayed diagnosis and initiation of treatment for this patient. This case highlights the complexity of identifying multiallelic variants during exome and genome sequencing analysis. Additionally, this case is the first report of facial malformations in a patient with <i>RAPSN</i>-associated CMS due to variants outside of the promoter region. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT02450851.</p>","PeriodicalId":30325,"journal":{"name":"Case Reports in Genetics","volume":"2025 ","pages":"1882021"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12558694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}