{"title":"Abnormal PAR1/2 Number Can Influence Effector T Cell Subsets in Turner Syndrome.","authors":"Ai Miyakoshi, Sumiko Sueyoshi, Akifumi Ijuin, Haru Hamada, Mayuko Nishi, Shiori Tochihara, Marina Saito, Hiroe Ueno, Michi Kasai, Shin Saito, Ryoko Asano, Taichi Mizushima, Etsuko Miyagi, Mariko Murase, Miki Tanoshima, Hideya Sakakibara, Tomonari Hayama","doi":"10.1159/000546378","DOIUrl":"10.1159/000546378","url":null,"abstract":"<p><strong>Introduction: </strong>Turner syndrome is a complicated gonadal insufficiency, infertility, and endocrine disease caused by the partial to complete loss of one X chromosome. Women with Turner syndrome have been reported to show altered effector T-cell subgroups; however, the relationship between T-cell subgroups and chromosome type remains unknown.</p><p><strong>Methods: </strong>In this study, we investigated immune abnormalities and karyotypes of Turner syndrome. Using flowcytometry, we examined the T-cell subsets of 20 women with Turner syndrome and 23 women serving as controls (without recurrent pregnancy loss), between July 2021 and June 2022. Background data of the women with Turner syndrome were also collected.</p><p><strong>Results: </strong>Significantly lower levels of helper T-cells 1 and 2 were observed in women with Turner syndrome than in the control group (4.5 ± 2.88 vs. 8.54 ± 4.45, <i>p</i> < 0.05, 0.56 ± 0.38 vs. 0.97 ± 0.48, <i>p</i> < 0.05, respectively). With respect to karyotypes, deletion of a specific region, pseudoautosomal region 2, which typically escapes X-inactivation, might influence regulatory T cells (Treg) levels as copy number of PAR2 and Treg rate were positively correlated (<i>r</i> = 0.76).</p><p><strong>Conclusion: </strong>Individuals with Turner syndrome showed an altered T-cell subset, which might be caused by the deletion of a specific part of the X chromosome, pseudoautosomal region 2. This finding suggests that women with Turner syndrome in a specific karyotype show altered T-cell subsets, and more cases are needed to determine whether these T-cell changes could influence pregnancy outcomes.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":" ","pages":"1-11"},"PeriodicalIF":0.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A New Family with X-Linked Intellectual Disability 90: A Case Report of a <i>Novel DLG3</i> Variant and Literature Review.","authors":"Ceren Alavanda, Kısmet Çıkı","doi":"10.1159/000546429","DOIUrl":"https://doi.org/10.1159/000546429","url":null,"abstract":"<p><strong>Introduction: </strong>X-linked intellectual disability (XLID) is a highly heterogeneous disease. Apart from Fragile X, other diseases that cause XLID are quite rare. The <i>DLG3</i> gene variants cause XLID90.</p><p><strong>Case presentation: </strong>This study presents 2 patients diagnosed with XLID90 after identifying a <i>novel</i> variant in the <i>DLG3</i> gene through whole exome sequencing analysis. Both patients had autism spectrum disorder, intellectual disability, and dysmorphism. Additionally, an arachnoid cyst, which has not been previously reported in XLID90, was also detected in the patients. XLID90 has neither specific clinical findings nor dysmorphic features. Therefore, a detailed literature review is essential for clearly elucidating the phenotype. Here, one hundred and two XLID90 cases from 18 publications reporting pathogenic variants in the <i>DLG3</i> gene were reviewed to investigate the detailed clinical findings among these patients. The literature review has shown that ID is more frequently observed in patients with truncating variants, while seizures are more commonly seen in patients with non-truncating variants.</p><p><strong>Conclusion: </strong>This study will provide homogeneous healthcare to patients and allow for appropriate genetic counseling.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serap Ketenci-İşlek, Gizem Ürel-Demir, Gülen Eda Utine, Pelin Özlem Şimşek-Kiper
{"title":"First Report of a Novel <i>ZNF462</i> Variant Linked to Weiss-Kruszka Syndrome and Congenital Diaphragmatic Hernia: Insights into Potential Additional Malformations.","authors":"Serap Ketenci-İşlek, Gizem Ürel-Demir, Gülen Eda Utine, Pelin Özlem Şimşek-Kiper","doi":"10.1159/000546167","DOIUrl":"10.1159/000546167","url":null,"abstract":"<p><strong>Introduction: </strong>Weiss-Kruszka syndrome is a rare, autosomal dominant neurodevelopmental disorder caused by pathogenic variants in the <i>ZNF462</i>, located at chromosome 9p31.2. Clinically, it is characterized by craniofacial dysmorphism, global developmental delay, intellectual disability, short stature, congenital anomalies of the heart and brain, and feeding difficulties. The phenotypic spectrum is notably heterogeneous, with variable expressivity and occasional incomplete penetrance.</p><p><strong>Case presentation: </strong>Herein, we report a novel de novo heterozygous frameshift variant in <i>ZNF462</i>, designated c.2924del; p.(Gln975ArgfsTer3) (NM_021224.6), identified in a pediatric patient.</p><p><strong>Conclusion: </strong>Importantly, our patient presented with a congenital diaphragmatic hernia - an anomaly not previously described in association with Weiss-Kruszka syndrome. To date, 48 cases have been reported in the literature. Our findings further broaden the phenotypic spectrum linked to <i>ZNF462</i> variants and emphasize the need for continued clinical and molecular characterization. Through the detailed documentation of this unique case, we aimed to enhance the understanding of the clinical variability and potential comorbidities associated with this emerging syndrome.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing Genetic Insight: Chromosomal Microarray Enhances Understanding of Genetics in Rubinstein-Taybi Syndrome.","authors":"Dilsu Dicle Erkan, Merve Soğukpınar, Gizem Ürel Demir, Gülen Eda Utine, Pelin Özlem Şimşek-Kiper","doi":"10.1159/000541941","DOIUrl":"10.1159/000541941","url":null,"abstract":"<p><strong>Introduction: </strong>Rubinstein-Taybi syndrome (RSTS) is characterized by distinctive craniofacial features, growth deficiencies, and broad thumbs and halluces. Most diagnoses are made through sequence analysis of the <i>CREBBP</i> or <i>EP300</i> genes. Here we focused on two cases diagnosed through chromosomal microarray analysis (CMA), highlighting the significance of genetic variations in RSTS.</p><p><strong>Case presentation: </strong>After detailed clinical examinations and genetic evaluations of 2 patients with suspected RSTS, CMA was conducted to identify copy number variations. CMA revealed a 128-kb deletion in the <i>CREBBP</i> gene in case 1 presenting with dysmorphic features and growth delays. Case 2, a 14-month-old girl with global developmental delay and similar dysmorphic features, was found to have a 1,467-kb deletion encompassing part of the <i>EP300</i> gene.</p><p><strong>Conclusion: </strong>Our study underscores the importance of CMA as a critical diagnostic tool for RSTS, particularly in cases where sequence analysis fails to identify pathogenic variants. The identification of significant deletions in the <i>CREBBP</i> and <i>EP300</i> genes through CMA not only confirms the diagnosis of RSTS but also expands our understanding of the genetic complexity of the syndrome. Since CMA is already included as part of the diagnostic evaluation for RSTS, these findings further emphasize its value in ensuring accurate diagnosis and improving the management of this rare condition.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":"16 3","pages":"283-290"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdulkerim Kolkıran, Tuğba Daşar, Ahmet Kablan, Pelin Özlem Şimşek-Kiper
{"title":"Kniest Dysplasia without Ocular and Auditory Abnormalities in a Boy of 12 Months.","authors":"Abdulkerim Kolkıran, Tuğba Daşar, Ahmet Kablan, Pelin Özlem Şimşek-Kiper","doi":"10.1159/000541135","DOIUrl":"10.1159/000541135","url":null,"abstract":"<p><strong>Introduction: </strong>Kniest dysplasia is a rare skeletal disorder, characterized by mild dysmorphic features, cleft palate, short stature, short limbs, prominent joints, restricted joint mobility, hearing impairment, and ocular manifestations such as high-degree myopia, retinal detachment, and cataract. Typical radiological findings include platyspondyly, coronal clefts, and dumbbell-shaped long tubular bones.</p><p><strong>Case presentation: </strong>Herein, we report on an 8-month-old boy who was referred to the pediatric genetic department due to narrow thorax and short extremities. He had mild dysmorphic features, cleft palate, narrow thorax, short extremities, and short stature. On radiographies, platyspondyly, hemivertebra, and dumbbell-shaped long tubular bones were detected. Clinical and radiological findings were consistent with Kniest dysplasia. Clinical exome sequencing was performed and revealed a heterozygous, pathogenic c.905C>T (p.Ala302Val) variant in the <i>COL2A1</i> gene, confirming the initial clinical diagnosis.</p><p><strong>Discussion: </strong>Kniest dysplasia is a very rare skeletal dysplasia, and an accurate clinical diagnosis is important to provide the best possible follow-up.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":"16 3","pages":"247-251"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiara Minotti, Ludovico Graziani, Alessia Micalizzi, Maria Lisa Dentici, Rossella Capolino, Lorenzo Sinibaldi, Valentina Lanari, Bruno Dallapiccola, Giuseppe Novelli, Antonio Novelli, Maria Cristina Digilio
{"title":"Clinical Variability of Shashi-Pena Syndrome: A Novel <i>ASXL2</i> Variant Associated with Overgrowth and Minor Neurodevelopmental Features.","authors":"Chiara Minotti, Ludovico Graziani, Alessia Micalizzi, Maria Lisa Dentici, Rossella Capolino, Lorenzo Sinibaldi, Valentina Lanari, Bruno Dallapiccola, Giuseppe Novelli, Antonio Novelli, Maria Cristina Digilio","doi":"10.1159/000541070","DOIUrl":"10.1159/000541070","url":null,"abstract":"<p><strong>Introduction: </strong>Shashi-Pena syndrome (SHAPNS) is a rare congenital disorder characterized by macrocephaly, delayed psychomotor development with intellectual disability, hypotonia, seizures, episodic hypoglycemia, distinct facial features, and glabellar nevus flammeus, caused by heterozygous variants of the <i>ASXL2</i> gene.</p><p><strong>Case presentation: </strong>We report on a 15-year-old patient in care at our hospital since the age of 4 years presenting with minor neurodevelopmental problems, marked postnatal overgrowth without advanced bone age, and dental anomalies.</p><p><strong>Conclusion: </strong>Patients described in the literature with SHAPNS are reported indicating a broad spectrum of clinical manifestations. The present patient manifests an atypical presentation of SHAPNS due to a novel heterozygous <i>ASXL2</i> variant. This study supports the inclusion of SHAPNS in overgrowth disorders with macrocephaly, suggesting the analysis of the <i>ASXL2</i> gene even in suspected subjects with normal bone age and confirms dental anomalies as a clinical feature of this syndrome. SHAPNS could be inferred even in the absence of developmental delay or epilepsy.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":"16 3","pages":"252-258"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mertcan Tan, Musa Turgut, Özmert Muhammed Ali Özdemir, Kadri Karaer
{"title":"Presentation of Pallister-Hall-Like Syndrome in a Girl with a Homozygous Rare Variant in the <i>SMO</i> Gene.","authors":"Mertcan Tan, Musa Turgut, Özmert Muhammed Ali Özdemir, Kadri Karaer","doi":"10.1159/000541401","DOIUrl":"10.1159/000541401","url":null,"abstract":"<p><strong>Introduction: </strong>Pallister-Hall-Like Syndrome (PHLS) (OMIM #241800), a rare ciliopathy associated with defects in the Sonic Hedgehog pathway, is characterized by postaxial polydactyly, hypothalamic hamartoma, cardiac and skeletal anomalies, and craniofacial dysmorphisms.</p><p><strong>Case report: </strong>This report describes a 3-day-old girl from a consanguineous family diagnosed with bilateral postaxial polydactyly and facial dysmorphism. Genetic analysis revealed a homozygous pathogenic c.1726 C>T; p.Arg576Trp variant in the <i>SMO</i> gene.</p><p><strong>Conclusion: </strong>Consanguineous marriage causes predisposition to ultra-rare conditions. There have been eleven documented cases of this ultra-rare syndrome. To our knowledge, this is the first reported case in Turkiye, enriching our clinical understanding of PHLS.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":"16 3","pages":"259-263"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome Caused by Truncating Mutations in the <i>Prg4</i> Gene: Case Series and Literature Review.","authors":"Hatice Ağır, İsmihan Sunar, Mehmet Burak Mutlu","doi":"10.1159/000542596","DOIUrl":"10.1159/000542596","url":null,"abstract":"<p><strong>Introduction: </strong>Camptodactyly-arthropathy-coxa vara-pericarditis (CACP) syndrome is an autosomal recessive condition characterized by early-onset camptodactyly, noninflammatory arthropathy, coxa vara deformity, and, rarely, pericardial effusion. The disease gene has been assigned to human chromosome regions 1q25-q31, and truncating mutations have been identified in the <i>proteoglycan</i>-<i>4</i> (<i>PRG4</i>) gene formerly known as megakaryocyte stimulating factor gene.</p><p><strong>Methods: </strong>A literature review was performed with the findings in patients in terms of CACP syndrome. Also, whole-exome sequencing was performed for all cases. Segregation analyses of the detected variants were performed according to the possibilities.</p><p><strong>Results: </strong>We present 3 Turkish patients with CACP syndrome mimicking juvenile idiopathic arthritis (JIA). All patients were exposed to biologic therapy due to recalcitrant JIA. We have detected two pathogenic PRG4 variants. Case 3 had a novel pathogenic PRG4 variant not reported for the CACP syndrome so far. These two variants cause premature truncation of the protein. A deletion was detected in case 1 in the homozygous state in the <i>PRG4</i> gene (NM_005807.6: c.3848del, p.Gly1283GlufsTer6, chr1-186281360-G-). A previously described deletion was detected in case 2 and case 3 in the homozygous state in the <i>PRG4</i> gene (NM_005807.6: c.1910_1911delCT, p.Pro637ArgfsTer9, chr1-186276761-CT).</p><p><strong>Conclusion: </strong>In the current study, we report three pathogenic PRG4 variants including a novel mutation. We consider that a detailed anamnesis, including kinship and meticulous physical examination of camptodactyly in the absence of inflammatory response, may reveal CACP syndrome masquerading as JIA. The <i>PRG4</i> gene analysis presents the early diagnosis for patients and prenatal counseling and preimplantation genetic diagnosis for carrier families.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":"16 3","pages":"223-234"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rumeysa Atasay, Leyla Nur Yilmaz, Ayten Gulec, Mehmet Canpolat, Huseyin Per, Fatih Kardas, Bilge Ozsait Selcuk, Birsen Karaman, Aslihan Kiraz, Munis Dundar
{"title":"Blended Phenotypes of Sexual Development Disorder and Coenzyme Q10 Deficiency, Together with a Sibling with Homozygous Variants in the <i>AHI1</i> Gene.","authors":"Rumeysa Atasay, Leyla Nur Yilmaz, Ayten Gulec, Mehmet Canpolat, Huseyin Per, Fatih Kardas, Bilge Ozsait Selcuk, Birsen Karaman, Aslihan Kiraz, Munis Dundar","doi":"10.1159/000541717","DOIUrl":"10.1159/000541717","url":null,"abstract":"<p><strong>Introduction: </strong>In consanguineous marriages, different homozygous variants in a single gene may occur in the same family. This may lead to blended phenotypes. This study presents a family in which different rare mechanisms come together as a result of consanguineous marriage. Primary coenzyme Q10 deficiency is a very rare disease that occurs due to homozygous or compound heterozygous variants in the <i>COQ4</i> gene.</p><p><strong>Case presentation: </strong>A 2-year-old proband with a blended phenotype with sex development disorder and coenzyme Q (CoQ) 10 deficiency has psychomotor retardation, dysmorphic findings, hypotonia, micropenis, and bilateral cryptorchidism. The patient's cytogenetic analysis results were compatible with <i>SRY</i>-positive 46,XX sex reversal disease. In the subsequent whole-exome analysis, a c.437T>G (Phe146Cys) missense homozygous probable pathogenic variant was detected in the 5th exon of the <i>COQ4</i> gene (NM_016035) that explains other clinical findings. The brother of the index was previously deceased due to hydrocephalus and had a nonsense homozygous variant c.1051C>T p.(Arg351*) in the 7th exon of the <i>AHI1</i> gene (NM_001134830).</p><p><strong>Discussion: </strong>Alterations in exons 5-7 of the COQ4 gene manifest early in life, resulting in neonatal fatality and a more pronounced clinical trajectory. Conversely, mutations occurring in exons 1-4 emerge later and exhibit a less severe clinical progression. Interestingly, the c.437T>G variant within exon 5 of the COQ4 gene induces comparatively milder clinical symptoms, deviating from the documented cases in the literature. To our knowledge, there is no other reported case in the literature with a blended phenotype of a sexual development anomaly and primary CoQ10 deficiency.</p>","PeriodicalId":48566,"journal":{"name":"Molecular Syndromology","volume":"16 3","pages":"271-277"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}