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A new sporadic case of early-onset Loeys-Dietz syndrome due to the recurrent mutation p.R528C in the TGFBR2 gene substantiates interindividual clinical variability


Jamsheer, A; Henggeler, C; Wierzba, J; Loeys, B; De Paepe, A; Stheneur, C H; Badziag, B; Matuszewska, K; Mátyás, G; Latos-Bielenska, A (2009). A new sporadic case of early-onset Loeys-Dietz syndrome due to the recurrent mutation p.R528C in the TGFBR2 gene substantiates interindividual clinical variability. Journal of Applied Genetics, 50(4):405-410.

Abstract

We report on a 2-year-old Polish girl with typical manifestations of Loeys-Dietz syndrome (LDS), a rare genetic condition belonging to the group of marfanoid-habitus disorders. The characteristic LDS symptoms observed in the presented girl included craniofacial dysmorphism (craniosynostosis, cleft palate, hypertelorism), arachnodactyly, camptodactyly, scoliosis, joint laxity, talipes equinovarus, translucent and hyperelastic skin, and umbilical hernia. Mild dilatation of the ascending aorta and tortuous course of the left internal carotid artery were recognized during her second year of life. Molecular genetic testing revealed a heterozygous missense mutation (c.1582C>T, p.R528C) in the transforming growth factor beta receptor II gene (TGFBR2). This mutation has been previously associated with LDS in five unrelated cases, and was never reported in the patients with other marfanoid-habitus disorders. Comparison of the phenotypes of our patient and these five individuals with c.1582C>T showed that only the hallmark triad of the syndrome consisting of hypertelorism, aortic root dilatation/aneurysm, and cleft palate or bifid uvula was present in all six cases. Interestingly, none of the five individuals who underwent psychological evaluation showed developmental delay. The pattern of all other LDS features showed interindividual variability. Our data support the recently reported observation that symptoms of LDS can develop at very young age, making early diagnosis and management essential for these patients. This is the first report on the Polish infant with typical LDS symptoms caused by a TGFBR2 mutation.

We report on a 2-year-old Polish girl with typical manifestations of Loeys-Dietz syndrome (LDS), a rare genetic condition belonging to the group of marfanoid-habitus disorders. The characteristic LDS symptoms observed in the presented girl included craniofacial dysmorphism (craniosynostosis, cleft palate, hypertelorism), arachnodactyly, camptodactyly, scoliosis, joint laxity, talipes equinovarus, translucent and hyperelastic skin, and umbilical hernia. Mild dilatation of the ascending aorta and tortuous course of the left internal carotid artery were recognized during her second year of life. Molecular genetic testing revealed a heterozygous missense mutation (c.1582C>T, p.R528C) in the transforming growth factor beta receptor II gene (TGFBR2). This mutation has been previously associated with LDS in five unrelated cases, and was never reported in the patients with other marfanoid-habitus disorders. Comparison of the phenotypes of our patient and these five individuals with c.1582C>T showed that only the hallmark triad of the syndrome consisting of hypertelorism, aortic root dilatation/aneurysm, and cleft palate or bifid uvula was present in all six cases. Interestingly, none of the five individuals who underwent psychological evaluation showed developmental delay. The pattern of all other LDS features showed interindividual variability. Our data support the recently reported observation that symptoms of LDS can develop at very young age, making early diagnosis and management essential for these patients. This is the first report on the Polish infant with typical LDS symptoms caused by a TGFBR2 mutation.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Medical Molecular Genetics
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2009
Deposited On:15 Dec 2009 14:19
Last Modified:05 Apr 2016 13:15
Publisher:Polska Akademia Nauk
ISSN:1234-1983
Publisher DOI:10.1007/BF03195701
Permanent URL: http://doi.org/10.5167/uzh-18933

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