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Dual diagnosis of achondroplasia and mandibulofacial dysostosis with microcephaly.
Lyulcheva-Bennett, Ekaterina; Kershaw, Christopher; Baker, Eleanor; Gillies, Stuart; McCarthy, Emma; Higgs, Jenny; Canham, Natalie; Hennigan, Dawn; Parks, Chris; Bennett, Daimark.
Afiliación
  • Lyulcheva-Bennett E; Liverpool Centre for Genomic Medicine, Liverpool Women's NHS Foundation Trust, Liverpool, L8 7SS, UK. katya.bennett@lwh.nhs.uk.
  • Kershaw C; Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7ZB, UK. katya.bennett@lwh.nhs.uk.
  • Baker E; North West Genomic Laboratory Hub, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
  • Gillies S; North West Genomic Laboratory Hub, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
  • McCarthy E; North West Genomic Laboratory Hub, Liverpool Women's Hospital, Liverpool, L8 7SS, UK.
  • Higgs J; North West Genomic Laboratory Hub, Liverpool Women's Hospital, Liverpool, L8 7SS, UK.
  • Canham N; Liverpool Centre for Genomic Medicine, Liverpool Women's NHS Foundation Trust, Liverpool, L8 7SS, UK.
  • Hennigan D; Liverpool Centre for Genomic Medicine, Liverpool Women's NHS Foundation Trust, Liverpool, L8 7SS, UK.
  • Parks C; Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, L14 5AB, UK.
  • Bennett D; Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, L14 5AB, UK.
BMC Med Genomics ; 17(1): 226, 2024 Sep 06.
Article en En | MEDLINE | ID: mdl-39243045
ABSTRACT

BACKGROUND:

Achondroplasia and mandibulofacial dysostosis with microcephaly (MFDM) are rare monogenic, dominant disorders, caused by gain-of-function fibroblast growth factor receptor 3 (FGFR3) gene variants and loss-of-function elongation factor Tu GTP binding domain-containing 2 (EFTUD2) gene variants, respectively. The coexistence of two distinct Mendelian disorders in a single individual is uncommon and challenges the traditional paradigm of a single genetic disorder explaining a patient's symptoms, opening new avenues for diagnosis and management. CASE PRESENTATION We present a case of a female patient initially diagnosed with achondroplasia due to a maternally inherited pathogenic FGFR3 variant. She was referred to our genetic department due to her unusually small head circumference and short stature, which were both significantly below the expected range for achondroplasia. Additional features included distinctive facial characteristics, significant speech delay, conductive hearing loss, and epilepsy. Given the complexity of her phenotype, she was recruited to the DDD (Deciphering Developmental Disorders) study and the 100,000 Genomes project for further investigation. Subsequent identification of a complex EFTUD2 intragenic rearrangement confirmed an additional diagnosis of mandibulofacial dysostosis with microcephaly (MFDM).

CONCLUSION:

This report presents the first case of a dual molecular diagnosis of achondroplasia and mandibulofacial dysostosis with microcephaly in the same patient. This case underscores the complexity of genetic diagnoses and the potential for coexistence of multiple genetic syndromes in a single patient. This case expands our understanding of the molecular basis of dual Mendelian disorders and highlights the importance of considering the possibility of dual molecular diagnoses in patients with phenotypic features that are not fully accounted for by their primary diagnosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acondroplasia / Ribonucleoproteína Nuclear Pequeña U5 / Receptor Tipo 3 de Factor de Crecimiento de Fibroblastos / Disostosis Mandibulofacial / Microcefalia Límite: Female / Humans Idioma: En Revista: BMC Med Genomics Asunto de la revista: GENETICA MEDICA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acondroplasia / Ribonucleoproteína Nuclear Pequeña U5 / Receptor Tipo 3 de Factor de Crecimiento de Fibroblastos / Disostosis Mandibulofacial / Microcefalia Límite: Female / Humans Idioma: En Revista: BMC Med Genomics Asunto de la revista: GENETICA MEDICA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido