Clinical and mutation data in 12 patients with the clinical diagnosis of Nager syndrome

J. C. Czeschik, C. Voigt, Y. Alanay, B. Albrecht, S. Avci, D. FitzPatrick, D. R. Goudie, U. Hehr, A. J. Hoogeboom, H. Kayserili, P. O. Simsek-Kiper, L. Klein-Hitpass, A. Kuechler, V. Lopez-Gonzalez, M. Martin, S. Rahmann, B. Schweiger, M. Splitt, B. Wollnik, H-J LudeckeM. Zeschnigk, D. Wieczorek

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    Abstract

    Nager syndrome (MIM #154400) is the best-known preaxial acrofacial dysostosis, mainly characterized by craniofacial and preaxial limb anomalies. The craniofacial abnormalities mainly consist of downslanting palpebral fissures, malar hypoplasia, micrognathia, external ear anomalies, and cleft palate. The preaxial limb defects are characterized by radial and thumb hypoplasia or aplasia, duplication of thumbs and proximal radioulnar synostosis. Haploinsufficiency of SF3B4 (MIM *605593), which encodes SAP49, a component of the pre-mRNA spliceosomal complex, has recently been identified as the underlying cause of Nager syndrome. In our study, we performed exome sequencing in two and Sanger sequencing of SF3B4 in further ten previously unreported patients with the clinical diagnosis of Nager syndrome, including one familial case. We identified heterozygous SF3B4 mutations in seven out of twelve patients. Four of the seven mutations were shown to be de novo; in three individuals, DNA of both parents was not available. No familial mutations were discovered. Three mutations were nonsense, three were frameshift mutations and one T > C transition destroyed the translation start signal. In three of four SF3B4 negative families, EFTUD2 was analyzed, but no pathogenic variants were identified. Our results indicate that the SF3B4 gene is mutated in about half of the patients with the clinical diagnosis of Nager syndrome and further support genetic heterogeneity for this condition.

    Original languageEnglish
    Pages (from-to)885-898
    Number of pages14
    JournalHuman Genetics
    Volume132
    Issue number8
    DOIs
    Publication statusPublished - 2013

    Keywords

    • ATRESIA
    • Thumb hypoplasia
    • EFTUD2
    • Exome sequencing
    • ACROFACIAL DYSOSTOSIS
    • Preaxial limb defect
    • SF3B4
    • MANDIBULOFACIAL DYSOSTOSIS
    • Acrofacial dysostosis
    • COMPONENT
    • Radial hypoplasia
    • HAPLOINSUFFICIENCY
    • TREACHER-COLLINS-SYNDROME

    Cite this

    Czeschik, J. C., Voigt, C., Alanay, Y., Albrecht, B., Avci, S., FitzPatrick, D., Goudie, D. R., Hehr, U., Hoogeboom, A. J., Kayserili, H., Simsek-Kiper, P. O., Klein-Hitpass, L., Kuechler, A., Lopez-Gonzalez, V., Martin, M., Rahmann, S., Schweiger, B., Splitt, M., Wollnik, B., ... Wieczorek, D. (2013). Clinical and mutation data in 12 patients with the clinical diagnosis of Nager syndrome. Human Genetics, 132(8), 885-898. https://doi.org/10.1007/s00439-013-1295-2