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MAB21L1 loss of function causes a syndromic neurodevelopmental disorder with distinctive cerebellar, ocular, cranio facial and genital features (COFG syndrome)

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SCHOOL OF MEDICINE
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Rad, Abolfazl
Altunoğlu, Umut
Miller, Rebecca
Maroofian, Reza
James, Kiely N.
Çağlayan, Ahmet Okay
Najafi, Maryam
Stanley, Valentina
Boustany, Rose-Mary
Yeşil, Gözde

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Background: Putative nucleotidyltransferase MAB21L1 is a member of an evolutionarily well-conserved family of the male abnormal 21 (MAB21)-like proteins. Little is known about the biochemical function of the protein; however, prior studies have shown essential roles for several aspects of embryonic development including the eye, midbrain, neural tube and reproductive organs. Objective: a homozygous truncating variant in MAB21L1 has recently been described in a male affected by intellectual disability, scrotal agenesis, ophthalmological anomalies, cerebellar hypoplasia and facial dysmorphism. We employed a combination of exome sequencing and homozygosity mapping to identify the underlying genetic cause in subjects with similar phenotypic features descending from five unrelated consanguineous families. Results: we identified four homozygous MAB21L1 loss of function variants (p.Glu281fs∗20, p.Arg287Glufs∗14 p.Tyr280∗ and p.Ser93Serfs∗48) and one missense variant (p.Gln233Pro) in 10 affected individuals from 5 consanguineous families with a distinctive autosomal recessive neurodevelopmental syndrome. Cardinal features of this syndrome include a characteristic facial gestalt, corneal dystrophy, hairy nipples, underdeveloped labioscrotal folds and scrotum/scrotal agenesis as well as cerebellar hypoplasia with ataxia and variable microcephaly. Conclusion: this report defines an ultrarare but clinically recognisable Cerebello-Oculo-Facio-Genital syndrome associated with recessive MAB21L1 variants. Additionally, our findings further support the critical role of MAB21L1 in cerebellum, lens, genitalia and as craniofacial morphogenesis.

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BMJ Publishing Group

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Medicine, Genetics and heredity

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Journal of Medical Genetics

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10.1136/jmedgenet-2018-105623

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