Abstract
Xq28 duplications encompassing MECP2 have been described in male patients with a severe neurodevelopmental disorder associated with hypotonia and spasticity, severe learning disability and recurrent pneumonia. We identified an Xq28 duplication in three families where several male patients had presented with intestinal pseudo-obstruction or bladder distension. The affected boys had similar dysmorphic facial appearances. Subsequently, we ascertained seven further families where the proband presented with similar features. We demonstrated duplications of the Xq28 region in five of these additional families. In addition to MECP2, these duplications encompassed several other genes already known to be associated with diseases including SLC6A8, L1CAM and Filamin A (FLNA). The two remaining families were shown to have intragenic duplications of FLNA only. We discuss which elements of the Xq28 duplication phenotype may be associated with the various genes in the duplication. We propose that duplication of FLNA may contribute to the bowel and bladder phenotype seen in these seven families.
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References
Meins M, Lehmann J, Gerresheim F et al: Submicroscopic duplication in Xq28 causes increased expression of the MECP2 gene in a boy with severe mental retardation and features of Rett syndrome. J Med Genet 2005; 42: e12.
Van Esch H, Bauters M, Ignatius J et al: Duplication of the MECP2 Region is a frequent cause of severe mental retardation and progressive neurological symptoms in males. Am J Hum Genet 2005; 77: 442–453.
Sanlaville D, Prieur M, de Blois M-C et al: Functional disomy of the Xq28 chromosome region. Eur J Hum Genet 2005; 13: 579–585.
Smyk M, Obersztyn E, Nowakowska B et al: Different-sized duplications of Xq28, including MECP2, in three males with mental retardation, absent or delayed speech, and recurrent infections. Am J Med Genet B Neuropsychiatr Genet 2008; 147B: 799–806.
Friez MJ, Jones JR, Clarkson K et al: Recurrent infections, hypotonia, and mental retardation caused by duplication of MECP2 and adjacent region in Xq28. Pediatrics 2006; 118: e1687–e1695.
Lugtenberg D, de Brouwer APM, Kleefstra T et al: Chromosomal copy number changes in patients with non-syndromic X linked mental retardation detected by array CGH. J Med Genet 2006; 43: 362–370.
del Gaudio D, Fang P, Scaglia F et al: Increased MECP2 gene copy number as the result of genomic duplication in neurodevelopmentally delayed males. Genet Med 2006; 8: 784–792.
Lachlan KL, Collinson MN, Sandford ROC, van Zyl B, Jacobs PA, Thomas NS : Functional disomy resulting from duplications of distal Xq in four unrelated patients. Hum Genet 2004; 115: 399–408.
Lammer EJ, Punglia DR, Fuchs AE, Rowe AG, Cotter PD : Inherited duplication of Xq27.2 → qter: phenocopy of infantile Prader–Willi syndrome. Clin Dysmorphol 2001; 10: 141–144.
Novelli A, Bernardini L, Salpietro DC et al: Disomy of distal Xq in males. Am J Med Genet A 2004; 128A: 165–169.
Gargiulo A, Auricchio R, Barone MV et al: Filamin A is mutated in X-linked chronic idiopathic intestinal pseudo-obstruction with central nervous system involvement. Am J Hum Genet 2007; 80: 751–758.
FitzPatrick DR, Strain L, Thomas AE et al: Neurogenic chronic idiopathic intestinal pseudo-obstruction, patent ductus arteriosus, and thrombocytopenia segregating as an X linked recessive disorder. J Med Genet 1997; 34: 666–669.
Schouten JP, McElgunn CJ, Waaijer R, Zwijnenburg D, Diepvens F, Pals G : Relative quantification of 40 nucleic acid sequences by multiplex ligation-dependent probe amplification. Nucleic Acids Res 2002; 30: e57.
Robertson SP : Filamin A: phenotypic diversity. Curr Opin Genet Dev 2005; 15: 301–307.
Fox JW, Lamperti ED, Eksioğlu YZ et al: Mutations in filamin 1 prevent migration of cerebral cortical neurons in human periventricular heterotopia. Neuron 1998; 21: 1315–1325.
Fink JM, Dobyns WB, Guerrini R, Hirsch BA : Identification of a duplication of Xq28 associated with bilateral periventricular nodular heterotopia. Am J Hum Genet 1997; 61: 379–387.
Nagano T, Morikubo S, Sato M : Filamin A and FILIP (Filamin A-Interacting Protein) regulate cell polarity and motility in neocortical subventricular and intermediate zones during radial migration. J Neurosci 2004; 24: 9648–9657.
Sheen VL, Dixon PH, Fox JW et al: Mutations in the X-linked Filamin 1 gene cause periventricular nodular heterotopia in males as well as in females. Hum Mol Genet 2001; 10: 1775–1783.
Hehr U, Hehr A, Uvanik G, Phelan E, Winkler J, Reardon W : A filamin A splice mutation resulting in a syndrome of facial dysmorphism, periventricular nodular heterotopia, and severe constipation reminiscent of cerebro-fronto-facial syndrome. J Med Genet 2006; 43: 541–544.
Pollock I, Holmes SJK, Patton MA, Hamilton PA, Stacey TE : Congenital intestinal pseudo-obstruction associated with a giant platelet disorder. J Med Genet 1991; 28: 495–496.
Harris DJ, Ashcraft KW, Beatty EC, Holder TM, Leonidas JC : Natal teeth, patent ductus arteriosus and intestinal pseudo-obstruction: a lethal syndrome in the newborn. Clin Genet 1976; 9: 479–482.
Auricchio A, Brancolini V, Casari G et al: The locus for a novel syndromic form of neuronal intestinal pseudoobstruction maps to Xq28. Am J Hum Genet 1996; 58: 743–748.
Parrini E, Ramazzotti A, Dobyns WB et al: Periventricular heterotopia: phenotypic heterogeneity and correlation with Filamin A mutations. Brain 2006; 129: 1892–1906.
Unger S, Mainberger A, Spitz C et al: Filamin A mutation is one cause of FG syndrome. Am J Med Genet A 2007; 143A: 1876–1879.
Risheg H, Graham Jr JM, Clark RD et al: A recurrent mutation in MED12 leading to R961W causes Opitz–Kaveggia syndrome. Nat Genet 2007; 39: 451–453.
Acknowledgements
This study was supported in part by Central Manchester and Manchester Children's University Hospitals NHS Trust through funding from North West Development Agency and PRIN 2005, Fondazione Mariani and Fondazione CARIPLO. We are grateful to G Black and R Parveen, University of Manchester, L Gaunt, CMMC, SD Arrigo, Istituto Neurologico, C Besta, Milan, L Garavelli, Ospedale S Maria Nuova Reggio Emilia and S Bernasconi Università degli Studi, Parma, Italy.
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Clayton-Smith, J., Walters, S., Hobson, E. et al. Xq28 duplication presenting with intestinal and bladder dysfunction and a distinctive facial appearance. Eur J Hum Genet 17, 434–443 (2009). https://doi.org/10.1038/ejhg.2008.192
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DOI: https://doi.org/10.1038/ejhg.2008.192
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