Clinical, Genetic and Orthopedic Characteristics of Desbuquois Dysplasia
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| 1. | Title | Title of document | Clinical, Genetic and Orthopedic Characteristics of Desbuquois Dysplasia |
| 2. | Creator | Author's name, affiliation, country | Tatyana V. Markova; Research Centre for Medical Genetics; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Vladimir M. Kenis; H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Mechnikov North-Western State Medical University; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Evgeniy V. Melchenko; H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Peter A. Sparber; Research Centre for Medical Genetics; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Marina S. Petukhova; Research Centre for Medical Genetics; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Igor O. Bychkov; Research Centre for Medical Genetics; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Tatyana S. Nagornova; Research Centre for Medical Genetics; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Olga L. Shatokhina; Research Centre for Medical Genetics; Russian Federation |
| 2. | Creator | Author's name, affiliation, country | Elena L. Dadali; Research Centre for Medical Genetics; Russian Federation |
| 3. | Subject | Discipline(s) | |
| 3. | Subject | Keyword(s) | Desbuquois dysplasia; CANT1 gene; XYLT1 gene; exome sequencing; expansion of the GGC repeat |
| 4. | Description | Abstract | Introduction. Desbuquois dysplasia is a rare skeletal dysplasia with an autosomal recessive inheritance, resembling to the group of multiple joint dislocations. The disease is caused by mutations in the CANT1 and XYLT1 genes, the protein products of which are involved in the degradation of proteoglycans, which play an important role in endochondral ossification. The polymorphism of clinical and radiological characteristics and the genetic heterogeneity of Desbuquois dysplasia necessitate the description of the phenotypic characteristics of patients with various types of mutations, which optimize diagnosis. Objective — description of the clinical and radiological characteristics of three Russian patients with Desbuquois dysplasia of types 1 and 2 with remarkable orthopedic manifestation, caused by mutations in the CANT1 and XYLT1 genes. Materials and Methods. Genealogical, clinical, radiographic and genetic data of three unrelated Russian patients aged 2 to 8 years was carried out. Genetic testing was carried out using clinical exome sequencing and methyl-sensitive PCR. Results. Two patients were diagnosed with type 1 disease due to a previously described homozygous mutation in the CANT1 gene: c.898C>T (p.Arg300Cys), and one — type 2 due to heterozygous mutations in the XYLT1 gene. One mutation: c.1651C>T (p.Arg551Cys) was detected during exome sequencing, and the second mutation: expansion of GGC repeats in the promoter region of the gene, revealed by methyl-sensitive PCR of the first exon of the gene. The main clinical signs of the disease were micromelic dwarfism, hypermobility in the joints and specific facial dysmorphisms, radiographic analysis revealed characteristic «monkey wrench» appearance of the proximal femur in all 3 patients, additional ossification center of the second metacarpal, advanced bone age and multiple dislocations in the joints. The patients also had extra-skeletal manifestations (congenital glaucoma, obstructive bronchitis, renal hypoplasia and congenital heart malformations). Conclusion. Genetic heterogeneity and the presence of polymorphism of clinical manifestations make it possible to consider sequencing of the clinical exome as the optimal method for diagnosing Desbuquois dysplasia types 1 and 2. Analysis of the literature and the results of our molecular genetic data indicate the possibility of expansion of the GGC repeat in the XYLT1 gene in patients with clinical manifestations of type 2 Desbuquois dysplasia. |
| 5. | Publisher | Organizing agency, location | Vreden National Medical Research Center of Traumatology and Orthopedics |
| 6. | Contributor | Sponsor(s) |
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| 7. | Date | (DD-MM-YYYY) | 28.10.2021 |
| 8. | Type | Status & genre | Peer-reviewed Article |
| 8. | Type | Type | Research Article |
| 9. | Format | File format | |
| 10. | Identifier | Uniform Resource Identifier | https://journal.rniito.org/jour/article/view/1655 |
| 10. | Identifier | Digital Object Identifier (DOI) | 10.21823/2311-2905-2021-27-3-71-83 |
| 10. | Identifier | Digital Object Identifier (DOI) (PDF (Rus)) | 10.21823/2311-2905-ID-1117 |
| 11. | Source | Title; vol., no. (year) | Traumatology and Orthopedics of Russia; Vol 27, No 3 (2021) |
| 12. | Language | English=en | ru |
| 13. | Relation | Supp. Files |
Fig. 1. Proband 1 — girl, 6 years 5 months of age:a — short stature with multiple deformities of the limbs and spine, deformation of the lower extremities due to bilateral knee dislocation hampers the ability to stand and walk independently; b — feet with adduction of the forefoot, the first toes are short, with characteristic valgus deformity (41KB) doi: 10.21823/2311-2905-ID2840 Fig. 2. X-rays of proband 1:a — AP X-ray of the lower limbs: “monkey wrench” shape of the femoral necks (white arrows); rotational dislocation of the knee — distal femur in the AP view (white circle), proximal tibia — in lateral view (black circle); dislocation of the patella (black arrow);b — AP X-ray of the spine: severe right-side lumbar scoliosis (white arrow);c — X-ray of the upper limb: varus deformity of the proximal humerus (white arrow), radial head subluxation (black arrow);d — AP X-rays of the hands: ulnar deviation secondary to the inclination of the distal radial joint surface (white arrows); short second metacarpals (black arrows); extra-phalanx of the second finger separated from second metacarpal and basal phalanx on the left side (black arrowhead) and fused with the phalanx on the right side (white arrowhead), bifid distal phalanx of the thumb (red arrow) (51KB) doi: 10.21823/2311-2905-ID2842 Fig 3. Proband 2 — boy, 8 years 5 months of age:а — proband 2: disproportionately short stature, multiple deformities of the limbs; dysmorphic facial features (round face, large eyes, flattening of the nasal ridge and midface); pectus carinatum;b — ulnar deviation of the hands; brachy-, campto- and clinodactyly more pronounced in the index fingers (27KB) doi: 10.21823/2311-2905-ID2843 Fig. 4. X-rays of proband 2:а — AP X-ray of the hips: “monkey wrench” type of the proximal femur (white arrows) and elongated minor trochanter (black arrows);b — AP X-ray of the knee joints: rotational dislocation (white arrows) and dislocation of the patella (black arrows);с — AP X-rays of the hands: flattened distal radius epiphyses (white arrows); extra-phalanges of the second digit is fused with the second metacarpal and basal phalanx on the left side (white arrowhead) and separated from the phalanx on the right side (black arrowhead); bifid distal phalanx of the thumb (red arrow) (41KB) doi: 10.21823/2311-2905-ID2844 Fig. 5. Proband 3 — boy, 2 years 8 months of age:а — disproportionately short stature with relatively short limbs, narrow chest, short neck, lumbar hyperlordosis, large head size, rounded face, protruding eyes, depressed nasal ridge, micrognathia;b — AP X-ray of the lower limbs and spine: “monkey wrench” shape of the proximal femur (white arrows), elongated and cone-shaped minor trochanter (black arrows); broad and shortened isthmus of the iliac bone (black arrowheads); mild scoliosis (red arrow);с — AP X-ray of the hands: advanced bone age, short metacarpals, broad phalanges (31KB) doi: 10.21823/2311-2905-ID2845 Fig. 6. Analysis of methylation of exon 1 of XYLT1 gene, visualization of methyl-sensitive PCR products;a — primers specific to methylated exon 1, the presence of a PCR reaction product indicates methylation of this region;b — primers specific to unmethylated exon 1;c — primers to the control methylated locus: 1 — length marker PUC19, 2 — healthy control, 3 — proband, 4 — sister of the proband, 5 — father of the proband, 6 — mother of the proband;d — analysis of allelic imbalance according to variant c.1651C> T, Senger chromatogram of the amplification product of the XYLT1 cDNA region of the proband (12KB) doi: 10.21823/2311-2905-ID2846 |
| 14. | Coverage | Geo-spatial location, chronological period, research sample (gender, age, etc.) | |
| 15. | Rights | Copyright and permissions |
Copyright (c) 2021 Markova T.V., Kenis V.M., Melchenko E.V., Sparber P.A., Petukhova M.S., Bychkov I.O., Nagornova T.S., Shatokhina O.L., Dadali E.L.![]() This work is licensed under a Creative Commons Attribution 4.0 International License. |
