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Deletion of ERF and CIC causes abnormal skull morphology and global developmental delay
Ist Teil von
Cold Spring Harbor molecular case studies, 2021-06, Vol.7 (3), p.a005991
Ort / Verlag
United States: Cold Spring Harbor Laboratory Press
Erscheinungsjahr
2021
Quelle
MEDLINE
Beschreibungen/Notizen
The ETS2 repressor factor (ERF) is a transcription factor in the RAS-MEK-ERK signal transduction cascade that regulates cell proliferation and differentiation, and pathogenic sequence variants in the
gene cause variable craniosynostosis inherited in an autosomal dominant pattern. The reported
variants are largely loss-of-function, implying haploinsufficiency as a primary disease mechanism; however,
gene deletions have not been reported previously. Here we describe three probands with macrocephaly, craniofacial dysmorphology, and global developmental delay. Clinical genetic testing for fragile X and other relevant sequencing panels were negative; however, chromosomal microarray identified heterozygous deletions (63.7-583.2 kb) on Chromosome 19q13.2 in each proband that together included five genes associated with Mendelian diseases (
,
,
,
, and
). Parental testing indicated that the aberrations were apparently de novo in two of the probands and were inherited in the one proband with the smallest deletion. Deletion of
is consistent with the reported loss-of-function
variants, prompting clinical copy-number-variant classifications of likely pathogenic. Moreover, the recent characterization of heterozygous loss-of-function
sequence variants as a cause of intellectual disability and neurodevelopmental disorders inherited in an autosomal dominant pattern is also consistent with the developmental delays and intellectual disabilities identified among the two probands with
deletions. Taken together, this case series adds to the previously reported patients with
and/or
sequence variants and supports haploinsufficiency of both genes as a mechanism for a variable syndromic cranial phenotype with developmental delays and intellectual disability inherited in an autosomal dominant pattern.