Exome sequencing identifies a novel TTC37 mutation in the first reported case of Trichohepatoenteric syndrome (THE-S) in South Africa

dc.contributor.authorKinnear, Craigen_ZA
dc.contributor.authorGlanzmann, Brigitteen_ZA
dc.contributor.authorBanda, Ericen_ZA
dc.contributor.authorSchlechter, Nikolaen_ZA
dc.contributor.authorDurrheim, Glendaen_ZA
dc.contributor.authorNeethling, Annikaen_ZA
dc.contributor.authorNel, Etienneen_ZA
dc.contributor.authorSchoeman, Mardelleen_ZA
dc.contributor.authorJohnson, Glynisen_ZA
dc.contributor.authorVan Helden, Paul D.en_ZA
dc.contributor.authorHoal, Eileen Gen_ZA
dc.contributor.authorEsser, Monikaen_ZA
dc.contributor.authorUrban, Michaelen_ZA
dc.contributor.authorMoller, Marloen_ZA
dc.date.accessioned2017-03-15T07:18:59Z
dc.date.available2017-03-15T07:18:59Z
dc.date.issued2017-03-14
dc.date.updated2017-03-15T07:02:28Z
dc.descriptionCITATION: Kinnear, C., et al. 2017. Exome sequencing identifies a novel TTC37 mutation in the first reported case of Trichohepatoenteric syndrome (THE-S) in South Africa. BMC Medical Genetics, 18:26, doi:10.1186/s12881-017-0388-5.
dc.descriptionThe original publication is available at https://bmcmedgenet.biomedcentral.com
dc.description.abstractBackground Trichohepatoenteric syndrome (THE-S) or phenotypic diarrhoea of infancy is a rare autosomal recessive disorder characterised by severe infantile diarrhoea, facial dysmorphism, immunodeficiency and woolly hair. It was first described in 1982 in two infants with intractable diarrhoea, liver cirrhosis and abnormal hair structure on microscopy. We report on two siblings from a consanguineous family of Somali descent who, despite extensive clinical investigation, remained undiagnosed until their demise. The index patient died of fulminant cytomegalovirus pneumonitis at 3 months of age. Methods Whole exome sequencing (WES) was performed on a premortem DNA sample from the index case. Variants in a homozygous recessive state or compound heterozygous state were prioritized as potential candidate variants using TAPER™. Sanger sequencing was done to genotype the parents, unaffected sibling and a deceased sibling for the variant of interest. Results Exome sequencing identified a novel homozygous mutation (c.4507C > T, rs200067423) in TTC37 which was confirmed by Sanger sequencing in the index case. The identification of this mutation led to the diagnosis of THE-S in the proband and the same homozygous variant was confirmed in a male sibling who died 4 years earlier with severe chronic diarrhoea of infancy. The unaffected parents and sister were heterozygous for the identified variant. Conclusions WES permitted definitive genetic diagnosis despite an atypical presentation in the index case and suggests that severe infection, likely secondary to immunodeficiency, may be a presenting feature. In addition definitive molecular diagnosis allows for genetic counseling and future prenatal diagnosis, and demonstrates the value of WES for post-mortem diagnosis of disorders with a non-specific clinical presentation in which a Mendelian cause is suspected.
dc.description.urihttp://scientiamilitaria.journals.ac.za/pub/article/view/190
dc.description.versionPublisher's version
dc.format.extent11 pages
dc.identifier.citationKinnear, C., et al. 2017. Exome sequencing identifies a novel TTC37 mutation in the first reported case of Trichohepatoenteric syndrome (THE-S) in South Africa. BMC Medical Genetics, 18:26, doi:10.1186/s12881-017-0388-5
dc.identifier.issn1471-2350 (online)
dc.identifier.otherdoi:10.1186/s12881-017-0388-5
dc.identifier.urihttp://hdl.handle.net/10019.1/100674
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectTrichohepatoenteric syndrome -- Genetic aspectsen_ZA
dc.subjectWhole exome sequencingen_ZA
dc.subjectExomesen_ZA
dc.subjectDiarrhea, infantileen_ZA
dc.subjectMutation (Biology)en_ZA
dc.titleExome sequencing identifies a novel TTC37 mutation in the first reported case of Trichohepatoenteric syndrome (THE-S) in South Africa
dc.typeArticle
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