Abstract
Mucolipidosis type II α/β (ML II α/β) and mucolipidosis type III α/β (ML III α/β) have been shown to be caused by an absence or reduced level of uridine diphosphate (UDP)-N-acetylglucosamine-1-phosphotransferase enzyme (EC 2.7.8.17) activity, respectively. Both disorders are caused by mutations in the GNPTAB gene and are inherited in an autosomal recessive manner. Here we report a 2-year-old female patient being diagnosed as a case of ML II α/β due to coarse face, severe developmental delay, multiple dysostosis, noticeable increase of multiple lysosomal enzymes activity in plasma and normal acid mucopolysaccharides in urine. Mutational analysis of the GNPTAB gene has revealed a novel homozygous mutation in the patient (c.3250-2A>G) with both parents being heterozygote. Transcript analyses showed that this novel splice site mutation leads to exon 17 skipping and a frameshift afterwards (p.P1084_R1112del F1113Vfs*1). Consequently, we confirmed the association of this mutation with ML II α/β. Our finding expands the number of reported cases of this rare metabolic disorder and adds to the GNPTAB mutation database.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Encarnacao M, Lacerda L, Costa R, Prata MJ, Coutinho MF, et al. Molecular analysis of the GNPTAB and GNPTG genes in 13 patients with mucolipidosis type II or type III – identification of eight novel mutations. Clin Genet 2009;76:76–84.10.1111/j.1399-0004.2009.01185.xSearch in Google Scholar PubMed
2. Bargal R, Zeigler M, Abu-Libdeh B, Zuri V, Mandel H, et al. When mucolipidosis III meets mucolipidosis II: GNPTA gene mutations in 24 patients. Mol Genet Metab 2006;88:359–63.10.1016/j.ymgme.2006.03.003Search in Google Scholar PubMed
3. Lin MH, Pitukcheewanont P. Mucolipidosis type II (I-cell disease) masquerading as rickets: two case reports and review of literature. J Pediatr Endocrinol Metab 2012;25:191–5.10.1515/jpem-2011-0429Search in Google Scholar PubMed
4. Alegra T, Cury G, Todeschini LA, Schwartz IV. Should neonatal hyperparathyroidism associated with mucolipidosis II/III be treated pharmacologically? J Pediatr Endocrinol Metab 2013;26:1011–3.10.1515/jpem-2012-0356Search in Google Scholar PubMed
5. Velho RV, De Pace R, Klunder S, Sperb-Ludwig F, Lourenco CM, et al. Analyses of disease-related GNPTAB mutations define a novel GlcNAc-1-phosphotransferase interaction domain and an alternative site-1 protease cleavage site. Hum Mol Genet 2015;24:3497–505.10.1093/hmg/ddv100Search in Google Scholar PubMed PubMed Central
6. Kudo M, Brem MS, Canfield WM. Mucolipidosis II (I-cell disease) and mucolipidosis IIIA (classical pseudo-hurler polydystrophy) are caused by mutations in the GlcNAc-phosphotransferase alpha/beta-subunits precursor gene. Am J Hum Genet 2006;78:451–63.10.1086/500849Search in Google Scholar PubMed PubMed Central
7. Yang Y, Wu J, Liu H, Chen X, Wang Y, et al. Two homozygous nonsense mutations of GNPTAB gene in two Chinese families with mucolipidosis II alpha/beta using targeted next-generation sequencing. Genomics 2013;102:169–73.10.1016/j.ygeno.2013.06.001Search in Google Scholar PubMed
8. Ghafouri-Fard S, Abbasi F, Azizi F, Javaheri M, Mehdizadeh M, et al. Hyperostosis-hyperphosphatemia syndrome (HHS): report of two cases with a recurrent mutation and review of the literature. J Pediatr Endocrinol Metab 2015;28:231–5.10.1515/jpem-2014-0178Search in Google Scholar PubMed
©2016 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Original Articles
- Decreased undercarboxylated osteocalcin in children with type 2 diabetes mellitus
- Evaluation of left and right ventricular functions using conventional and tissue Doppler echocardiography in children with type 1 diabetes mellitus
- Prevalence of psychosocial morbidity in children with type 1 diabetes mellitus: a survey from Northern India
- Increased GLP-1 response to oral glucose in pre-pubertal obese children
- Prevalence of idiopathic intracranial hypertension and associated factors in obese children and adolescents
- Idiopathic postprandial hyperinsulinaemic hypoglycaemia
- Feeding, eating and behavioral disturbances in Prader-Willi syndrome and non-syndromal obesity
- Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study
- Ghrelin, insulin-like growth factor I and adipocytokines concentrations in born small for gestational age prepubertal children after the catch-up growth
- Zoledronate for Osteogenesis imperfecta: evaluation of safety profile in children
- Elevated serum adiponectin is related to elevated serum ferritin and interleukin-6 in β-thalassaemia major children
- GCK mutations in Chinese MODY2 patients: a family pedigree report and review of Chinese literature
- Cystinosis in Eastern Turkey
- Microarray analysis of slipped capital femoral epiphysis growth plates
- Case Reports
- Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy: report of three cases from Iran
- Type 1 diabetes and GAD65 limbic encephalitis: a case report of a 10-year-old girl
- A novel splice site mutation in the GNPTAB gene in an Iranian patient with mucolipidosis II α/β
- Parent observed neuro-behavioral and pro-social improvements with oxytocin following surgical resection of craniopharyngioma
- A fatal outcome of complicated severe diabetic ketoacidosis in a 11-year-old girl
Articles in the same Issue
- Frontmatter
- Original Articles
- Decreased undercarboxylated osteocalcin in children with type 2 diabetes mellitus
- Evaluation of left and right ventricular functions using conventional and tissue Doppler echocardiography in children with type 1 diabetes mellitus
- Prevalence of psychosocial morbidity in children with type 1 diabetes mellitus: a survey from Northern India
- Increased GLP-1 response to oral glucose in pre-pubertal obese children
- Prevalence of idiopathic intracranial hypertension and associated factors in obese children and adolescents
- Idiopathic postprandial hyperinsulinaemic hypoglycaemia
- Feeding, eating and behavioral disturbances in Prader-Willi syndrome and non-syndromal obesity
- Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study
- Ghrelin, insulin-like growth factor I and adipocytokines concentrations in born small for gestational age prepubertal children after the catch-up growth
- Zoledronate for Osteogenesis imperfecta: evaluation of safety profile in children
- Elevated serum adiponectin is related to elevated serum ferritin and interleukin-6 in β-thalassaemia major children
- GCK mutations in Chinese MODY2 patients: a family pedigree report and review of Chinese literature
- Cystinosis in Eastern Turkey
- Microarray analysis of slipped capital femoral epiphysis growth plates
- Case Reports
- Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy: report of three cases from Iran
- Type 1 diabetes and GAD65 limbic encephalitis: a case report of a 10-year-old girl
- A novel splice site mutation in the GNPTAB gene in an Iranian patient with mucolipidosis II α/β
- Parent observed neuro-behavioral and pro-social improvements with oxytocin following surgical resection of craniopharyngioma
- A fatal outcome of complicated severe diabetic ketoacidosis in a 11-year-old girl