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2017 ; 18
(1
): 37
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Whole-exome sequencing and digital PCR identified a novel compound heterozygous
mutation in the NPHP1 gene in a case of Joubert syndrome and related disorders
#MMPMID28347285
Koyama S
; Sato H
; Wada M
; Kawanami T
; Emi M
; Kato T
BMC Med Genet
2017[Mar]; 18
(1
): 37
PMID28347285
show ga
BACKGROUND: Joubert syndrome and related disorders (JSRD) is a clinically and
genetically heterogeneous condition with autosomal recessive or X-linked
inheritance, which share a distinctive neuroradiological hallmark, the so-called
molar tooth sign. JSRD is classified into six clinical subtypes based on
associated variable multiorgan involvement. To date, 21 causative genes have been
identified in JSRD, which makes genetic diagnosis difficult. CASE PRESENTATION:
We report here a case of a 28-year-old Japanese woman diagnosed with JS with
oculorenal defects with a novel compound heterozygous mutation
(p.Ser219*/deletion) in the NPHP1 gene. Whole-exome sequencing (WES) of the
patient identified the novel nonsense mutation in an apparently homozygous state.
However, it was absent in her mother and heterozygous in her father. A read
depth-based copy number variation (CNV) detection algorithm using WES data of the
family predicted a large heterozygous deletion mutation in the patient and her
mother, which was validated by digital polymerase chain reaction, indicating that
the patient was compound heterozygous for the paternal nonsense mutation and the
maternal deletion mutation spanning the site of the single nucleotide change.
CONCLUSION: It should be noted that analytical pipelines that focus purely on
sequence information cannot distinguish homozygosity from hemizygosity because of
its inability to detect large deletions. The ability to detect CNVs in addition
to single nucleotide variants and small insertion/deletions makes WES an
attractive diagnostic tool for genetically heterogeneous disorders.