Clinical Variability in a Family with Noonan Syndrome with a Homozygous PTPN11 Gene Variant in Two Individuals

INTRODUCTION: Noonan syndrome (NS) is characterized by dysmorphic facial features, short stature, congenital heart defects, and varying levels of developmental delays. It is a genetic, multisystem disorder with autosomal dominant inheritance and is the most common of the RASopathies. In approximately 50% of patients, NS is caused by variants in the Protein Tyrosine Phosphatase Non-Receptor Type 11 (PTPN11) gene. The aim of this study was to evaluate two patients with a previously reported PTPN11 homozygous variant for the first time and seven other kindred members carrying the same heterozygous variant in terms of clinical, biochemical, genetic, and response to treatment. METHODS: Nine patients diagnosed with NS due to the same variants in the PTPN11 gene were included in the study. RESULTS: The median (range) age at diagnosis was 11.5 (6.8-13.9) years and the mean follow-up duration was 4.7 (1-7.6) years. In eight patients (88.9%), short stature was present. The height standard deviation score of the patients on admission was -3.24+-1.15. In six of the patients, growth hormone treatment was initiated. Cardiovascular or bleeding disorders were not detected in any of the patients. Three (33.3%) had hearing loss, two (22.2%) had ocular findings and one (11.1%) had a horseshoe kidney. The mean psychomotor development performance score was 84.03+-17.09 and the verbal score was 82.88+-9.42. Genetic analysis revealed a variant in the PTPN11 gene [c.772G>A; (p.Glu258Lys)] that had been previously described and was detected in all patients. Two patients were homozygous for this variant and short stature was more severe in these two. DISCUSSION AND CONCLUSION: A previously described in PTPN11 affected nine members of the same kindred, two with homozygous inheritance and the remainder being heterozygous. To the best of our knowledge, these are the first homozygous PTPN11 case reports published, coming from two related consanguineous families

Karadeniz ve Akdeniz tsunamileri için model geliştirme ve risk analizi projesi

TÜBİTAK ÇAYDAG15.07.201

Marmara Denizi için Web-CBS tabanlı tsunami baskın haritalarının hazırlanması.

Tsunamis, as the catastrophic disasters, can cause loss of live and property when they come to the shores. Preparation of emergency plans is essential to reduce the damage. Consequently, any initiative in tsunami modeling and inundation mapping is of vital importance for progressing safety surveillance and maintenance. In an effort to achieve a thorough analysis of effect of tsunami, it is critical to estimate the geographical extent of possibly affected area and to predict tsunami impacts. The inundation mapping system also must serve to manage the simulation data in a scalable environment to reach end-users in the time of event. For this purpose, in this study, the generation of a Web based Geographic Information System (GIS) to serve inundation maps through web. The research methodology consists of four main stages: (i) simulating tsunamis based on six different scenarios (ii) processing simulation data through a GIS application; (iii) development of web interfaces and implementation of the developed model for Web-GIS application; (iv) verification of the created model for Marmara Sea Region. The proposed system is expected to be an efficient tool for improving inundation mapping efforts for expected tsunamis in Turkey.M.S. - Master of Scienc

Smith-Lemli-Opitz syndrome: A case report

Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive multiple malformation and intellectual disability syndrome. SLOS is caused by DHCR7 mutations in the gene encoding for the delta 7 steroid reductase enzyme that converts 7-dehydro- cholesterol to cholesterol. An 11-month-old boy was admitted to our clinic for failure to thrive, vomiting and ambiguous genitalia. SLOS was considered in the differential diagnosis due to clinical features and low serum cholesterol levels. Sequencing analysis of the DHCR7 gene showed a homozygous p.R352Q (c.1055 G;gt;A) mutation in the patient. SLOS should be taken into consideration in cases with multiple congenital anomalies, ambiguous genitalia, and mental retardation combined with low cholesterol levels.Smith-Lemli-Opitz sendromu (SLOS), otozomal resesif geçişli nöromotor gerilik ve davranış bozuklukları ile birlikte seyreden bir multipl konjenital malformasyon sendromudur. SLOS’a kolesterol biyosentezinde 7-dehidrokolesterolü (7DHK) kolesterole çeviren delta7-sterolredüktaz enzimini kodlayan DHCR7 genindeki mutasyonlar neden olmaktadır. Onbir aylık erkek olgu kliniğimize beslenememe ve kusmaya bağlı büyüme geriliği ve kuşkulu genitalya yakınmaları ile getirildi. Muayene bulguları ve serum kolesterol düşüklüğü nedeniyle SLOS düşünüldü. DHCR7 gen dizi analizinde her iki allelde (homozigot) p.R352Q (c.1055 G>A) mutasyonu saptandı. Multipl konjenital anomalileri, belirsiz dış genital yapı ve nöromotor geriliği bulunan hastalarda kolesterol düşüklüğü saptanması durumunda SLOS’un ayırıcı tanıda yer almasının uygun olacağı vurgulanmak istenmiştir

Smith-Lemli-Opitz sendromu: Olgu sunumu

Smith-Lemli-Opitz sendromu (SLOS), otozomal resesif geçişli nöromotor gerilik ve davranış bozuklukları ile birlikte seyreden bir multipl konjenital malformasyon sendromudur. SLOS’a kolesterol biyosentezinde 7-dehidrokolesterolü (7DHK) kolesterole çeviren delta7-sterolredüktaz enzimini kodlayan DHCR7 genindeki mutasyonlar neden olmaktadır. Onbir aylık erkek olgu kliniğimize beslenememe ve kusmaya bağlı büyüme geriliği ve kuşkulu genitalya yakınmaları ile getirildi. Muayene bulguları ve serum kolesterol düşüklüğü nedeniyle SLOS düşünüldü. DHCR7 gen dizi analizinde her iki allelde (homozigot) p.R352Q (c.1055 G>A) mutasyonu saptandı. Multipl konjenital anomalileri, belirsiz dış genital yapı ve nöromotor geriliği bulunan hastalarda kolesterol düşüklüğü saptanması durumunda SLOS’un ayırıcı tanıda yer almasının uygun olacağı vurgulanmak istenmiştir.Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive multiple malformation and intellectual disability syndrome. SLOS is caused by DHCR7 mutations in the gene encoding for the delta 7 steroid reductase enzyme that converts 7-dehydro- cholesterol to cholesterol. An 11-month-old boy was admitted to our clinic for failure to thrive, vomiting and ambiguous genitalia. SLOS was considered in the differential diagnosis due to clinical features and low serum cholesterol levels. Sequencing analysis of the DHCR7 gene showed a homozygous p.R352Q (c.1055 G>A) mutation in the patient. SLOS should be taken into consideration in cases with multiple congenital anomalies, ambiguous genitalia, and mental retardation combined with low cholesterol levels

An investigation of the etiology and follow-up findings in 35 children with overgrowth syndromes, including biallelic SUZ12 variant.

Overgrowth-intellectual disability (OGID) syndromes are clinically and genetically heterogeneous group of disorders. The aim of this study was to examine the molecular etiology and long-term follow-up findings of Turkish OGID cohort. Thirty-five children with OGID were included in the study. Single gene sequencing, clinical exome analysis, chromosomal microarray analysis and whole exome sequencing were performed. Five pathogenic copy number variants were detected in the patients; three of them located on chromosome 5q35.2 (encompassing NSD1), others on 9q22.3 and 22q13.31. In 19 of 35 patients; we identified pathogenic variants in OGID genes associated with epigenetic regulation, NSD1 (n = 15), HIST1H1E (n = 1), SETD1B (n = 1), and SUZ12 (n = 2). The pathogenic variants in PIK3CA (n = 2), ABCC9 (n = 1), GPC4 (n = 2), FIBP (n = 1), and TMEM94 (n = 1) which had a role in other growth pathways were detected in seven patients. The diagnostic yield was 31/35(88%). Twelve pathogenic variants were novel. The common facial feature of the patients was prominent forehead. The patients with Sotos syndrome were observed to have milder intellectual disability than patients with other OGID syndromes. In conclusion, this study showed, for the first time, that biallelic variants of SUZ12 caused Imagawa-Matsumoto syndrome, monoallelic variants in SETDIB resulted in OGID. Besides expanded the phenotypes of very rare OGID syndromes caused by FIBP and TMEM94