De Novo SETD5 Loss-Of-Function Variant As a Cause for Intellectual Disability in a 10-Year Old Boy with an Aberrant Blind Ending Bronchus
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This is a repository copy of De novo SETD5 loss-of-function variant as a cause for intellectual disability in a 10-year old boy with an aberrant blind ending bronchus.. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/124015/ Version: Accepted Version Article: Green, C., Willoughby, J., Study, D.D.D. et al. (1 more author) (2017) De novo SETD5 loss-of-function variant as a cause for intellectual disability in a 10-year old boy with an aberrant blind ending bronchus. American Journal of Medical Genetics Part A, 173 (2). pp. 3165-3171. ISSN 1552-4825 https://doi.org/10.1002/ajmg.a.38461 This is the peer reviewed version of the following article: Green C, Willoughby J, DDD Study. Balasubramanian M. De novo SETD5 loss-of-function variant as a cause for intellectual disability in a 10-year old boy with an aberrant blind ending bronchus. Am J Med Genet Part A. 2017;173A:3165–3171, which has been published in final form at https://doi.org/10.1002/ajmg.a.38461. 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[email protected] https://eprints.whiterose.ac.uk/ American Journal of Medical Genetics: Part A De Novo SETD5 Loss-of-Function Variant as a Cause for Intellectual Disability in a 10-year old boy ith an Aberrant Blind Ending Bronchus For Peer Review Journal: American Journal of Medical Genetics: Part A Manuscript ID 16-1145.R1 Wiley - Manuscript type: Clinical Report Date Submitte by the Author: 11-Apr-2017 Complete List of Authors: (reen, Claire* Sheffiel Chil ren's ,-S .oun ation Trust, Sheffiel Clinical (enetics Willou0hby, Joshua* Sheffiel Chil ren's ,-S .oun ation Trust, Sheffiel Dia0nostic (enetics Ser1ice 2alasubramanian, Meena* Sheffiel Chil ren's ,-S .oun ation Trust, Sheffiel Clinical (enetics Ser1ice* 3p micro eletion, SETD5, intellectual isability, aberrant blin en in0 3eywor s: bronchus, loss of function Search Terms: SETD5, clinical 0enetics, molecular 0enetics, 0enetic counsellin0 John Wiley & Sons, Inc. Page 1 of 19 American Journal of Medical Genetics: Part A Green et al. Page | 1 1 2 3 De Novo SETD5 Loss-of-Function Variant as a Cause for Intellectual Disability 4 5 in a 10-year old boy with an Aberrant Blind Ending Bronchus 6 7 8 9 SETD5 10 hort Title: variant and blind ending bronchus 11 1 2 3 1 12 Green C , Willoughby J , DDD Study , Balasubramanian M 13 14 1Sheffield Clinical Genetics Service, Sheffield Children’s NHS Foundation Trust, UK 15 16 2Sheffield Diagnostic Genetics Service, Sheffield Children’s NHS Foundation Trust, 17 18 For Peer Review 19 UK 20 3 21 DDD Study, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK 22 23 24 25 Correspondence to: 26 27 Dr Meena Balasubramanian 28 29 30 Sheffield Clinical Genetics Service 31 32 Sheffield Children's NHS Foundation Trust 33 34 Sheffield, UK 35 36 Ph: +44 114 2717025 37 38 39 Fax: +44 114 2737467 40 41 E-mail. meena.balasubramanian7nhs.net 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 John Wiley & Sons, Inc. American Journal of Medical Genetics: Part A Page 2 of 19 Green et al. Page | 2 1 2 3 AB TRACT 4 5 Although rare, 3p microdeletion cases have been well described in the clinical 6 7 literature. The clinical phenotype includes; intellectual disability (ID), growth 8 9 10 retardation, facial dysmorphism and cardiac malformations. Advances in 11 12 chromosome microarray (C A) testing narrowed the 3p23 critical region to a 120kb 13 14 region, and recent Whole E,ome Sequencing (WES) studies have suggested that 15 16 the SETD5 gene contributes significantly to the 3p23 phenotype. Loss-of-Function 17 18 SETD5For Peer Review 19 (LoF) variants in are now considered a likely cause of ID. 20 21 We report here a patient with a frameshift LoF variant in e,on 12 of SETD5. 22 23 This patient has features overlapping with other patients described with LoF SETD5 24 25 variants to include; similar facial morphology, feeding difficulties, intellectual 26 27 disability, behavioural abnormalities and leg length discrepancy. In addition, he 28 29 30 presents with an aberrant blind ending bronchus. 31 32 This report adds to publications describing intragenic mutations in SETD5 and 33 34 supports the assertion that de novo LoF mutations in SETD5 present with an 35 36 overlapping but distinct phenotype in comparison with 3p23 microdeletion 37 38 39 syndromes. 40 41 42 43 KE( )ORD 44 45 3p microdeletion, 3p23, SETD5, aberrant blind ending bronchus, intellectual 46 47 disability, loss of function. 48 49 50 51 52 53 54 55 56 57 58 59 60 John Wiley & Sons, Inc. Page 3 of 19 American Journal of Medical Genetics: Part A Green et al. Page | 3 1 2 3 I,TROD-CTIO, 4 5 Intellectual Disability (ID) has a worldwide prevalence of appro,imately 1A- 6 7 3A and has become the most frequent reason for referral to paediatric genetic 8 9 10 services B aulik and Darmstadt 2001C. Due to its clinical and genetic heterogeneity, 11 12 the underlying cause for ID remains unclear. However, advances in genetic testing 13 14 have led to the elucidation of several novel genes linked to ID, some of the most 15 16 successful studies have led to the identification of de novo LoF sequence variants in 17 18 For Peer Review 19 candidate genes Bde Ligt and others 2012; Rauch and others; Eissers and others 20 21 2010C. 22 23 Distal deletions of the short arm of chromosome 3 were first characterised by 24 25 cytogenetic and FISH analysis BAqua and others 1993; EerGaal and De Nef 1918C. 26 27 This condition results in a well-described syndrome associated with a clinical 28 29 30 phenotype that includes; intellectual disability, growth retardation, facial 31 32 dysmorphism and cardiac malformations. The severity of the condition varies 33 34 considerably, with the siIe of the deletion apparently correlating with the severity of 35 36 the phenotype BDrumheller and others 1994C. 37 38 39 A report by Kellogg and others B2013C described 0 patients with 3p23.3 40 41 deletions and ID, including 3 previously reported patients by Peltekova and others 42 43 B2012C, Riess and others B2012C and Gunnarsson and Foyn Bruun B2010C. These 44 45 3p23.3 deletion carriers had a narrow range of overlap comprising of 3 genes 46 47 including SETD5. In addition to ID, patients had a common phenotype of depressed 48 49 50 nasal bridge (3/0), low set ears (3/0) and philtrum differences (3/0). Other features 51 52 were more variable including; cardiac malformations (2/0), ptosis (2/0), low birth 53 54 weight/growth retardation (2/0), seiIures (2/0) and microcephaly (2/0) BKellogg and 55 56 others 2013C. 57 58 59 60 John Wiley & Sons, Inc. American Journal of Medical Genetics: Part A Page 4 of 19 Green et al. Page | . 1 2 3 Following this, 1 patients with independent LoF variants in SETD5 from a 4 5 cohort of 994 patients with moderate/severe ID (0.1A of cohort) were reported. 6 7 Features included; speech delay, behavioural problems and autism. Similar 8 9 10 dysmorphology i.e. brachycephaly, prominent forehead, abnormal eyebrows, similar 11 12 nose morphology (long, thin, tubular), eye morphology (long, narrow, upslanting 13 14 palpebral fissures, mild ptosis, unilateral amblyopia, nystagmus, strabismus) and 15 16 large, fleshy, low set ears were reported. Again, more variable features included; 17 18 For Peer Review 19 cardiac malformations (2/1), skeletal abnormalities (leg length discrepancy, scoliosis, 20 21 kyphosis, lordosis) and genitourinary abnormalities (0/1) BGroIeva and others 2010C. 22 23 Kuechler and others B2013C went on to e,pand the phenotype further and 24 25 described 0 unrelated patients with 0 different non-recurrent microdeletions on 26 27 chromosome 3p23 narrowing down the smallest region of overlap to 90kb including 28 29 SETD5 30 only 2 coding genes, and parts of TH) PD3. Included in the cohort were 2 31 32 patients with intragenic SETD5 variants. Patients were compared with those from 33 34 Kellogg and others B2013C, Peltekova and others B2012C, Riess and others B2012C and 35 36 Gunnarsson and Foyn Bruun B2010C. Both microdeletion carriers and intragenic 37 38 SETD5 39 variant carriers had a similar craniofacial phenotype of striking eyebrows 40 41 (full, broad, straight, arched or with synophyrys), a tubular nose with broad nasal 42 43 bridge, bulbous nasal tip, anteverted nares, a long philtrum and downturned corners 44 45 of the mouth. Just like previous reports, features which showed incomplete 46 47 penetrance were cardiac malformations and posta,ial polydactyly. 48 49 50 An emerging behavioural phenotype was supported with almost all the LoF 51 52 mutation carriers and 3 microdeletion carriers showing some behavioural problems.