Abstract

Cockayne syndrome (CS) is a rare autosomal recessive multisystem disorder characterized by impaired neurological and sensory functions, cachectic dwarfism, microcephaly, and photosensitivity. This syndrome shows a variable age of onset and rate of progression, and its phenotypic spectrum include a wide range of severity. Due to the progressive nature of this disorder, diagnosis can be more important when additional signs and symptoms appear gradually and become steadily worse over time. Therefore, mutation analysis of genes involved in CS pathogenesis can be helpful to confirm the suspected clinical diagnosis. Here, we report a novel mutation in ERCC8 gene in a 16-year-old boy who suffers from poor weight gain, short stature, microcephaly, intellectual disability, and photosensitivity. The patient was born to consanguineous family with no previous documented disease in his parents. To identify disease-causing mutation in the patient, whole exome sequencing utilizing next-generation sequencing on an Illumina HiSeq 2000 platform was performed. Results revealed a novel homozygote mutation in ERCC8 gene (NM_000082: exon 11, c.1122G>C) in our patient. Another gene (ERCC6), which is also involved in CS did not have any disease-causing mutations in the proband. The new identified mutation was then confirmed by Sanger sequencing in the proband, his parents, and extended family members, confirming co-segregation with the disease. In addition, different bioinformatics programs which included MutationTaster, I-Mutant v2.0, NNSplice, Combined Annotation Dependent Depletion, The PhastCons, Genomic Evolutationary Rate Profiling conservation score, and T-Coffee Multiple Sequence Alignment predicted the pathogenicity of the mutation. Our study identified a rare novel mutation in ERCC8 gene and help to provide accurate genetic counseling and prenatal diagnosis to minimize new affected individuals in this family.

Highlights

  • Cockayne syndrome (CS), which was first reported by Edward Alfred Cockayne, a British physician, is a rare early-onset, progressive neurological disorder characterized by generalized growth retardation, which manifests as cachectic dwarfism, microcephaly, extreme cutaneous photosensitivity, partial hearing loss, facio-skeletal and/or gait abnormalities, and retinopathy

  • A number of studies have been conducted concerning this disorder, and they have reported that the disease is caused by homozygous or compound heterozygous mutations in either ERCC Excision Repair 6 (ERCC6) gene or the ERCC8 gene [1,2,3,4,5]

  • We report a novel mutation in ERCC8 gene in a 16-year-old boy affected by characteristic abnormalities of CS

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Summary

INTRODUCTION

Cockayne syndrome (CS), which was first reported by Edward Alfred Cockayne, a British physician, is a rare early-onset, progressive neurological disorder characterized by generalized growth retardation, which manifests as cachectic dwarfism, microcephaly, extreme cutaneous photosensitivity, partial hearing loss, facio-skeletal and/or gait abnormalities, and retinopathy. A number of studies have been conducted concerning this disorder, and they have reported that the disease is caused by homozygous or compound heterozygous mutations in either ERCC Excision Repair 6 (ERCC6) gene ( known as CSB) or the ERCC8 gene ( known as CSA) [1,2,3,4,5] This syndrome shows a different age of onset and rate of progression with broad range of severity from severe form with manifestation of abnormalities at birth or in the early neonatal period to mild and late-onset presentations. The CADD score combines information from 63 different annotations including PhastCons, GERP, PhyloP, SIFT, and PolyPhen, using a support vector machine classifier It measures deleteriousness by using observed variant frequency as the basis for its calculation. The variant is likely to be missense mutation, but splicing defect cannot be entirely ruled out

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