Abstract

BackgroundCongenital generalized lipodystrophy (CGL) also known as Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a genetically heterogeneous disorder characterized by loss of adipose tissues, Acanthosis nigricans, diabetes mellitus, muscular hypertrophy, hepatomegaly and hypertriglyceridemia. There are four subclinical phenotypes of CGL (CGL1-4) and mutations in four genes AGPAT2, BSCL2, CAV1 and PTRF have been assigned to each type.MethodsThe study included clinical and molecular investigations of CGL disease in a consanguineous Pakistani family. For mutation screening all the coding exons including splice junctions of AGPAT2, BSCL2, CAV1 and PTRF genes were PCR amplified and sequenced directly using an automated DNA sequencer ABI3730.ResultsSequence analysis revealed a single base pair deletion mutation (c.636delC; p.Tyr213ThrfsX20) in exon 5 of BSCL2 gene causing a frame shift and premature termination codon.ConclusionMutation identified here in BSCL2 gene causing congenital generalized lipodystrophy is the first report in Pakistani population. The patients exhibited characteristic features of generalized lipodystrophy, Acanthosis nigricans, diabetes mellitus and hypertrophic cardiomyopathy.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1913913076864247.

Highlights

  • Congenital generalized lipodystrophy (CGL) known as Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a genetically heterogeneous disorder characterized by loss of adipose tissues, Acanthosis nigricans, diabetes mellitus, muscular hypertrophy, hepatomegaly and hypertriglyceridemia

  • Congenital generalized lipodystrophy (CGL), or BerardinelliSeip congenital lipodystrophy (BSCL), is a genetically heterogeneous disorder characterized by loss of adipose tissues and sub-cutaneous fats, enlarged fatty liver, hypertrophic muscles, Acanthosis nigricans, increased serum triglyceride level, insulin intolerance or diabetes mellitus

  • Clinical features of the affected individuals Skin The affected members (IV-1 and IV-3) of the family showed characteristic features of congenital generalized lipodystrophy. Both the affected individuals had acanthosis nigricans which was more prominent around neck and in body folds including axillae, anticubital fossae and popliteal fossae

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Summary

Introduction

Congenital generalized lipodystrophy (CGL) known as Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a genetically heterogeneous disorder characterized by loss of adipose tissues, Acanthosis nigricans, diabetes mellitus, muscular hypertrophy, hepatomegaly and hypertriglyceridemia. Congenital generalized lipodystrophy (CGL), or BerardinelliSeip congenital lipodystrophy (BSCL), is a genetically heterogeneous disorder characterized by loss of adipose tissues and sub-cutaneous fats, enlarged fatty liver, hypertrophic muscles, Acanthosis nigricans, increased serum triglyceride level, insulin intolerance or diabetes mellitus. The affected individuals of congenital generalized lipodystrophy type 1 (CGL1, MIM 608594) are characterized by typical poor fat accumulation in the metabolically active and mechanical adipose tissues. In addition these patients have special features of lytic bone lesions that are absent in other forms of CGL [1,2]. The seipin-deficient individuals have generalized congenital lipodystrophy, hypertrophic cardiomyopathy, higher rates of mild mental retardation and an earlier onset of diabetes [7,8,9]

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