Abstract

Microcephaly-capillary malformation syndrome (MICCAP: OMIM 614261) is a severe monogenic disorder inherited in an autosomal recessive manner caused by mutations in the STAMBP gene. There are less than 20 published cases of the syndrome to date. The paper reports three new cases of rare MICCAP syndrome. The cause of the disorder was confirmed in three affected individuals from two unrelated families by pedigree analysis, biochemical analysis, RFLP analysis and automated Sanger sequencing. The two brothers were homozygous for the potentially pathogenic STAMBP gene variant c.188A>G (p.Tyr63Cys). Clinical phenotype of the girl from the second family resulted from the combination of two genetic disorders: galactosemia caused by the compound heterozygosity for the pathogenic GALT gene variants (c.563A>G and c.855G>T), and MICCAP caused by the STAMBP gene variants (c.204-5c>g and с.668_669delCA), one of which originated de novo. The prevalence of microcephaly-capillary malformation syndrome in Russia is evaluated, it is one per 120,000 people (CI: 1/356 724–1/62 691). The carrier frequency is one per 173 people. The target STAMBP gene analysis makes the genetic confirmation of the MICCAP syndrome quicklier. When determining the tactics of diagnosis and therapy in each particular case, the possibility of combination of two rare genetic disorders in one patient should be considered.

Highlights

  • Microcephaly-capillary malformation syndrome (MICCAP: OMIM 614261) is a severe monogenic disorder inherited in an autosomal recessive manner caused by mutations in the STAMBP gene

  • The elevated level of GTP linked Ras protein has been revealed in the cell lines of patients affected with the STAMBP gene mutations, which indicates the involvement of the STAMBP protein in the Ras-MAPK signal transduction pathway [1]

  • Two patients with MICCAP syndrome have been reported in Russia: a girl with compound heterozygosity for the c.204-5С>G and c.273delA variants [10], and a boy with homozygosity for the c.188A>G (p.Tyr63Cys) variant of the STAMBP gene [11]

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Summary

CLINICAL CASE MEDICAL GENETICS

Shchagina OA , Semenova NA, Bessonova LA, Larshina EA, Beskorovainiy NS, Zakharova EYu, Ryzhkova OP, Poliakov AV. Microcephaly-capillary malformation syndrome (MICCAP: OMIM 614261) is a severe monogenic disorder inherited in an autosomal recessive manner caused by mutations in the STAMBP gene. Clinical phenotype of the girl from the second family resulted from the combination of two genetic disorders: galactosemia caused by the compound heterozygosity for the pathogenic GALT gene variants (c.563A>G and c.855G>T), and MICCAP caused by the STAMBP gene variants (c.204-5C>G and с.668_669delCA), one of which originated de novo. Author contribution: Shchagina OA — study design, molecular genetic analysis, frequency estimation, statistical analysis; Semenova NA, Bessonova LA — clinical examination and genetic counseling of the patients’ families; Larshina EA — biochemical assays, GALT gene analysis; Beskorovainiy NS — exome sequencing data processing; Zakharova EYu — biochemical analysis, prevalence calculation; Ryzhkova OP — pathogenicity analysis of genetic variants, exome sequencing; Poliakov AV — selection of primers for molecular genetic analysis. The informed consent to molecular genetic testing, and anonymity-preserving clinical and molecular genetics data publishing (including photos and videos) was submitted by all participants or their legal representatives

СИНДРОМ МИКРОЦЕФАЛИИ В СОЧЕТАНИИ C КАПИЛЛЯРНЫМИ МАЛЬФОРМАЦИЯМИ
Clinical cases
Discussion
Findings
CONCLUSION
Additional information
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