Abstract

Meckel syndrome (MKS) is a pre‐ or perinatal multisystemic ciliopathic lethal disorder with an autosomal recessive mode of inheritance. Meckel syndrome is usually manifested with meningo‐occipital encephalocele, polycystic kidney dysplasia, postaxial polydactyly and hepatobiliary ductal plate malformation. Germline variants in CEP290 cause MKS4. In this study, we investigated a 35‐years‐old Chinese female who was 17+1 weeks pregnant. She had a history of adverse pregnancy of having foetus with multiple malformations. We performed ultrasonography and identified the foetus with occipital meningoencephalocele and enlarged cystic dysplastic kidneys. So, she decided to terminate her pregnancy and further genetic molecular analysis was performed. We identified the aborted foetus without postaxial polydactyly. Histological examination of foetal kidney showed cysts in kidney and thinning of the renal cortex with glomerular atrophy. Whole exome sequencing identified a novel homozygous variant (c.2144T>G; p.L715*) in exon 21 of the CEP290 in the foetus. Sanger sequencing confirmed that both the parents of the foetus were carrying this variant in a heterozygous state. This variant was not identified in two elder sisters of the foetus as well as in the 100 healthy individuals. Western blot analysis showed that this variant leads to the formation of truncated CEP290 protein with the molecular weight of 84 KD compared with the wild‐type CEP290 protein of 290 KD. Hence, it is a loss‐of‐function variant. We also found that the mutant cilium appears longer in length than the wild‐type cilium. Our present study reported the first variant of CEP290 associated with MKS4 in Chinese population.

Highlights

  • Meckel syndrome type 4 (MKS4) [MIM# 611134] is a pre- or perinatal lethal ciliopathic disorder with an autosomal recessive mode of inheritance.[1]

  • MKS has been reported to be caused by the germline variants of eight genes (CEP290, MKS1, B9D1, B9D2, CC2D2A, RPGRIP1L, TMEM67, TMEM216).[4]

  • We found a small amount of liquid at the dark area in the foetus with very less amniotic fluid (AFI: 1.0 cm)

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Summary

| INTRODUCTION

Meckel syndrome type 4 (MKS4) [MIM# 611134] is a pre- or perinatal lethal ciliopathic disorder with an autosomal recessive mode of inheritance.[1]. Variants of CEP290 have been reported to cause MKS 4 [MIM# 611134] in very few cases. We investigated a 35-years-old Chinese female who was 17+1 weeks pregnant (gravida 6, para 2) She had a history of adverse pregnancy of having foetus with multiple malformations. We performed ultrasonography and identified the foetus with all classic MKS symptoms, that is occipital meningoencephalocele, enlarged cystic dysplastic kidneys. She decided to terminate her pregnancy and further genetic molecular analysis was performed. Whole exome sequencing identified a novel homozygous variant (c.2144T>G; p.L715*) in exon 21 of the CEP290 gene in the foetus. Our present study identified the first variant in CEP290 gene associated with MKS in Chinese population. We emphasize the significance of whole exome sequencing for identifying candidate variant in the MKS patients with CEP290 variants

| MATERIALS AND METHODS
| DISCUSSION
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