Document Detail


Costello syndrome associated with novel germline HRAS mutations: an attenuated phenotype?
MedLine Citation:
PMID:  18247425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Costello syndrome is a rare congenital disorder typically characterized by severe failure-to-thrive, cardiac abnormalities including tachyarrhythmia and hypertrophic cardiomyopathy, distinctive facial features, a predisposition to papillomata and malignant tumors, neurologic abnormalities, developmental delay, and mental retardation. Its underlying cause is de novo germline mutations in the oncogene HRAS. Almost all Costello syndrome mutations affect one of the glycine residues in position 12 or 13 of the protein product. More than 80% of patients with Costello syndrome share the same underlying mutation, resulting in a G12S amino acid change. We report on two patients with novel HRAS mutations affecting amino acids 58 (T58I) and 146 (A146V), respectively. Despite facial features that appear less coarse than those typically seen in Costello patients, both patients show many of the physical and developmental problems characteristic for Costello syndrome. These novel HRAS mutations may be less common than the frequently reported G12S change, or patients with these changes may be undiagnosed due to their less coarse facial features. In addition to the findings previously known to occur in Costello syndrome, one of our patients had hypertrophic pyloric stenosis. This led us to review the medical histories on a cohort of proven HRAS mutation positive Costello syndrome patients, and we found a statistically significantly (P < 0.001) increased frequency of pyloric stenosis in Costello syndrome (5/58) compared to the general population frequency of 2-3/1,000. Thus we add hypertrophic pyloric stenosis to the abnormalities seen with increased frequency in Costello syndrome.
Authors:
Karen W Gripp; A Micheil Innes; Marni E Axelrad; Tanya L Gillan; Jillian S Parboosingh; Christine Davies; Norma J Leonard; Monique Lapointe; Daniel Doyle; Sarah Catalano; Linda Nicholson; Deborah L Stabley; Katia Sol-Church
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of medical genetics. Part A     Volume:  146A     ISSN:  1552-4833     ISO Abbreviation:  Am. J. Med. Genet. A     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-04-16     Revised Date:  2008-05-29    
Medline Journal Info:
Nlm Unique ID:  101235741     Medline TA:  Am J Med Genet A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  683-90     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Division of Medical Genetics, A. I. duPont Hospital for Children, Wilmington, Delaware 19899, USA. kgripp@nemours.org
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / diagnosis*,  genetics
Base Sequence
Child
Child, Preschool
Cognition / physiology
DNA Mutational Analysis
Developmental Disabilities / complications,  diagnosis*,  genetics
Facial Asymmetry / complications,  congenital*,  genetics
Female
Germ-Line Mutation*
Humans
Infant
Male
Proto-Oncogene Proteins p21(ras) / genetics*
Psychological Tests
Pyloric Stenosis / complications,  diagnosis
Syndrome
Grant Support
ID/Acronym/Agency:
4P20 RR020173-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
EC 3.6.5.2/HRAS protein, human; EC 3.6.5.2/Proto-Oncogene Proteins p21(ras)

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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