4.5 Article

TMEM231 Gene Conversion Associated with Joubert and Meckel-Gruber Syndromes in the Same Family

Journal

HUMAN MUTATION
Volume 37, Issue 11, Pages 1144-1148

Publisher

WILEY-BLACKWELL
DOI: 10.1002/humu.23054

Keywords

TMEM231; whole exome sequencing; translocation; gene conversion; cilia

Funding

  1. Intramural Research Program of the National Human Genome Research Institute
  2. National Institutes of Health (NIH)
  3. NIH Medical Research Scholars Program
  4. Pfizer Inc.
  5. Doris Duke Charitable Foundation
  6. Newport Foundation
  7. American Association for Dental Research
  8. Howard Hughes Medical Institute
  9. Colgate-Palmolive Company

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Joubert and Meckel-Gruber syndromes (JS and MGS) are ciliopathies with overlapping features. JS patients manifest the molar tooth sign on brain imaging and variable eye, kidney, and liver disease. MGS presents with polycystic kidneys, occipital encephalocele, and polydactyly; it is typically perinatally fatal. Both syndromes are genetically heterogeneous; some genes cause either syndrome. Here, we report two brothers married to unrelated women. The first brother had three daughters with JS and a son with polycystic kidneys who died at birth. The second brother's wife had a fetal demise due to MGS. Whole exome sequencing identified TMEM231 NM_001077416.2: c.784G>A; p.(Asp262Asn) in all children and the wife of the first brother; the second brother's wife had a c.406T>G;p.(Trp136Gly) change. In-depth analysis uncovered a rare gene conversion event in TMEM231, leading to loss of exon 4, in all the affected children of first brother. We believe that the combination of this gene conversion with different missense mutations led to a spectrum of phenotypes that span JS and MGS.

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