• Am. J. Med. Genet. A · Oct 2014

    Case Reports

    Atypical Aicardi-Goutieres syndrome: is the WRN locus a modifier?

    • Davor Lessel, Bidisha Saha, Fuki Hisama, Bahar Kaymakamzade, Gulay Nurlu, Yasemin Gursoy-Özdemir, Holger Thiele, Peter Nürnberg, George M Martin, Christian Kubisch, and Junko Oshima.
    • Institute of Human Genetics, University of Ulm, Ulm, Germany.
    • Am. J. Med. Genet. A. 2014 Oct 1; 164A (10): 2510-3.

    AbstractWe describe a 28-year-old Turkish man with consanguineous parents who presented with an aged appearance with prematurely gray hair and scleroderma-like skin, spastic paraplegia, and apparent disability. The proband and each of his parents were heterozygous for a mutation in WRN, which could not explain his symptoms. Exome sequencing of the proband's blood DNA showed a homozygous c.626-1G > C mutation in intron 5 of the SAMHD1 gene, which encodes a triphosphohydrolase involved in the regulation of intracellular dNTP pools and which is mutated in Aicardi-Goutieres syndrome. The RNA studies confirmed aberrant splicing of exon 6, and family studies showed that both parents are heterozygous for this mutation. We conclude that mutations in SAMHD1 - in addition to causing an early-onset form of encephalopathy in Aicardi-Goutieres syndrome - may present with modest signs of accelerated aging similar to Werner syndrome. The extent to which heterozygosity at the WRN locus may modify the effect of biallelic SAMHD1 mutations is unknown. It is conceivable that synergistic effects of these two mutations might be responsible for the unusual phenotype.© 2014 Wiley Periodicals, Inc.

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