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Journal of Applied Genetics

, Volume 51, Issue 4, pp 523–528 | Cite as

An infant with cartilage-hair hypoplasia due to a novel homozygous mutation in the promoter region of theRMRP gene associated with chondrodysplasia and severe immunodeficiency

  • N. Vatanavicharn
  • N. Visitsunthorn
  • T. Pho-iam
  • O. Jirapongsananuruk
  • P. Pacharn
  • K. Chokephaibulkit
  • C. Limwongse
  • P. Wasant
Case report

Abstract

Cartilage-hair hypoplasia (CHH) is a rare autosomal-recessive disorder characterized by short-limbed dwarfism, sparse hair, and immune deficiency. It is caused by mutations in theRMRP gene, which encodes the RNA component of the mitochondrial RNA-processing ribonuclease (RNase MRP). Several mutations have been identified in its promoter region or transcribed sequence. However, homozygous mutations in the promoter region have been only reported in a patient with primary immunodeficiency without other features of CHH. We report on a Thai girl who first presented with chronic diarrhea, recurrent pneumonia, and severe failure to thrive, without apparently disproportionate dwarfism. The diagnosis of CHH was made after the severe wasting was corrected, and disproportionate growth became noticeable. The patient had the typical features of CHH, including sparse hair and metaphyseal abnormalities. The immunologic profiles were consistent with combined immune deficiency. Mutation analysis identified a novel homozygous mutation, g.-19_-25 dupACTACTC, in the promoter region of theRMRP gene. Identification of the mutation enabled us to provide a prenatal diagnosis in the subsequent pregnancy. This patient is the first CHH case with the characteristic features due to the homozygous mutation in the promoter region of theRMRP gene. The finding of severe immunodeficiency supports that promoter mutations markedly disrupt mRNA cleavage function, which causes cell-cycle impairment.

Keywords

cartilage-hair hypoplasia combined immune deficiency promoter region mutation RMRP gene 

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Copyright information

© Institute of Plant Genetics, Polish Academy of Sciences, Poznan 2010

Authors and Affiliations

  • N. Vatanavicharn
    • 1
  • N. Visitsunthorn
    • 2
  • T. Pho-iam
    • 3
  • O. Jirapongsananuruk
    • 2
  • P. Pacharn
    • 2
  • K. Chokephaibulkit
    • 4
  • C. Limwongse
    • 3
    • 5
    • 6
  • P. Wasant
    • 1
  1. 1.Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  2. 2.Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  3. 3.Neurogenetic Network, Division of Health Service Research and Development, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  4. 4.Division of Infectious Diseases, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  5. 5.Division of Molecular Genetics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  6. 6.Division of Medical Genetics, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

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