Genetics in medicine, 2019-08-01, Vol.21 (8), p.1797-1807
Purpose: Haploinsufficiency of USP7, located at chromosome 16p13.2, has recently been reported in seven individuals with neurodevelopmental phenotypes, including developmental delay/intellectual disability (DD/ID), autism spectrum disorder (ASD), seizures, and hypogonadism. Further, USP7 was identified to critically incorporate into the MAGEL2-USP7-TRIM27 (MUST), such that pathogenic variants in USP7 lead to altered endosomal F-actin polymerization and dysregulated protein recycling. Methods: We report 16 newly identified individuals with heterozygous USP7 variants, identified by genome or exome sequencing or by chromosome microarray analysis. Clinical features were evaluated by review of medical records. Additional clinical information was obtained on the seven previously reported individuals to fully elucidate the phenotypic expression associated with USP7 haploinsufficiency. Results: The clinical manifestations of these 23 individuals suggest a syndrome characterized by DD/ID, hypotonia, eye anomalies,feeding difficulties, GERD, behavioral anomalies, and ASD, and more specific phenotypes of speech delays including a nonverbal phenotype and abnormal brain magnetic resonance image findings including white matter changes based on neuroradiologic examination. Conclusion: The consistency of clinical features among all individuals presented regardless of de novo USP7 variant type supports haploinsufficiency as a mechanism for pathogenesis and refines the clinical impact faced by affected individuals and caregivers.
Adolescent ; Autism ; Autism Spectrum Disorder - genetics ; Autism Spectrum Disorder - physiopathology ; Behavior ; Child ; Child, Preschool ; Chromosome Deletion ; Chromosomes ; corpus callosum thinning ; DNA-Binding Proteins - genetics ; Family medical history ; Genetic counseling ; Genetics ; Genetics & Heredity ; Genetics(clinical) ; Genome, Human - genetics ; Genomes ; Genotype & phenotype ; Haploinsufficiency - genetics ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Intellectual Disability - genetics ; Intellectual Disability - physiopathology ; Laboratories ; Language Development Disorders - genetics ; Language Development Disorders - physiopathology ; Life Sciences & Biomedicine ; Medical records ; Medicine ; neurodevelopment ; Neurodevelopmental Disorders - genetics ; Neurodevelopmental Disorders - physiopathology ; Nuclear Proteins - genetics ; Patients ; Pediatrics ; Phenotype ; Problem Behavior ; Proteins ; Proteins - genetics ; Science & Technology ; speech delay ; USP7 ; white matter paucity ; Whole Exome Sequencing
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