Autosomal recessive Noonan syndrome associated with biallelic LZTR1 variants.

Genetics in Medicine : Official Journal of the American College of Medical Genetics
Jennifer J JohnstonLeslie G Biesecker

Abstract

To characterize the molecular genetics of autosomal recessive Noonan syndrome. Families underwent phenotyping for features of Noonan syndrome in children and their parents. Two multiplex families underwent linkage analysis. Exome, genome, or multigene panel sequencing was used to identify variants. The molecular consequences of observed splice variants were evaluated by reverse-transcription polymerase chain reaction. Twelve families with a total of 23 affected children with features of Noonan syndrome were evaluated. The phenotypic range included mildly affected patients, but it was lethal in some, with cardiac disease and leukemia. All of the parents were unaffected. Linkage analysis using a recessive model supported a candidate region in chromosome 22q11, which includes LZTR1, previously shown to harbor mutations in patients with Noonan syndrome inherited in a dominant pattern. Sequencing analyses of 21 live-born patients and a stillbirth identified biallelic pathogenic variants in LZTR1, including putative loss-of-function, missense, and canonical and noncanonical splicing variants in the affected children, with heterozygous, clinically unaffected parents and heterozygous or normal genotypes in unaffected siblings. These cl...Continue Reading

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Methods Mentioned

BETA
genotyping
Chip
exome sequencing

Software Mentioned

PhastCons
phyloP

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