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Mutational spectrum of COH1 and clinical heterogeneity in Cohen syndrome.
[cohen syndrome]
Cohen
syndrome
(
CS
)
is
an
autosomal
recessive
disorder
with
variability
in
the
clinical
manifestations
,
characterised
by
mental
retardation
,
postnatal
microcephaly
,
facial
dysmorphism
,
pigmentary
retinopathy
,
myopia
,
and
intermittent
neutropenia
.
Mutations
in
the
gene
COH
1
have
been
found
in
an
ethnically
diverse
series
of
patients
.
Brief
clinical
descriptions
of
24
patients
with
CS
are
provided
.
The
patients
were
from
16
families
of
different
ethnic
backgrounds
and
between
2
.
5
and
60
years
of
age
at
assessment
.
DNA
samples
from
all
patients
were
analysed
for
mutations
in
COH
1
by
direct
sequencing
.
Splice
site
mutations
were
characterised
using
reverse
transcriptase
PCR
analysis
from
total
RNA
samples
.
In
this
series
,
we
detected
25
different
COH
1
mutations
;
19
of
these
were
novel
,
including
9
nonsense
mutations
,
8
frameshift
mutations
,
4
verified
splice
site
mutations
,
3
larger
in
frame
deletions
,
and
1
missense
mutation
.
We
observed
marked
variability
of
developmental
and
growth
parameters
.
The
typical
facial
gestalt
was
seen
in
23
/
24
patients
.
Early
onset
progressive
myopia
was
present
in
all
the
patients
older
than
5
years
.
Widespread
pigmentary
retinopathy
was
found
in
12
/
14
patients
assessed
over
5
years
of
age
.
We
present
evidence
for
extended
allelic
heterogeneity
of
CS
,
with
the
vast
majority
of
mutations
leading
to
premature
termination
codons
in
COH
1
.
Our
data
confirm
the
broad
clinical
spectrum
of
CS
with
some
patients
lacking
even
the
characteristic
facial
gestalt
and
pigmentary
retinopathy
at
school
age
.
Diseases
Validation
Diseases presenting
"different ethnic backgrounds"
symptom
cadasil
cohen syndrome
proteus syndrome
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