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Heterozygous de novo and inherited mutations in the smooth muscle actin (ACTG2) gene underlie megacystis-microcolon-intestinal hypoperistalsis syndrome.
[megacystis-microcolon-intestinal hypoperistalsis syndrome]
Megacystis-
microcolon
-
intestinal
hypoperistalsis
syndrome
(
MMIHS
)
is
a
rare
disorder
of
enteric
smooth
muscle
function
affecting
the
intestine
and
bladder
.
Patients
with
this
severe
phenotype
are
dependent
on
total
parenteral
nutrition
and
urinary
catheterization
.
The
cause
of
this
syndrome
has
remained
a
mystery
since
Berdon
's
initial
description
in
1976
.
No
genes
have
been
clearly
linked
to
MMIHS
.
We
used
whole-exome
sequencing
for
gene
discovery
followed
by
targeted
Sanger
sequencing
in
a
cohort
of
patients
with
MMIHS
and
intestinal
pseudo-obstruction
.
We
identified
heterozygous
ACTG
2
missense
variants
in
15
unrelated
subjects
,
ten
being
apparent
de
novo
mutations
.
Ten
unique
variants
were
detected
,
of
which
six
affected
CpG
dinucleotides
and
resulted
in
missense
mutations
at
arginine
residues
,
perhaps
related
to
biased
usage
of
CpG
containing
codons
within
actin
genes
.
We
also
found
some
of
the
same
heterozygous
mutations
that
we
observed
as
apparent
de
novo
mutations
in
MMIHS
segregating
in
families
with
intestinal
pseudo-obstruction
,
suggesting
that
ACTG
2
is
responsible
for
a
spectrum
of
smooth
muscle
disease
.
ACTG
2
encodes
γ
2
enteric
actin
and
is
the
first
gene
to
be
clearly
associated
with
MMIHS
,
suggesting
an
important
role
for
contractile
proteins
in
enteric
smooth
muscle
disease
.
Diseases
Validation
Diseases presenting
"same heterozygous mutations"
symptom
megacystis-microcolon-intestinal hypoperistalsis syndrome
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