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Functional Cathepsin C mutations cause different Papillon-Lefèvre syndrome phenotypes.
[papillon-lefèvre syndrome]
The
autosomal-recessive
Papillon-
Lefèvre
syndrome
(
PLS
)
is
characterized
by
severe
aggressive
periodontitis
,
combined
with
palmoplantar
hyperkeratosis
,
and
is
caused
by
mutations
in
the
Cathepsin
C
(
CTSC
)
gene
.
This
study
aimed
to
identify
CTSC
mutations
in
different
PLS
phenotypes
,
including
atypical
forms
and
isolated
pre-pubertal
aggressive
periodontitis
(
PAP
)
.
Thirteen
families
with
different
phenotypes
were
analysed
by
direct
sequencing
of
the
entire
coding
region
and
the
regulatory
regions
of
CTSC
.
The
function
of
novel
mutations
was
tested
with
enzyme
activity
measurements
.
In
11
of
13
families
,
12
different
pathogenic
CTSC
mutations
were
found
in
10
typical
PLS
patients
,
three
atypical
cases
and
one
PAP
patient
.
Out
of
four
novel
mutations
,
three
result
in
protein
truncation
and
are
thus
considered
to
be
pathogenic
.
The
homozygous
c
.
854
C
>
T
nucleotide
exchange
(
p
.
P
285
L
)
was
associated
with
an
almost
complete
loss
of
enzyme
activity
.
The
observed
phenotypic
heterogeneity
could
not
be
associated
with
specific
genotypes
.
The
phenotypic
variability
of
the
PLS
associated
with
an
identical
genetic
background
may
reflect
the
influence
of
additional
genetic
or
environmental
factors
on
disease
characteristics
.
CTSC
mutation
analyses
should
be
considered
for
differential
diagnosis
in
all
children
suffering
from
severe
aggressive
periodontitis
.
Diseases
Validation
Diseases presenting
"atypical cases"
symptom
coats disease
congenital toxoplasmosis
dentin dysplasia
erythropoietic protoporphyria
heparin-induced thrombocytopenia
omenn syndrome
papillon-lefèvre syndrome
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