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Alpha-thalassemia intellectual disability: variable phenotypic expression among males with a recurrent nonsense mutation - c.109C>T (p.R37X).
[alpha-thalassemia]
Alpha-thalassemia
intellectual
disability
,
one
of
the
recognizable
X-
linked
disability
syndromes
,
is
characterized
by
short
stature
,
microcephaly
,
distinctive
facies
,
hypotonic
appearance
,
cardiac
and
genital
anomalies
,
and
marked
skewing
of
X-
inactivation
in
female
carriers
.
With
the
advent
of
next
generation
sequencing
,
mutations
have
been
identified
that
result
in
less
severe
phenotypes
lacking
one
or
more
of
these
phenotypic
manifestations
.
Here
we
report
five
unrelated
kindreds
in
which
a
c
.
109
C
>
T
(
p
.
R
37
X
)
mutation
segregates
with
a
variable
but
overall
milder
phenotype
.
The
distinctive
facial
appearance
of
alpha-thalassemia
intellectual
disability
was
present
in
only
one
of
the
18
affected
males
evaluated
beyond
the
age
of
puberty
,
although
suggestive
facial
appearance
was
present
in
several
during
infancy
or
early
childhood
.
Although
the
responsible
genetic
alteration
is
a
nonsense
mutation
in
exon
2
of
ATRX
,
the
phenotype
appears
to
be
partially
rescued
by
the
production
of
alternative
transcripts
and
/
or
other
molecular
mechanisms
.
Diseases
Validation
Diseases presenting
"intellectual disability"
symptom
22q11.2 deletion syndrome
alexander disease
alpha-thalassemia
aniridia
child syndrome
cohen syndrome
cowden syndrome
hirschsprung disease
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
kabuki syndrome
kallmann syndrome
monosomy 21
oculocutaneous albinism
oligodontia
phenylketonuria
proteus syndrome
triple a syndrome
wolf-hirschhorn syndrome
This symptom has already been validated