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Published in: Orphanet Journal of Rare Diseases 1/2019

Open Access 01-12-2019 | Intellectual Disability | Research

Kabuki syndrome: novel pathogenic variants, new phenotypes and review of literature

Authors: Huakun Shangguan, Chang Su, Qian Ouyang, Bingyan Cao, Jian Wang, Chunxiu Gong, Ruimin Chen

Published in: Orphanet Journal of Rare Diseases | Issue 1/2019

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Abstract

Objective

This study describes 5 novel variants of 7 KMT2D/KDM6A gene and summarizes the clinical manifestations and the mutational spectrum of 47 Chinese Kabuki syndrome (KS) patients.

Methods

Blood samples were collected for whole-exome sequencing (WES) for 7 patients and their parents if available. Phenotypic and genotypic spectra of 40 previously published unrelated Chinese KS patients were summarized.

Result

Genetic sequencing identified six KMT2D variants (c.3926delC, c.5845delC, c.6595delT, c.12630delG, c.16294C > T, and c.16442delG) and one KDM6A variant (c.2668-2671del). Of them, 4 variants (c.3926delC, c.5845delC, c.12630delG, and c.16442delG) in KMT2D gene and the variant (c.2668-2671del) in KDM6A gene were novel. Combining with previously published Chinese KS cases, the patients presented with five cardinal manifestations including facial dysmorphism, intellectual disability, growth retardation, fingertip pads and skeletal abnormalities. In addition, 29.5% (5/17) patients had brain abnormalities, such as hydrocephalus, cerebellar vermis dysplasia, thin pituitary and white matter myelination delay, corpus callosum hypoplasia and Dandy-Walker malformation.

Conclusion

In this report, five novel variants in KMT2D/KDM6A genes are described. A subset of Chinese KS patients presented with brain abnormalities that were not previously reported. Our study expands the mutational and phenotypic spectra of KS.
Literature
1.
go back to reference Niikawa N, Matsuura N, Fukushima Y, et al. Kabuki make-up syndrome: a syndrome of mental retardation, unusual facies, large and protruding ears, and postnatal growth deficiency. J Pediatr. 1981;99(4):565–9.CrossRef Niikawa N, Matsuura N, Fukushima Y, et al. Kabuki make-up syndrome: a syndrome of mental retardation, unusual facies, large and protruding ears, and postnatal growth deficiency. J Pediatr. 1981;99(4):565–9.CrossRef
2.
go back to reference Kuroki Y, Suzuki Y, Chyo H, et al. A new malformation syndrome of long palpebral fissures, large ears, depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. Pediatr. 1981;99:570–3.CrossRef Kuroki Y, Suzuki Y, Chyo H, et al. A new malformation syndrome of long palpebral fissures, large ears, depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. Pediatr. 1981;99:570–3.CrossRef
3.
go back to reference Bogershausen Y, Alanay N, Kiper YS, et al. A mutation screen in patients with kabuki syndrome. Hum Genet. 2011;130:715–24.CrossRef Bogershausen Y, Alanay N, Kiper YS, et al. A mutation screen in patients with kabuki syndrome. Hum Genet. 2011;130:715–24.CrossRef
4.
go back to reference Lederer D, Grisart B, Digilio MC, et al. Deletion of KDM6A, a histone demethylase interacting with MLL2, in three patients with kabuki syndrome. Am J Hum Genet. 2012;90:119–24.CrossRef Lederer D, Grisart B, Digilio MC, et al. Deletion of KDM6A, a histone demethylase interacting with MLL2, in three patients with kabuki syndrome. Am J Hum Genet. 2012;90:119–24.CrossRef
5.
go back to reference Digilio MC, Gnazzo M, Lepri F, Dentici ML, et al. Congenital heart defects in molecularly proven kabuki syndrome patients. Am J Med Genet A. 2017;173(11):2912–22.CrossRef Digilio MC, Gnazzo M, Lepri F, Dentici ML, et al. Congenital heart defects in molecularly proven kabuki syndrome patients. Am J Med Genet A. 2017;173(11):2912–22.CrossRef
6.
go back to reference Topcu Y, Bayram E, Karaoglu P, Yis U, Kurul SH. Kabuki syndrome and perisylvian cortical dysplasia in a Turkish girl. J Pediatr Neurosci. 2013;8(3):259–60.CrossRef Topcu Y, Bayram E, Karaoglu P, Yis U, Kurul SH. Kabuki syndrome and perisylvian cortical dysplasia in a Turkish girl. J Pediatr Neurosci. 2013;8(3):259–60.CrossRef
7.
go back to reference Liu S, Hong X, Shen C, Shi Q, et al. Kabuki syndrome: a Chinese case series and systematic review of the spectrum of mutations. BMC Med Genet. 2015;16:26.CrossRef Liu S, Hong X, Shen C, Shi Q, et al. Kabuki syndrome: a Chinese case series and systematic review of the spectrum of mutations. BMC Med Genet. 2015;16:26.CrossRef
8.
go back to reference Yang P, Tan H, Xia Y, Yu Q, et al. De novo exonic deletion of KDM6A in a Chinese girl with kabuki syndrome: a case report and brief literature review. Am J Med Genet A. 2016;170(6):1613–21.CrossRef Yang P, Tan H, Xia Y, Yu Q, et al. De novo exonic deletion of KDM6A in a Chinese girl with kabuki syndrome: a case report and brief literature review. Am J Med Genet A. 2016;170(6):1613–21.CrossRef
9.
go back to reference Wu BB, Su YJ, Wang HJ, et al. Report of 6 kabuki syndrome cases caused by KMT2D gene mutation and literature review. Chin J Evid Based Pediatr. 2017;12(2):135–9. Wu BB, Su YJ, Wang HJ, et al. Report of 6 kabuki syndrome cases caused by KMT2D gene mutation and literature review. Chin J Evid Based Pediatr. 2017;12(2):135–9.
10.
go back to reference Jun L, Guiling M, Ling Y, et al. A novel KMT2D mutation resulting in kabuki syndrome: a case report. Mol Med Rep. 2016;14:3641–5.CrossRef Jun L, Guiling M, Ling Y, et al. A novel KMT2D mutation resulting in kabuki syndrome: a case report. Mol Med Rep. 2016;14:3641–5.CrossRef
11.
go back to reference Xin C, Wang C, Wang Y, et al. Identification of novel KMT2D mutations in two Chinese children with kabuki syndrome: a case report and systematic literature review. BMC Med Genet. 2018;19:31.CrossRef Xin C, Wang C, Wang Y, et al. Identification of novel KMT2D mutations in two Chinese children with kabuki syndrome: a case report and systematic literature review. BMC Med Genet. 2018;19:31.CrossRef
12.
go back to reference Lin J-L, Lee W-I, Huang J-L, et al. Immunologic assessment and KMT2D mutation detection in kabuki syndrome. Clin Genet. 2015;88(3):255–60.CrossRef Lin J-L, Lee W-I, Huang J-L, et al. Immunologic assessment and KMT2D mutation detection in kabuki syndrome. Clin Genet. 2015;88(3):255–60.CrossRef
13.
go back to reference Jieling L, Jie C. Kabuki syndrome: two case report. J Clin Pediatr Dent. 2018;1(36):53–6. Jieling L, Jie C. Kabuki syndrome: two case report. J Clin Pediatr Dent. 2018;1(36):53–6.
14.
go back to reference Wang H, Wang X, Wu H, et al. Clinical and laboratory characteristics and genetic diagnosis of kabuki syndrome. Chin J Pediatr. 2018;56(11):846–9. Wang H, Wang X, Wu H, et al. Clinical and laboratory characteristics and genetic diagnosis of kabuki syndrome. Chin J Pediatr. 2018;56(11):846–9.
15.
go back to reference Guo Z, Liu F, Li HJ, et al. Novel KDM6A splice-site mutation in kabuki syndrome with congenital hydrocephalus: a case report. BMC Med Genet. 2018;19(1):0724–8. Guo Z, Liu F, Li HJ, et al. Novel KDM6A splice-site mutation in kabuki syndrome with congenital hydrocephalus: a case report. BMC Med Genet. 2018;19(1):0724–8.
16.
go back to reference Richards S, Aziz N, Bale S, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015;17:668–88.CrossRef Richards S, Aziz N, Bale S, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015;17:668–88.CrossRef
17.
go back to reference Makrythanasis P, van Bon BW, Steehouwer M, Rodríguez-Santiago B, et al. MLL2 mutation detection in 86 patients with kabuki syndrome: a genotype–phenotype study. Clin Genet. 2013;6(84):539–45.CrossRef Makrythanasis P, van Bon BW, Steehouwer M, Rodríguez-Santiago B, et al. MLL2 mutation detection in 86 patients with kabuki syndrome: a genotype–phenotype study. Clin Genet. 2013;6(84):539–45.CrossRef
18.
go back to reference Van Laarhoven PM, Neitzel LR, Quintana AM, Geiger EA, et al. Kabuki syndrome genes KMT2D and KDM6A: functional analyses demonstrate critical roles in craniofacial, heart and brain development. Hum Mol Genet. 2015;24(15):4443–53.CrossRef Van Laarhoven PM, Neitzel LR, Quintana AM, Geiger EA, et al. Kabuki syndrome genes KMT2D and KDM6A: functional analyses demonstrate critical roles in craniofacial, heart and brain development. Hum Mol Genet. 2015;24(15):4443–53.CrossRef
19.
go back to reference Sertçelik M, Uğur Ç, Şahin Aközel A, Gürkan CK, et al. A child with kabuki syndrome and autism Spectrum disorder. Noro Psikiyatr Ars. 2016;53(3):280–2.CrossRef Sertçelik M, Uğur Ç, Şahin Aközel A, Gürkan CK, et al. A child with kabuki syndrome and autism Spectrum disorder. Noro Psikiyatr Ars. 2016;53(3):280–2.CrossRef
20.
go back to reference Parisi L, Di Filippo T, Roccella M, et al. Autism spectrum disorder in kabuki syndrome: clinical, diagnostic and rehabilitative aspects assessed through the presentation of three cases. Minerva Pediatr. 2015;67(4):369–75.PubMed Parisi L, Di Filippo T, Roccella M, et al. Autism spectrum disorder in kabuki syndrome: clinical, diagnostic and rehabilitative aspects assessed through the presentation of three cases. Minerva Pediatr. 2015;67(4):369–75.PubMed
21.
go back to reference Tekendo-Ngongang C, Kruszka P, Martinez AF, Muenke M, et al. Novel heterozygous variants in KMT2D associated with holoprosencephaly. Clin Genet. 2019;96(3):1–5.CrossRef Tekendo-Ngongang C, Kruszka P, Martinez AF, Muenke M, et al. Novel heterozygous variants in KMT2D associated with holoprosencephaly. Clin Genet. 2019;96(3):1–5.CrossRef
22.
go back to reference Boisgontier J, Tacchella JM, Lemaître H, Lehman N, et al. Anatomical and functional abnormalities on MRI in kabuki syndrome. Neuroimage Clin. 2019;21:0802–8.CrossRef Boisgontier J, Tacchella JM, Lemaître H, Lehman N, et al. Anatomical and functional abnormalities on MRI in kabuki syndrome. Neuroimage Clin. 2019;21:0802–8.CrossRef
Metadata
Title
Kabuki syndrome: novel pathogenic variants, new phenotypes and review of literature
Authors
Huakun Shangguan
Chang Su
Qian Ouyang
Bingyan Cao
Jian Wang
Chunxiu Gong
Ruimin Chen
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2019
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-019-1219-x

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