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Published in: BMC Medical Genetics 1/2015

Open Access 01-12-2015 | Case report

Novel compound heterozygous mutations in AMN cause Imerslund-Gräsbeck syndrome in two half-sisters: a case report

Authors: Emma Montgomery, John A. Sayer, Laura A. Baines, Ann Marie Hynes, Virginia Vega-Warner, Sally Johnson, Judith A. Goodship, Edgar A. Otto

Published in: BMC Medical Genetics | Issue 1/2015

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Abstract

Background

Imerslund-Gräsbeck Syndrome (IGS) is a rare autosomal recessive disease characterized by intestinal vitamin B12 malabsorption. Clinical features include megaloblastic anemia, recurrent infections, failure to thrive, and proteinuria. Recessive mutations in cubilin (CUBN) and in amnionless (AMN) have been shown to cause IGS. To date, there are only about 300 cases described worldwide with only 37 different mutations found in CUBN and 30 different in the AMN gene.

Case presentation

We collected pedigree structure, clinical data, and DNA samples from 2 Caucasian English half-sisters with IGS. Molecular diagnostics was performed by direct Sanger sequencing of all 62 exons of the CUBN gene and 12 exons of the AMN gene. Because of lack of parental DNA, cloning, and sequencing of multiple plasmid clones was performed to assess the allele of identified mutations. Genetic characterization revealed 2 novel compound heterozygous AMN mutations in both half-sisters with IGS. Trans-configuration of the mutations was confirmed.

Conclusion

We have identified novel compound heterozygous mutations in AMN in a family from the United Kingdom with clinical features of Imerslund-Gräsbeck Syndrome.
Literature
1.
go back to reference Imerslund O. Idiopathic chronic megaloblastic anemia in children. Acta Paediatr Suppl. 1960;49 Suppl 119:1–115.PubMed Imerslund O. Idiopathic chronic megaloblastic anemia in children. Acta Paediatr Suppl. 1960;49 Suppl 119:1–115.PubMed
2.
go back to reference Grasbeck R, Gordin R, Kantero I, Kuhlback B. Selective vitamin B12 malabsorption and proteinuria in young people. A syndrome Acta Med Scand. 1960;167:289–96.CrossRefPubMed Grasbeck R, Gordin R, Kantero I, Kuhlback B. Selective vitamin B12 malabsorption and proteinuria in young people. A syndrome Acta Med Scand. 1960;167:289–96.CrossRefPubMed
3.
go back to reference Ovunc B, Otto EA, Vega-Warner V, Saisawat P, Ashraf S, Ramaswami G, et al. Exome sequencing reveals cubilin mutation as a single-gene cause of proteinuria. J Am Soc Nephrol. 2011;22:1815–20.CrossRefPubMedPubMedCentral Ovunc B, Otto EA, Vega-Warner V, Saisawat P, Ashraf S, Ramaswami G, et al. Exome sequencing reveals cubilin mutation as a single-gene cause of proteinuria. J Am Soc Nephrol. 2011;22:1815–20.CrossRefPubMedPubMedCentral
4.
go back to reference Aminoff M, Carter JE, Chadwick RB, Johnson C, Grasbeck R, Abdelaal MA, et al. Mutations in CUBN, encoding the intrinsic factor-vitamin B12 receptor, cubilin, cause hereditary megaloblastic anaemia 1. Nat Genet. 1999;21:309–13.CrossRefPubMed Aminoff M, Carter JE, Chadwick RB, Johnson C, Grasbeck R, Abdelaal MA, et al. Mutations in CUBN, encoding the intrinsic factor-vitamin B12 receptor, cubilin, cause hereditary megaloblastic anaemia 1. Nat Genet. 1999;21:309–13.CrossRefPubMed
5.
go back to reference Tanner SM, Aminoff M, Wright FA, Liyanarachchi S, Kuronen M, Saarinen A, et al. Amnionless, essential for mouse gastrulation, is mutated in recessive hereditary megaloblastic anemia. Nat Genet. 2003;33:426–9.CrossRefPubMed Tanner SM, Aminoff M, Wright FA, Liyanarachchi S, Kuronen M, Saarinen A, et al. Amnionless, essential for mouse gastrulation, is mutated in recessive hereditary megaloblastic anemia. Nat Genet. 2003;33:426–9.CrossRefPubMed
6.
go back to reference Grasbeck R, Tanner SM. Juvenile selective vitamin B12 malabsorption: 50 years after its description-10 years of genetic testing. Pediatr Res. 2011;70:222–8.CrossRefPubMedPubMedCentral Grasbeck R, Tanner SM. Juvenile selective vitamin B12 malabsorption: 50 years after its description-10 years of genetic testing. Pediatr Res. 2011;70:222–8.CrossRefPubMedPubMedCentral
7.
go back to reference Tanner SM, Li Z, Bisson R, Acar C, Oner C, Oner R, et al. Genetically heterogeneous selective intestinal malabsorption of vitamin B12: founder effects, consanguinity, and high clinical awareness explain aggregations in Scandinavia and the Middle East. Hum Mutat. 2004;23:327–33.CrossRefPubMed Tanner SM, Li Z, Bisson R, Acar C, Oner C, Oner R, et al. Genetically heterogeneous selective intestinal malabsorption of vitamin B12: founder effects, consanguinity, and high clinical awareness explain aggregations in Scandinavia and the Middle East. Hum Mutat. 2004;23:327–33.CrossRefPubMed
8.
go back to reference Tanner SM, Sturm AC, Baack EC, Liyanarachchi S, de la Chapelle A. Inherited cobalamin malabsorption. Mutations in three genes reveal functional and ethnic patterns Orphanet J Rare Dis. 2012;7:56.PubMed Tanner SM, Sturm AC, Baack EC, Liyanarachchi S, de la Chapelle A. Inherited cobalamin malabsorption. Mutations in three genes reveal functional and ethnic patterns Orphanet J Rare Dis. 2012;7:56.PubMed
9.
go back to reference Kalantry S, Manning S, Haub O, Tomihara-Newberger C, Lee HG, Fangman J, et al. The amnionless gene, essential for mouse gastrulation, encodes a visceral-endoderm-specific protein with an extracellular cysteine-rich domain. Nat Genet. 2001;27:412–6.CrossRefPubMed Kalantry S, Manning S, Haub O, Tomihara-Newberger C, Lee HG, Fangman J, et al. The amnionless gene, essential for mouse gastrulation, encodes a visceral-endoderm-specific protein with an extracellular cysteine-rich domain. Nat Genet. 2001;27:412–6.CrossRefPubMed
10.
go back to reference Fyfe JC, Madsen M, Hojrup P, Christensen EI, Tanner SM, de la Chapelle A, et al. The functional cobalamin (vitamin B12)-intrinsic factor receptor is a novel complex of cubilin and amnionless. Blood. 2004;103:1573–9.CrossRefPubMed Fyfe JC, Madsen M, Hojrup P, Christensen EI, Tanner SM, de la Chapelle A, et al. The functional cobalamin (vitamin B12)-intrinsic factor receptor is a novel complex of cubilin and amnionless. Blood. 2004;103:1573–9.CrossRefPubMed
11.
go back to reference Zhai XY, Nielsen R, Birn H, Drumm K, Mildenberger S, Freudinger R, et al. Cubilin- and megalin-mediated uptake of albumin in cultured proximal tubule cells of opossum kidney. Kidney Int. 2000;58:1523–33.CrossRefPubMed Zhai XY, Nielsen R, Birn H, Drumm K, Mildenberger S, Freudinger R, et al. Cubilin- and megalin-mediated uptake of albumin in cultured proximal tubule cells of opossum kidney. Kidney Int. 2000;58:1523–33.CrossRefPubMed
12.
go back to reference Tanner SM, Li Z, Perko JD, Oner C, Cetin M, Altay C, et al. Hereditary juvenile cobalamin deficiency caused by mutations in the intrinsic factor gene. Proc Natl Acad Sci U S A. 2005;102:4130–3.CrossRefPubMedPubMedCentral Tanner SM, Li Z, Perko JD, Oner C, Cetin M, Altay C, et al. Hereditary juvenile cobalamin deficiency caused by mutations in the intrinsic factor gene. Proc Natl Acad Sci U S A. 2005;102:4130–3.CrossRefPubMedPubMedCentral
14.
go back to reference Verroust PA, Christensen EA. Megalin and cubilin–the story of two multipurpose receptors. Neph Dial Transpl. 2002;17:1867–71.CrossRef Verroust PA, Christensen EA. Megalin and cubilin–the story of two multipurpose receptors. Neph Dial Transpl. 2002;17:1867–71.CrossRef
15.
go back to reference Amsellem S, Gburek J, Hamard G, Nielsen R, Willnow TE, Devuyst O, et al. Cubilin is essential for albumin reabsorption in the renal proximal tubule. J Am Soc Nephrol. 2010;21:1859–67.CrossRefPubMedPubMedCentral Amsellem S, Gburek J, Hamard G, Nielsen R, Willnow TE, Devuyst O, et al. Cubilin is essential for albumin reabsorption in the renal proximal tubule. J Am Soc Nephrol. 2010;21:1859–67.CrossRefPubMedPubMedCentral
16.
go back to reference Wahlstedt-Froberg V, Pettersson T, Aminoff M, Dugue B, Grasbeck R. Proteinuria in cubilin-deficient patients with selective vitamin B12 malabsorption. Pediatr Nephrol. 2003;18:417–21.PubMed Wahlstedt-Froberg V, Pettersson T, Aminoff M, Dugue B, Grasbeck R. Proteinuria in cubilin-deficient patients with selective vitamin B12 malabsorption. Pediatr Nephrol. 2003;18:417–21.PubMed
17.
go back to reference Levin-Iaina N, Dinour D, Morduchowicz G, Ganon L, Holtzman EJ. Molecular study of proteinuria in patients treated with B12 supplements: do not forget megaloblastic anemia type 1. Nephron Clin Pract. 2011;118:c67–71.CrossRefPubMed Levin-Iaina N, Dinour D, Morduchowicz G, Ganon L, Holtzman EJ. Molecular study of proteinuria in patients treated with B12 supplements: do not forget megaloblastic anemia type 1. Nephron Clin Pract. 2011;118:c67–71.CrossRefPubMed
Metadata
Title
Novel compound heterozygous mutations in AMN cause Imerslund-Gräsbeck syndrome in two half-sisters: a case report
Authors
Emma Montgomery
John A. Sayer
Laura A. Baines
Ann Marie Hynes
Virginia Vega-Warner
Sally Johnson
Judith A. Goodship
Edgar A. Otto
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medical Genetics / Issue 1/2015
Electronic ISSN: 1471-2350
DOI
https://doi.org/10.1186/s12881-015-0181-2

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