Original articles

Craniofacial features with disproportionate short stature and acanthosis nigricans caused by a R248C mutation in FGFR3: A case report and literature review

Expand
  • Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2020-01-16

  Online published: 2020-04-25

Abstract

Objective: To analyze the correlation between clinical phenotype and genotype in a patients presenting with Crouzon-like facial appearance, disproportionate short stature and acanthosis nigricans (AN) caused by fibroblast growth factor receptor 3 gene(FGFR3) mutation. Methods: The 13-year-old boy presented craniofacial dysmorphic features, with disproportionate short stature and severe acanthosis nigricans. The clinical data was retrieved and the laboratory parameters of glucose and lipid metabolism, and endocrine hormone were acquired. The results of skin pathology and bone X-ray exami-nation were analyzed. The DNA sample was extracted from peripheral blood withdrawn from the proband and family members for whole-exome sequencing (WES) and Sanger sequencing. Results: Laboratory examination revealed normal hormone level and slight insulin resistance without hyperglycemia. Skeletal survey showed no evidence of midface hypoplasia, brachycephaly or achondroplasia. Skin biopsy identified cutaneous papillomatosis consistent with the manifestations of AN. A spontaneous mutation (NM_00142: c.742C>T; Chr4: 1803564; p. R248C) was identified in FGFR3 by whole-exome sequen-cing, a causative gene established by American College of Medical Genetics and Genomics (ACMG) guidelines. Conclusions: The report described for the first time a case presenting Crouzon-like facial appearance with mild skeletal dysplasia and progressive acanthosis nigricans caused by classical R248C mutation in FGFR3. Sequencing of FGFR3 should be consi-dered in patients with short stature or subtle dysmorphic features, especially accompanied by signs of early onset AN.

Cite this article

ZHANG Juanjuan, ZHANG Wanyu, HAN Xiaowei, XIAO Yuan, LU Wenli, LÜ Sheng . Craniofacial features with disproportionate short stature and acanthosis nigricans caused by a R248C mutation in FGFR3: A case report and literature review[J]. Journal of Diagnostics Concepts & Practice, 2020 , 19(02) : 129 -134 . DOI: 10.16150/j.1671-2870.2020.02.006

References

[1] L'Hôte CG, Knowles MA. Cell responses to FGFR3 signalling: growth, differentiation and apoptosis[J]. Exp Cell Res, 2005, 304(2):417-431.
[2] Meyers GA, Orlow SJ, Munro IR, et al. Fibroblast growth factor receptor 3 (FGFR3) transmembrane mutation in Crouzon syndrome with acanthosis nigricans[J]. Nat Genet, 1995, 11(4):462-464.
[3] Muenke M, Gripp KW, McDonald-McGinn DM, et al. A unique point mutation in the fibroblast growth factor receptor 3 gene (FGFR3) defines a new craniosynostosis syndrome[J]. Am J Hum Genet, 1997, 60(3):555-564.
[4] Vajo Z, Francomano CA, Wilkin DJ. The molecular and genetic basis of fibroblast growth factor receptor 3 disorders: the achondroplasia family of skeletal dysplasias, Muenke craniosynostosis, and Crouzon syndrome with acanthosis nigricans[J]. Endocr Rev, 2000, 21(1):23-39.
[5] Baker KM, Olson DS, Harding CO, et al. Long-term survival in typical thanatophoric dysplasia type 1[J]. Am J Med Genet, 1997, 70(4):427-436.
[6] Hafner C, van Oers JM, Vogt T, et al. Mosaicism of activating FGFR3 mutations in human skin causes epidermal nevi[J]. J Clin Invest, 2006, 116(8):2201-2207.
[7] Webster MK, Donoghue DJ. FGFR activation in skeletal disorders: too much of a good thing[J]. Trends Genet, 1997, 13(5):178-182.
[8] Tavormina PL, Shiang R, Thompson LM, et al. Thanatophoric dysplasia (typesⅠand Ⅱ) caused by distinct mutations in fibroblast growth factor receptor 3[J]. Nat Genet, 1995, 9(3):321-328.
[9] Wilcox WR, Tavormina PL, Krakow D, et al. Molecular, radiologic, and histopathologic correlations in thanatophoric dysplasia[J]. Am J Med Genet, 1998, 78(3):274-281.
[10] Di Rocco F, Collet C, Legeai-Mallet L, et al. Crouzon syndrome with acanthosis nigricans: a case-based update[J]. Childs Nerv Syst, 2011, 27(3):349-354.
[11] García-Vargas A, Hafner C, Pérez-Rodríguez AG, et al. An epidermal nevus syndrome with cerebral involvement caused by a mosaic FGFR3 mutation[J]. Am J Med Genet A, 2008, 146A(17):2275-2279.
[12] Hyland VJ, Robertson SP, Flanagan S, et al. Somatic and germline mosaicism for a R248C missense mutation in FGFR3, resulting in a skeletal dysplasia distinct from thanatophoric dysplasia[J]. Am J Med Genet A, 2003, 120A(2):157-168.
[13] Collin B, Taylor IB, Wilkie AO, et al. Fibroblast growth factor receptor 3 (FGFR3) mutation in a verrucous epidermal naevus associated with mild facial dysmorphism[J]. Br J Dermatol, 2007, 156(6):1353-1356.
[14] Naski MC, Wang Q, Xu J, et al. Graded activation of fibroblast growth factor receptor 3 by mutations causing achondroplasia and thanatophoric dysplasia[J]. Nat Genet, 1996, 13(2):233-237.
[15] d'Avis PY, Robertson SC, Meyer AN, et al. Constitutive activation of fibroblast growth factor receptor 3 by mutations responsible for the lethal skeletal dysplasia thanatophoric dysplasia type Ⅰ[J]. Cell Growth Differ, 1998, 9(1):71-78.
[16] Avivi A, Zimmer Y, Yayon A, et al. Flg-2, a new member of the family of fibroblast growth factor receptors[J]. Oncogene, 1991, 6(6):1089-1092.
[17] Peters K, Ornitz D, Werner S, et al. Unique expression pattern of the FGF receptor 3 gene during mouse organogenesis[J]. Dev Biol, 1993, 155(2):423-430.
[18] Yokote H, Fujita K, Jing X, et al. Trans-activation of EphA4 and FGF receptors mediated by direct interactions between their cytoplasmic domains[J]. Proc Natl Acad Sci U S A, 2005, 102(52):18866-18871.
Outlines

/