Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene

Background: Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder resulting from mutations in the PHOX2B gene located on chromosome 4p12.3, characterized by hypoventilation secondary to missing responses to both hypercapnia and hypoxia. Case report: Proband. A girl, hospitali...

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Main Authors: Eva Klaskova, Jiri Drabek, Milada Hobzova, Vratislav Smolka, Miroslav Seda, Jiri Hyjanek, Rastislav Slavkovsky, Jana Stranska, Martin Prochazka
Format: Article
Language:English
Published: Palacký University Olomouc, Faculty of Medicine and Dentistry 2016-12-01
Series:Biomedical Papers
Subjects:
Online Access:https://biomed.papers.upol.cz/artkey/bio-201604-0006_Significant_phenotype_variability_of_congenital_central_hypoventilation_syndrome_in_a_family_with_polyalanine_e.php
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author Eva Klaskova
Jiri Drabek
Milada Hobzova
Vratislav Smolka
Miroslav Seda
Jiri Hyjanek
Rastislav Slavkovsky
Jana Stranska
Martin Prochazka
author_facet Eva Klaskova
Jiri Drabek
Milada Hobzova
Vratislav Smolka
Miroslav Seda
Jiri Hyjanek
Rastislav Slavkovsky
Jana Stranska
Martin Prochazka
author_sort Eva Klaskova
collection DOAJ
description Background: Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder resulting from mutations in the PHOX2B gene located on chromosome 4p12.3, characterized by hypoventilation secondary to missing responses to both hypercapnia and hypoxia. Case report: Proband. A girl, hospitalised 5 times for respiratory failure from 6 weeks old, presented at 4 years of age severe cyanosis related to pneumonia. Tracheostomy was done, and she was discharged home using a portable positive pressure ventilator during sleep. Proband's father: The father was retrospectively found out to suffer from severe headache and excessive daytime sleepiness. Molecular genetic evaluation of PHOX2B gene was performed and casual polyalanine repeat expansion mutation c.741_755dup15 in exon 3 was found both in proband and her father in heterozygous form. The proband's grandmother died of respiratory failure after administration of benzodiazepine at the age of fifty years. Considering the grandmother's history, she is highly suspected of having had CCHS as well. Conclusion: Repeated respiratory failure of girl was explained by PHOX2B mutation and Ondina curse. Proband´s father has incompletely penetrated PHOX2B heterozygous mutation as well and proband´s grandmother died probably from the consequences of drug interaction with PHOX2B mutated background as well. Both daughter and father currently require overnight mechanical ventilatory support. Although most PHOX2B mutations occur de novo, our case is a rare three generation family affected by autosomal dominant inheritance with incomplete penetrance manifested as the late-form of CCHS and proven PHOX2B mutation in two generations.
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spelling doaj.art-02e24507bce042a6865dd03e28732e7c2022-12-22T00:52:18ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212016-12-01160449549810.5507/bp.2016.038bio-201604-0006Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B geneEva Klaskova0Jiri Drabek1Milada Hobzova2Vratislav Smolka3Miroslav Seda4Jiri Hyjanek5Rastislav Slavkovsky6Jana Stranska7Martin Prochazka8Department of Paediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicInstitute of Molecular and Translational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Respiratory Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Paediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Paediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicCenter of Prenatal Diagnosis U.S.G.POL, s. r. o., Olomouc, Czech RepublicInstitute of Molecular and Translational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicInstitute of Molecular and Translational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicDepartment of Medical Genetics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech RepublicBackground: Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder resulting from mutations in the PHOX2B gene located on chromosome 4p12.3, characterized by hypoventilation secondary to missing responses to both hypercapnia and hypoxia. Case report: Proband. A girl, hospitalised 5 times for respiratory failure from 6 weeks old, presented at 4 years of age severe cyanosis related to pneumonia. Tracheostomy was done, and she was discharged home using a portable positive pressure ventilator during sleep. Proband's father: The father was retrospectively found out to suffer from severe headache and excessive daytime sleepiness. Molecular genetic evaluation of PHOX2B gene was performed and casual polyalanine repeat expansion mutation c.741_755dup15 in exon 3 was found both in proband and her father in heterozygous form. The proband's grandmother died of respiratory failure after administration of benzodiazepine at the age of fifty years. Considering the grandmother's history, she is highly suspected of having had CCHS as well. Conclusion: Repeated respiratory failure of girl was explained by PHOX2B mutation and Ondina curse. Proband´s father has incompletely penetrated PHOX2B heterozygous mutation as well and proband´s grandmother died probably from the consequences of drug interaction with PHOX2B mutated background as well. Both daughter and father currently require overnight mechanical ventilatory support. Although most PHOX2B mutations occur de novo, our case is a rare three generation family affected by autosomal dominant inheritance with incomplete penetrance manifested as the late-form of CCHS and proven PHOX2B mutation in two generations.https://biomed.papers.upol.cz/artkey/bio-201604-0006_Significant_phenotype_variability_of_congenital_central_hypoventilation_syndrome_in_a_family_with_polyalanine_e.phpcongenital central hypoventilation syndromephox2b genelate-onset formrespiratory failure
spellingShingle Eva Klaskova
Jiri Drabek
Milada Hobzova
Vratislav Smolka
Miroslav Seda
Jiri Hyjanek
Rastislav Slavkovsky
Jana Stranska
Martin Prochazka
Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene
Biomedical Papers
congenital central hypoventilation syndrome
phox2b gene
late-onset form
respiratory failure
title Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene
title_full Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene
title_fullStr Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene
title_full_unstemmed Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene
title_short Significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the PHOX2B gene
title_sort significant phenotype variability of congenital central hypoventilation syndrome in a family with polyalanine expansion mutation of the phox2b gene
topic congenital central hypoventilation syndrome
phox2b gene
late-onset form
respiratory failure
url https://biomed.papers.upol.cz/artkey/bio-201604-0006_Significant_phenotype_variability_of_congenital_central_hypoventilation_syndrome_in_a_family_with_polyalanine_e.php
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