Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations

Hypophosphatasia (HPP), a genetic disorder characterized by decreased tissue-nonspecific alkaline phosphatase (TNSALP) activity, is caused by loss-of-function mutations in the ALPL gene, which encodes TNSALP. The most frequent pathogenic variant in Japanese patients with HPP is a frameshift mutation...

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Main Authors: Hiroshi Kitoh, Masako Izawa, Hiroshi Kaneko, Akiko Kitamura, Saori Matsuyama, Kohji Kato, Tomoo Ogi
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Bone Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352187222004600
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author Hiroshi Kitoh
Masako Izawa
Hiroshi Kaneko
Akiko Kitamura
Saori Matsuyama
Kohji Kato
Tomoo Ogi
author_facet Hiroshi Kitoh
Masako Izawa
Hiroshi Kaneko
Akiko Kitamura
Saori Matsuyama
Kohji Kato
Tomoo Ogi
author_sort Hiroshi Kitoh
collection DOAJ
description Hypophosphatasia (HPP), a genetic disorder characterized by decreased tissue-nonspecific alkaline phosphatase (TNSALP) activity, is caused by loss-of-function mutations in the ALPL gene, which encodes TNSALP. The most frequent pathogenic variant in Japanese patients with HPP is a frameshift mutation in the ALPL gene, c.1559delT, and its carrier frequency is reported to be one in 480 in the Japanese population. We report the cases of two Japanese children with HPP who had a heterozygous c.1559delT variant in the ALPL gene. One case (involving a neonate) exhibited respiratory insufficiency associated with vitamin B6 dependent convulsions, significant defective mineralization similar to the severe form of HPP, and extremely low ALP activity. Enzyme replacement therapy (ERT) using asfotase alfa promptly improved her respiratory insufficiency, bone mineralization, and maintained her motor development during infancy. The second case involved a 10-year-old boy who demonstrated diffuse musculoskeletal pain and weakness that progressively disturbed mobility. Although he showed no bony lesions, the clinical symptoms and biochemical abnormalities were compatible with childhood HPP. ERT successfully relieved the severe generalized pain and significantly improved motor function.
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spelling doaj.art-f78e672c32c642a5a0fb2b749ea160772022-12-22T03:01:09ZengElsevierBone Reports2352-18722022-12-0117101626Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populationsHiroshi Kitoh0Masako Izawa1Hiroshi Kaneko2Akiko Kitamura3Saori Matsuyama4Kohji Kato5Tomoo Ogi6Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi 474-8710, Japan; Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan; Corresponding author at: Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi 474-8710, Japan.Department of Endocrinology and Metabolism, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi 474-8710, JapanDepartment of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi 474-8710, JapanDepartment of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi 474-8710, JapanDepartment of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi 474-8710, JapanDepartment of Genetics, Research Institute of Environmental Medicine (RIeM), Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8601, JapanDepartment of Genetics, Research Institute of Environmental Medicine (RIeM), Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8601, JapanHypophosphatasia (HPP), a genetic disorder characterized by decreased tissue-nonspecific alkaline phosphatase (TNSALP) activity, is caused by loss-of-function mutations in the ALPL gene, which encodes TNSALP. The most frequent pathogenic variant in Japanese patients with HPP is a frameshift mutation in the ALPL gene, c.1559delT, and its carrier frequency is reported to be one in 480 in the Japanese population. We report the cases of two Japanese children with HPP who had a heterozygous c.1559delT variant in the ALPL gene. One case (involving a neonate) exhibited respiratory insufficiency associated with vitamin B6 dependent convulsions, significant defective mineralization similar to the severe form of HPP, and extremely low ALP activity. Enzyme replacement therapy (ERT) using asfotase alfa promptly improved her respiratory insufficiency, bone mineralization, and maintained her motor development during infancy. The second case involved a 10-year-old boy who demonstrated diffuse musculoskeletal pain and weakness that progressively disturbed mobility. Although he showed no bony lesions, the clinical symptoms and biochemical abnormalities were compatible with childhood HPP. ERT successfully relieved the severe generalized pain and significantly improved motor function.http://www.sciencedirect.com/science/article/pii/S2352187222004600HypophosphatasiaAlkaline phosphataseALPL genec.1559delTEnzyme replacement therapy
spellingShingle Hiroshi Kitoh
Masako Izawa
Hiroshi Kaneko
Akiko Kitamura
Saori Matsuyama
Kohji Kato
Tomoo Ogi
Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations
Bone Reports
Hypophosphatasia
Alkaline phosphatase
ALPL gene
c.1559delT
Enzyme replacement therapy
title Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations
title_full Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations
title_fullStr Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations
title_full_unstemmed Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations
title_short Two children with hypophosphatasia with a heterozygous c.1559delT variant in the ALPL gene, the most common variant in Japanese populations
title_sort two children with hypophosphatasia with a heterozygous c 1559delt variant in the alpl gene the most common variant in japanese populations
topic Hypophosphatasia
Alkaline phosphatase
ALPL gene
c.1559delT
Enzyme replacement therapy
url http://www.sciencedirect.com/science/article/pii/S2352187222004600
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