Targeted next generation sequencing and family survey enable correct genetic diagnosis in CRX associated macular dystrophy - a case report

<strong>Background</strong> We present 3 members of a family with macular dystrophy, originally diagnosed as Stargardt disease, with a significantly variable age at onset, caused by a heterozygous mutation in CRX. <br> <strong>Case presentation</strong> A 43-year-old fe...

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Hlavní autoři: Al-Khuzaei, S, Hudspith, KAZ, Broadgate, S, Shanks, ME, Clouston, P, Németh, AH, Halford, S, Downes, SM
Médium: Journal article
Jazyk:English
Vydáno: BioMed Central 2021
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Shrnutí:<strong>Background</strong> We present 3 members of a family with macular dystrophy, originally diagnosed as Stargardt disease, with a significantly variable age at onset, caused by a heterozygous mutation in CRX. <br> <strong>Case presentation</strong> A 43-year-old female with bull’s eye maculopathy, whose sister was diagnosed with Stargardt disease previously at another centre, was found to have a single ABCA4 variant. Further examination of the family revealed that the asymptomatic father was also affected, indicating a dominant pattern of inheritance. In addition, the ABCA4 variant was not identified in the sister originally diagnosed with Stargardt disease. Next generation sequencing identified a heterozygous c.121C > T, p.R41W missense mutation in CRX in all 3 affected members. <br> <strong>Conclusions</strong> We describe a common phenotype, but with variable age at onset, with autosomal dominant inheritance and reduced penetrance in a family found to have a pathogenic sequence variant in CRX. This illustrates the importance of panel based molecular genetic testing accompanied by family studies to establish a definitive diagnosis.