European guidance for the molecular diagnosis of pseudohypoparathyroidism not caused by point genetic variants at GNAS: an EQA study

Eur J Hum Genet. 2015 Apr;23(4):438-44. doi: 10.1038/ejhg.2014.127. Epub 2014 Jul 9.

Abstract

Pseudohypoparathyroidism is a rare endocrine disorder that can be caused by genetic (mainly maternally inherited inactivating point mutations, although intragenic and gross deletions have rarely been reported) or epigenetic alterations at GNAS locus. Clinical and molecular characterization of this disease is not that easy because of phenotypic, biochemical and molecular overlapping features between both subtypes of the disease. The European Consortium for the study of PHP (EuroPHP) designed the present work with the intention of generating the standards of diagnostic clinical molecular (epi)genetic testing in PHP patients. With this aim, DNA samples of eight independent PHP patients carrying GNAS genetic and/or epigenetic defects (three patients with GNAS deletions, two with 20q uniparental disomy and three with a methylation defect of unknown origin) without GNAS point mutations were anonymized and sent to the five participant laboratories for their routine genetic analysis (methylation-specific (MS)-MLPA, pyrosequencing and EpiTYPER) and interpretations. All laboratories were able to detect methylation defects and, after the data analysis, the Consortium compared the results to define technical advantages and disadvantages of different techniques. To conclude, we propose as first-level investigation in PHP patients copy number and methylation analysis by MS-MLPA. Then, in patients with partial methylation defect, the result should be confirmed by single CpG bisulphite-based methods (ie pyrosequencing), whereas in case of a complete methylation defect without detectable deletion, microsatellites or SNP genotyping should be performed to exclude uniparental disomy 20.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chromogranins
  • DNA Methylation
  • Epigenesis, Genetic
  • Europe
  • GTP-Binding Protein alpha Subunits, Gs / genetics*
  • Gene Deletion
  • Genetic Testing / standards*
  • Genetic Variation*
  • Genotyping Techniques
  • Humans
  • Practice Guidelines as Topic
  • Pseudohypoparathyroidism / diagnosis*
  • Pseudohypoparathyroidism / genetics*
  • Sequence Analysis, DNA
  • Syntaxin 16 / genetics
  • Uniparental Disomy / genetics

Substances

  • Chromogranins
  • STX16 protein, human
  • Syntaxin 16
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs