Phenotype-genotype correlation in Wilson disease in a large Lebanese family: association of c.2299insC with hepatic and of p. Ala1003Thr with neurologic phenotype

PLoS One. 2014 Nov 12;9(11):e109727. doi: 10.1371/journal.pone.0109727. eCollection 2014.

Abstract

Genotype phenotype correlations in Wilson disease (WD) are best established in homozygous patients or in compound heterozygous patients carrying the same set of mutations. We determined the clinical phenotype of patients with WD carrying the c.2298_2299insC in Exon 8 (c.2299insC) or the p. Ala1003Thr missense substitution in Exon 13 mutations in the homozygous or compound heterozygous state. We investigated 76 members of a single large Lebanese family. Their genotypes were determined, and clinical assessments were carried out for affected subjects. We also performed a literature search retrieving the phenotypes of patients carrying the same mutations of our patients in the homozygous or compound heterozygous state. There were 7 consanguineous marriages in this family and the prevalence of WD was 8.9% and of carriers of ATP7B mutation 44.7%. WD was confirmed in 9 out of 76 subjects. All 9 had the c.2299insC mutation, 5 homozygous and 4-compound heterozygous with p. Ala1003Thr. Six of our patients had hepatic, 2 had neurologic and 1 had asymptomatic phenotype. Based on our data and a literature review, clear phenotypes were reported for 38 patients worldwide carrying the c.2299insC mutation. About 53% of those have hepatic and 29% have neurologic phenotype. Furthermore, there were 10 compound heterozygous patients carrying the p. Ala1003Thr mutation. Among those, 80% having c.2299insC as the second mutation had hepatic phenotype, and all others had neurologic phenotype. We hereby report an association between the c.2299insC mutation and hepatic phenotype and between the p. Ala1003Thr mutation and neurologic phenotype.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Triphosphatases / genetics
  • Adolescent
  • Alanine
  • Cation Transport Proteins / genetics
  • Child
  • Child, Preschool
  • Consanguinity
  • Copper-Transporting ATPases
  • DNA Mutational Analysis
  • Exons
  • Female
  • Genetic Association Studies*
  • Genotype
  • Hepatolenticular Degeneration / genetics*
  • Hepatolenticular Degeneration / pathology*
  • Humans
  • Infant
  • Lebanon
  • Male
  • Mutation
  • Pedigree
  • Phenotype
  • Threonine

Substances

  • Cation Transport Proteins
  • Threonine
  • Adenosine Triphosphatases
  • ATP7B protein, human
  • Copper-Transporting ATPases
  • Alanine

Grants and funding

The authors thank The Medical Practice Plan of AUB-MC and the University Research Board of the American University of Beirut for supporting the study by research grants to J. Usta. The funders had no role in study design, data collection and anlysis, decision to publish or preparation of the manuscript.