Refining the phenotypic spectrum of CCDC88A‐related PEHO‐like syndrome

• Published in: American journal of medical genetics. Part A Vol. 194; no. 2; pp. 226 - 232
• Main Authors: Issa, Mahmoud Y., Hafez, Mona A., Mounir, Samir M., Abdel Ghafar, Sherif F., Zaki, Maha S., Abdel‐Hamid, Mohamed S.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2024; Wiley Subscription Services, Inc
• Subjects: Atrophy; brain dysplasia; Brain Edema - genetics; Brain stem; CCDC88A gene; Child; Convulsions; Corpus callosum; Edema; Encephalopathy; Epilepsy; Female; Humans; Intellectual disabilities; microcephaly; Microencephaly; Microfilament Proteins - genetics; Neurodegenerative Diseases; Optic atrophy; Optic Atrophy - genetics; PEHO like syndrome; Spasms, Infantile - genetics; Substantia alba; Syndrome; Vesicular Transport Proteins - genetics; whole exome sequencing; microcephaly; CCDC88A gene; PEHO like syndrome; brain dysplasia; whole exome sequencing
• ISSN: 1552-4825; 1552-4833; 1552-4833
• DOI: 10.1002/ajmg.a.63425

Progressive encephalopathy with edema, hypsarrhythmia, and optic atrophy (PEHO) and PEHO‐like syndromes are very rare infantile disorders characterized by profound intellectual disability, hypotonia, convulsions, optic, and progressive brain atrophy. Many causative genes for PEHO and PEHO‐like syndromes have been identified including CCDC88A. So far, only five patients from two unrelated families with biallelic CCDC88A variants have been reported in the literature. Herein, we describe a new family from Egypt with a lethal epileptic encephalopathy. Our patient was the youngest child born to a highly consanguineous couple and had a family history of five deceased sibs with the same condition. She presented with postnatal microcephaly, poor visual responsiveness, and epilepsy. Her brain MRI showed abnormal cortical gyration with failure of opercularization of the insula, hypogenesis of corpus callosum, colpocephaly, reduced white matter, hypoplastic vermis, and brain stem. Whole exome sequencing identified a new homozygous frameshift variant in CCDC88A gene (c.1795_1798delACAA, p.Thr599ValfsTer4). Our study presents the third reported family with this extremely rare disorder. We also reviewed all described cases to better refine the phenotypic spectrum associated with biallelic loss of function variants in the CCDC88A gene.