Tyrosinemia type II: Mutation update, 11 novel mutations and description of 5 independent subjects with a novel founder mutation

• Published in: Clinical genetics Vol. 92; no. 3; pp. 306 - 317
• Main Authors: Peña‐Quintana, L., Scherer, G., Curbelo‐Estévez, M.L., Jiménez‐Acosta, F., Hartmann, B., La Roche, F., Meavilla‐Olivas, S., Pérez‐Cerdá, C., García‐Segarra, N., Giguère, Y., Huppke, P., Mitchell, G.A., Mönch, E., Trump, D., Vianey‐Saban, C., Trimble, E.R., Vitoria‐Miñana, I., Reyes‐Suárez, D., Ramírez‐Lorenzo, T., Tugores, A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2017; Wiley
• Subjects: Adolescent; Age of Onset; Alleles; Alternative splicing; Child; Child, Preschool; Data processing; Female; Founder Effect; Genetic Association Studies; Genetic Loci; genetics; Genotype; Hereditary diseases; Humans; Infant; Infant, Newborn; Life Sciences; Male; Metabolites; Mutation; Neonates; Pedigree; Phenotype; Polymorphism, Single Nucleotide; Richner‐Hanhart; Skin diseases; TAT; Tyrosine; Tyrosine Transaminase - genetics; tyrosinemia; Tyrosinemias - diagnosis; Tyrosinemias - diet therapy; Tyrosinemias - genetics; Young Adult; Richner-Hanhart; genetics; tyrosinemia; TAT; DIAGNOSIS; OCULOCUTANEOUS TYROSINEMIA; PLANTAR KERATODERMA; WILSON-DISEASE; IDENTIFICATION; AMINOTRANSFERASE GENE; DELETION; FEATURES; RICHNER-HANHART-SYNDROME; DELAYED; TAT GENE
• ISSN: 0009-9163; 1399-0004; 1399-0004
• DOI: 10.1111/cge.13003

Background Tyrosinemia type II, also known as Richner‐Hanhart Syndrome, is an extremely rare autosomal recessive disorder, caused by mutations in the gene encoding hepatic cytosolic tyrosine aminotransferase, leading to the accumulation of tyrosine and its metabolites which cause ocular and skin lesions, that may be accompanied by neurological manifestations, mostly intellectual disability. Aims To update disease‐causing mutations and current clinical knowledge of the disease. Materials and Methods Genetic and clinical information were obtained from a collection of both unreported and previously reported cases. Results We report 106 families, represented by 143 individuals, carrying a total of 36 genetic variants, 11 of them not previously known to be associated with the disease. Variants include 3 large deletions, 21 non‐synonymous and 5 nonsense amino‐acid changes, 5 frameshifts and 2 splice variants. We also report 5 patients from Gran Canaria, representing the largest known group of unrelated families sharing the same P406L mutation. Conclusions Data analysis did not reveal a genotype‐phenotype correlation, but stressed the need of early diagnosis: All patients improved the oculocutaneous lesions after dietary treatment but neurological symptoms prevailed. The discovery of founder mutations in isolated populations, and the benefits of early intervention, should increase diagnostic awareness in newborns. Novel tyrosine aminotransferase mutations in tyrosinemia type II.