Association of X‐linked hydrocephalus and Hirschsprung disease: Report of a new patient with a mutation in the L1CAM gene

• Published in: American journal of medical genetics. Part A Vol. 158A; no. 4; pp. 816 - 820
• Main Authors: Fernández, Raquel M., Núñez‐Torres, Rocío, García‐Díaz, Lutgardo, de Agustín, Juan Carlos, Antiñolo, Guillermo, Borrego, Salud
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2012; Wiley-Liss; Wiley Subscription Services, Inc
• Subjects: Abnormalities, Multiple - genetics; Base Sequence; Biological and medical sciences; Cerebral Aqueduct - abnormalities; Cerebral Aqueduct - pathology; Cerebrospinal fluid. Meninges. Spinal cord; Corpus Callosum - pathology; DNA Mutational Analysis; Gastroenterology. Liver. Pancreas. Abdomen; Genetic Diseases, X-Linked - diagnosis; Genetic Diseases, X-Linked - genetics; Genetic Diseases, X-Linked - pathology; Hirschsprung disease; Hirschsprung Disease - diagnosis; Hirschsprung Disease - genetics; Hirschsprung Disease - pathology; Humans; hydrocephalus; Hydrocephalus - diagnosis; Hydrocephalus - genetics; Hydrocephalus - pathology; Infant; L1CAM; Male; Malformations; Medical genetics; Medical sciences; Nervous system (semeiology, syndromes); Neural Cell Adhesion Molecule L1 - genetics; Neurology; RET proto‐oncogene; Sequence Analysis, DNA; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Sex linked character; Nervous system diseases; hydrocephalus; RET proto-oncogene; Neuronal intestinal malformation; L1CAM; Congenital disease; Cerebral disorder; Genetic disease; Colonic disease; Case study; Association; C-Onc gene; Hirschsprung disease; Central nervous system disease; Digestive diseases; Intestinal disease; Genetics; X-Chromosome; Mutation; Hydrocephaly; Protooncogene
• ISSN: 1552-4825; 1552-4833
• DOI: 10.1002/ajmg.a.35244

X‐linked hydrocephalus (XLH) has an incidence of 1/30,000 male births and is characterized by intellectual disability, spastic paraplegia, adducted thumbs, and agenesis of corpus callosum, and/or corticospinal tract. The great proportion of cases is ascribed to loss of function mutations of L1CAM gene. Hirschsprung disease (HSCR) is characterized by the absence of ganglion cells in the submucosal and myenteric plexuses along a variable portion of the intestinal tract and has incidence of about 1/5,000. Although with several genes involved in its pathogenesis, the major HSCR gene is the RET proto‐oncogene. To date only a few patients have been reported with both phenotypes and mutations in the L1CAM gene. In this report, we describe a new patient with concurrent XLH and HSCR. L1CAM mutational screening showed the presence of the G698R hemizygous mutation, which is a deleterious substitution affecting a key residue necessary for the correct folding of the protein. Moreover, the patient also carried the transcriptional enhancer RET mutation (c.73 + 9277T > C) in heterozygosis. We speculate that both the RET enhancer variant, and the L1CAM mutation may act in combination to produce the enteric phenotype, probably with the participation of other still unidentified molecular events. While it is obvious that additional studies are necessary to further delineate the association between XLH and HSCR in the presence of L1CAM mutations, the documentation of this new patient reinforces the role of this gene acting either in a direct or indirect way in the pathogenesis of Hirschsprung disease. © 2012 Wiley Periodicals, Inc.