Display options
Share it on

Am J Med Genet A. 2021 Jul;185(7):2153-2159. doi: 10.1002/ajmg.a.62205. Epub 2021 Apr 14.

Hypotrichosis-lymphedema-telangiectasia syndrome: Report of ileal atresia associated with a SOX18 de novo pathogenic variant and review of the phenotypic spectrum.

American journal of medical genetics. Part A

Richard Coulie, Dmitriy M Niyazov, Michael J Gambello, Elodie Fastré, Pascal Brouillard, Miikka Vikkula

Affiliations

  1. Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium.
  2. Section of Medical Genetics, Ochsner Health System and University of Queensland, New Orleans, Louisiana, USA.
  3. Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA.
  4. Walloon Excellence in Lifesciences and Biotechnology (WELBIO), University of Louvain, Brussels, Belgium.

PMID: 33851505 DOI: 10.1002/ajmg.a.62205

Abstract

Hypotrichosis-lymphedema-telangiectasia syndrome (HLTS) is a rare condition caused by pathogenic variants in the SOX18 gene. SOX18 plays a key role in angio- and lymphangiogenesis due to its expression in venous endothelial cells from which the lymphatic system develops. It is also expressed in embryonic hair follicles, heart, and vascular smooth muscle cells. The main clinical symptoms of HLTS include sparse hair, alopecia totalis, lymphedema, most often affecting lower limbs, and telangiectatic lesions. Only 10 patients with a SOX18 pathogenic variant have been described that presented with additional features such as hydrocele, renal failure, arterial or pulmonary hypertension, aortic dilatation, and facial dysmorphism. Here, we summarize these phenotypic variations and report an additional HLTS patient, with a 14-nucleotide de novo duplication in SOX18 and congenital ileal atresia, a feature not previously associated with HLTS.

© 2021 Wiley Periodicals LLC.

Keywords: HLTRS; HLTS; genetic; lymphangiogenesis; phenotype; transcription factor

References

  1. Adams, S. D., & Stanton, M. P. (2014). Malrotation and intestinal atresias. Early Human Development, 90(12), 921-925. https://doi.org/10.1016/j.earlhumdev.2014.09.017 - PubMed
  2. Bastaki, F., Mohamed, M., Nair, P., Saif, F., Tawfiq, N., Al-Ali, M. T., Brandau, O., & Hamzeh, A. R. (2016). A novel SOX18 mutation uncovered in Jordanian patient with hypotrichosis-lymphedema-telangiectasia syndrome by whole exome sequencing. Molecular and Cellular Probes, 30(1), 18-21. https://doi.org/10.1016/j.mcp.2015.11.005 - PubMed
  3. Best, K. E., Tennant, P. W., Addor, M. C., Bianchi, F., Boyd, P., Calzolari, E., Dias, C. M., Doray, B., Draper, E., Garne, E., Gatt, M., Greenlees, R., Haeusler, M., Khoshnood, B., McDonnell, B., Mullaney, C., Nelen, V., Randrianaivo, H., Rissmann, A., … Rankin, J. (2012). Epidemiology of small intestinal atresia in Europe: A register-based study. Archives of Disease in Childhood. Fetal and Neonatal Edition, 97(5), F353-F358. https://doi.org/10.1136/fetalneonatal-2011-300631 - PubMed
  4. Brouillard, P., Devriendt, K., & Vikkula, M. (2016). SOX18 and the hypotrichosis-lymphedema-telangiectasia syndrome. In R. P. Erickson & A. Wynshaw-Boris (Eds.), Inborn errors of development. The molecular basis of clinical disorders of morphogenesis (3rd ed., pp. 867-870). Oxford University Press. - PubMed
  5. Devriendt, K., Vikkula, M., Irrthum, A., Matthijs, G., Mertens, A., & Fryns, J. P. (2002). Autosomal recessive alopecia and lymphedema. Genetic Counseling, 13, 74-75. - PubMed
  6. Downes, M., François, M., Ferguson, C., Parton, R. G., & Koopman, P. (2009). Vascular defects in a mouse model of hypotrichosis-lymphedema-telangiectasia syndrome indicate a role for SOX18 in blood vessel maturation. Human Molecular Genetics, 18(15), 2839-2850. https://doi.org/10.1093/hmg/ddp219 - PubMed
  7. Glade, C., van Steensel, M. A., & Steijlen, P. M. (2001). Hypotrichosis, lymphedema of the legs and acral telangiectasias- -new syndrome? European Journal of Dermatology: EJD, 11(6), 515-517. - PubMed
  8. Irrthum, A., Devriendt, K., Chitayat, D., Matthijs, G., Glade, C., Steijlen, P. M., Fryns, J. P., Van Steensel, M. A., & Vikkula, M. (2003). Mutations in the transcription factor gene SOX18 underlie recessive and dominant forms of hypotrichosis-lymphedema-telangiectasia. American Journal of Human Genetics, 72(6), 1470-1478. https://doi.org/10.1086/375614 - PubMed
  9. Louw, J. H., & Barnard, C. N. (1955). Congenital intestinal atresia; observations on its origin. Lancet (London, England), 269(6899), 1065-1067. https://doi.org/10.1016/s0140-6736 - PubMed
  10. Mardy, A. H., Chetty, S. P., Norton, M. E., & Sparks, T. N. (2019). A system-based approach to the genetic etiologies of non-immune hydrops fetalis. Prenatal Diagnosis, 39(9), 732-750. https://doi.org/10.1002/pd.5479 - PubMed
  11. Moalem, S., Brouillard, P., Kuypers, D., Legius, E., Harvey, E., Taylor, G., Francois, M., Vikkula, M., & Chitayat, D. (2015). Hypotrichosis-lymphedema-telangiectasia-renal defect associated with a truncating mutation in the SOX18 gene. Clinical Genetics, 87(4), 378-382. https://doi.org/10.1111/cge.12388 - PubMed
  12. Overman, J., Fontaine, F., Wylie-Sears, J., Moustaqil, M., Huang, L., Meurer, M., Chiang, I. K., Lesieur, E., Patel, J., Zuegg, J., Pasquier, E., Sierecki, E., Gambin, Y., Hamdan, M., Khosrotehrani, K., Andelfinger, G., Bischoff, J., & Francois, M. (2019). R-propranolol is a small molecule inhibitor of the SOX18 transcription factor in a rare vascular syndrome and hemangioma. eLife, 8, e43026. https://doi.org/10.7554/eLife.43026 - PubMed
  13. Proesmans, W., Legius, E., Van Herck, K., & Van Damme, B. (1989). Cutaneous telangiectasia, sparse hair and membranoproliferative glomerulonephritis. Pediatric Nephrology, 3(2), 162-165. http://doi.org/10.1007/bf00852899 - PubMed
  14. Valenzuela, I., Fernández-Alvarez, P., Plaja, A., Ariceta, G., Sabaté-Rotés, A., García-Arumí, E., Vendrell, T., & Tizzano, E. (2018). Further delineation of the SOX18-related hypotrichosis, lymphedema, telangiectasia syndrome (HTLS). European Journal of Medical Genetics, 61(5), 269-272. https://doi.org/10.1016/j.ejmg.2018.01.001 - PubMed
  15. Wangberg, H., Wigby, K., & Jones, M. C. (2018). A novel autosomal dominant mutation in SOX18 resulting in a fatal case of hypotrichosis-lymphedema-telangiectasia syndrome. American Journal of Medical Genetics. Part A, 176(12), 2824-2828. https://doi.org/10.1002/ajmg.a.40532 - PubMed
  16. Werler, M. M., Sheehan, J. E., & Mitchell, A. A. (2002). Maternal medication use and risks of gastroschisis and small intestinal atresia. American Journal of Epidemiology, 155(1), 26-31. https://doi.org/10.1093/aje/155.1.26 - PubMed
  17. Wünnemann, F., Kokta, V., Leclerc, S., Thibeault, M., McCuaig, C., Hatami, A., Stheneur, C., Grenier, J. C., Awadalla, P., Mitchell, G. A., Andelfinger, G., & Preuss, C. (2016). Aortic dilatation associated with a de novo mutation in the SOX18 gene: Expanding the clinical spectrum of hypotrichosis-lymphedema-telangiectasia syndrome. The Canadian Journal of Cardiology, 32(1), 135.e1-135.e1357. https://doi.org/10.1016/j.cjca.2015.04.004 - PubMed

Publication Types