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Clin Dysmorphol. 2021 Apr 01;30(2):83-88. doi: 10.1097/MCD.0000000000000351.

Heterozygous intragenic deletions of FREM1 are not associated with trigonocephaly.

Clinical dysmorphology

Angelika J Dawson, Karine Hovanes, Jing Liu, Sandra Marles, Cheryl Greenberg, Aziz Mhanni, Albert Chudley, Patrick Frosk, Trilochan Sahoo, Denny Schanze, Martin Zenker

Affiliations

  1. Genomics, Shared Health Manitoba, Winnipeg.
  2. Department of Biochemistry and Medical Genetics, Program of Genetics and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada.
  3. Invitae, Irvine, California, USA.
  4. Institute of Human Genetics, University Hospital Magdeburg Leipziger Str. 44 39120 Magdeburg Germany.

PMID: 33038106 DOI: 10.1097/MCD.0000000000000351

Abstract

Recessive mutations in FRAS1-related extracellular matrix 1 (FREM1) are associated with two rare genetic disorders, Manitoba-oculo-tricho-anal (MOTA) and bifid nose with or without anorectal and renal anomalies (BNAR). Fraser syndrome is a more severe disorder that shows phenotypic overlap with both MOTA and anorectal and renal anomalies and results from mutations in FRAS1, FREM2 and GRIP1. Heterozygous missense mutations in FREM1 were reported in association with isolated trigonocephaly with dominant inheritance and incomplete penetrance. Moreover, large deletions encompassing FREM1 have been reported in association with a syndromic form of trigonocephaly and were designated as trigonocephaly type 2. Trigonocephaly results from premature closure of the metopic suture and typically manifests as a form of nonsyndromic craniosynostosis. We report on 20 patients evaluated for developmental delay and without abnormal metopic suture. Chromosomal microarray analysis revealed heterozygous FREM1 deletions in 18 patients and in 4 phenotypically normal parents. Two patients were diagnosed with MOTA and had homozygous FREM1 deletions. Therefore, although our results are consistent with the previous reports of homozygous deletions causing MOTA, we report no association between heterozygous FREM1 deletions and trigonocephaly in this cohort.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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