Multiple congenital anomalies-hypotonia-seizures syndrome 3 secondary to phosphatidylinositol glycan class T mutation: a neonatal case report

Authors

  • Ankit Ranjan Department of Neonatology, Rani Hospital, Ranchi, Jharkhand, India https://orcid.org/0000-0003-4073-1193
  • M. Shahbaz Alam Department of Neonatology, Rani Hospital, Ranchi, Jharkhand, India
  • Vinod Kumar Department of Neonatology, Rani Hospital, Ranchi, Jharkhand, India
  • Snigdha Samanta Department of Neonatology, Rani Hospital, Ranchi, Jharkhand, India
  • Rajesh Kumar Department of Neonatology, Rani Hospital, Ranchi, Jharkhand, India
  • Khalid M. Saifullah Department of Neonatology, Rani Hospital, Ranchi, Jharkhand, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20230443

Keywords:

Congenital fracture, MCAHS3, PIGT, Homozygous mutation, Hypotonia

Abstract

Multiple congenital anomalies-hypotonia-seizures syndrome 3 (MCAHS3) is caused by genetic defects in glycosyl-phosphatidylinositol transamidase complex synthesis due to mutations in the PIGT gene. The disease encompasses dysmorphism, cardiac, genito-urinary and skeletal anomalies, developmental delay and epilepsy in variable severity. Only 39 such cases have been reported till date in literature. We reported the first Indian case with neonatal presentation and overall the sixth case of MCAHS3 to present in neonatal age. The pro-band was a male baby born to non-consanguineous parents. He had perinatal depression, craniofacial dysmorphism, epileptic encephalopathy, left radio-ulnar congenital fractures and respiratory failure managed with multiple anti-epileptics, invasive ventilation and limb splinting. Clinical exome sequencing revealed an autosomal recessive homozygous PIGT gene mutation on exon 6 of chromosome 20 with a variant nomenclature of C.709G>C with heterozygous parents confirming MCAHS3. This report expands the range of information available on MCAHS3. It highlights the need to elaborately investigate dysmorphic newborns with severe hypotonia along with the described neurological symptoms, so as to pin point this potentially diagnosable entity.

Metrics

Metrics Loading ...

References

Kinoshita T. Glycosylphosphatidylinositol (GPI) Anchors: Biochemistry and Cell Biology: Introduction to a Thematic Review Series. J Lipid Res. 2016;57(1):4-5.

Bayat A, Pendziwiat M, Obersztyn E, Goldenberg P, Zacher P, Döring JH, et al. Deep-Phenotyping the Less Severe Spectrum of PIGT Deficiency and Linking the Gene to Myoclonic Atonic Seizures. Front Genet. 2021;12:663643.

Jiao X, Xue J, Gong P, Bao X, Wu Y, Zhang Y, et al. Analyzing clinical and genetic characteristics of a cohort with multiple congenital anomalies-hypotonia-seizures syndrome (MCAHS). Orphanet J Rare Dis. 2020;15(1):78.

Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013;13(1):1-13.

Mabry CC, Bautista A, Kirk RF, Dubilier LD, Braunstein H, Koepke JA. Familial hyperphosphatase with mental retardation, seizures, and neurologic deficits. J Pediatr. 1970;77(1):74-85.

Kvarnung M, Nilsson D, Lindstrand A, Korenke GC, Chiang SC, Blennow E, et al. A novel intellectual disability syndrome caused by GPI anchor deficiency due to homozygous mutations in PIGT. J Med Genet. 2013;50(8):521-8.

Bayat A, Knaus A, Juul AW, Dukic D, Gardella E, Charzewska A, et al. PIGT-CDG, a disorder of the glycosylphosphatidylinositol anchor: description of 13 novel patients and expansion of the clinical characteristics. Genet Med. 2019;21(10):2216-23.

Stanek A, Szczepanik E, Mierzewska H, Rydzanicz M, Rutkowska K, Knaus A, et al. Evidence of the milder phenotypic spectrum of c.1582G>A PIGT variant: Delineation based on seven novel Polish patients. Clin Genet. 2020;98(5):468-76.

Pagnamenta AT, Murakami Y, Taylor JM, Anzilotti C, Howard MF, Miller V, et al. Analysis of exome data for 4293 trios suggests GPI-anchor biogenesis defects are a rare cause of developmental disorders. Eur J Hum Genet. 2017;25(6):669-79.

Kohashi K, Ishiyama A, Yuasa S, Tanaka T, Miya K, Adachi Y, et al. Epileptic apnea in a patient with inherited glycosylphosphatidylinositol anchor deficiency and PIGT mutations. Brain Dev. 2018;40(1):53-7.

Nakashima M, Kashii H, Murakami Y, Kato M, Tsurusaki Y, Miyake N, et al. Novel compound heterozygous PIGT mutations caused multiple congenital anomalies-hypotonia-seizures syndrome 3. Neurogenetics. 2014;15(3):193-200.

Kuki I, Takahashi Y, Okazaki S, Kawawaki H, Ehara E, Inoue N, et al. Vitamin B6-responsive epilepsy due to inherited GPI deficiency. Neurology. 2013;81(16):1467-9.

Downloads

Published

2023-02-23

How to Cite

Ranjan, A., Alam, M. S., Kumar, V., Samanta, S., Kumar, R., & Saifullah , K. M. (2023). Multiple congenital anomalies-hypotonia-seizures syndrome 3 secondary to phosphatidylinositol glycan class T mutation: a neonatal case report. International Journal of Contemporary Pediatrics, 10(3), 394–397. https://doi.org/10.18203/2349-3291.ijcp20230443

Issue

Section

Case Reports