@article {568, title = {Xq26.3 Duplication in a Boy With Motor Delay and Low Muscle Tone Refines the X-Linked Acrogigantism Genetic Locus.}, journal = {J Endocr Soc}, volume = {2}, year = {2018}, month = {2018 Oct 01}, pages = {1100-1108}, abstract = {

We describe a 4-year-old boy with developmental delay who was found to carry by clinical grade (CG) molecular cytogenetics (MCs) a chromosome Xq26 microduplication. The report prompted a referral of the patient for possible X-linked acrogigantism (X-LAG), a well-defined condition (MIM300942) due to chromosomal microduplication of a nearby region. The patient was evaluated clinically and investigated for endocrine abnormalities related to X-LAG and not only did he not have acrogigantism, but his growth parameters and other hormones were all normal. We then performed high definition MCs and the duplication copy number variant (CNV) was confirmed to precisely map outside the X-LAG critical region and definitely did not harbor the X-LAG candidate gene, . The patient{\textquoteright}s phenotype resembled that of other patients with Xq26 CNVs. The case is instructive for the need for high definition MCs when CG MCs{\textquoteright} results are inconsistent with the patient{\textquoteright}s phenotype. It is also useful for further supporting the contention that is the gene responsible for X-LAG.

}, issn = {2472-1972}, doi = {10.1210/js.2018-00156}, author = {Trivellin, Giampaolo and Sharwood, Erin and Hijazi, Hadia and Carvalho, Claudia M B and Yuan, Bo and Tatton-Brown, Katrina and Coman, David and Lupski, James R and Cotterill, Andrew M and Lodish, Maya B and Stratakis, Constantine A} } @article {167, title = {Germline PRKACA amplification causes variable phenotypes that may depend on the extent of the genomic defect: molecular mechanisms and clinical presentations.}, journal = {Eur J Endocrinol}, volume = {172}, year = {2015}, month = {2015 06}, pages = {803-11}, abstract = {

OBJECTIVE: We have recently reported five patients with bilateral adrenocortical hyperplasia (BAH) and Cushing{\textquoteright}s syndrome (CS) caused by constitutive activation of the catalytic subunit of protein kinase A (PRKACA). By doing new in-depth analysis of their cytogenetic abnormality, we attempted a better genotype-phenotype correlation of their PRKACA amplification.

DESIGN: This study is a case series.

METHODS: Molecular cytogenetic, genomic, clinical, and histopathological analyses were performed in five patients with CS.

RESULTS: Reinvestigation of the defects of previously described patients by state-of-the-art molecular cytogenetics showed complex genomic rearrangements in the chromosome 19p13.2p13.12 locus, resulting in copy number gains encompassing the entire PRKACA gene; three patients (one sporadic case and two related cases) were observed with gains consistent with duplications, while two sporadic patients were observed with gains consistent with triplications. Although all five patients presented with ACTH-independent CS, the three sporadic patients had micronodular BAH and underwent bilateral adrenalectomy in early childhood, whereas the two related patients, a mother and a son, presented with macronodular BAH as adults. In at least one patient, PRKACA triplication was associated with a more severe phenotype.

CONCLUSIONS: Constitutional chromosomal PRKACA gene amplification is a recently identified genetic defect associated with CS, a trait that may be inherited in an autosomal dominant manner or occur de novo. Genomic rearrangements can be complex and can result in different copy number states of dosage-sensitive genes, e.g., duplication and triplication. PRKACA amplification can lead to variable phenotypes clinically and pathologically, both micro- and macro-nodular BAH, the latter of which we speculate may depend on the extent of amplification.

}, keywords = {Adrenal Glands, Adrenalectomy, Adult, Child, Child, Preschool, Cushing Syndrome, Cyclic AMP-Dependent Protein Kinase Catalytic Subunits, DNA Copy Number Variations, Female, Gene Amplification, Humans, Hyperplasia, Male, Phenotype, Young Adult}, issn = {1479-683X}, doi = {10.1530/EJE-14-1154}, author = {Lodish, Maya B and Yuan, Bo and Levy, Isaac and Braunstein, Glenn D and Lyssikatos, Charalampos and Salpea, Paraskevi and Szarek, Eva and Karageorgiadis, Alexander S and Belyavskaya, Elena and Raygada, Margarita and Faucz, Fabio Rueda and Izzat, Louise and Brain, Caroline and Gardner, James and Quezado, Martha and Carney, J Aidan and Lupski, James R and Stratakis, Constantine A} }