delineation of musculocontractural ehlers–danlos syndrome caused by dermatan sulfate epimerase deficiency

delineation of musculocontractural ehlers–danlos syndrome caused by dermatan sulfate epimerase deficiency

;Charlotte K. Lautrup;Keng W. Teik;Ai Unzaki;Shuji Mizumoto;Delfien Syx;Heng H. Sin;Irene K. Nielsen;Sara Markholt;Shuhei Yamada;Fransiska Malfait;Naomichi Matsumoto;Noriko Miyake;Tomoki Kosho
zhonghua shiyan yanke zazhi/chinese journal of experimental ophthalmology 2020 Vol. 8 pp. n/a-n/a
168
lautrup2020moleculardelineation

Abstract

Abstract Background Musculocontractural Ehlers–Danlos Syndrome (mcEDS) is a rare connective tissue disorder caused by biallelic loss‐of‐function variants in CHST14 (mcEDS‐CHST14) or DSE (mcEDS‐DSE), both of which result in defective dermatan sulfate biosynthesis. Forty‐one patients with mcEDS‐CHST14 and three patients with mcEDS‐DSE have been described in the literature. Methods Clinical, molecular, and glycobiological findings in three additional patients with mcEDS‐DSE were investigated. Results Three patients from two families shared craniofacial characteristics (hypertelorism, blue sclera, midfacial hypoplasia), skeletal features (pectus and spinal deformities, characteristic finger shapes, progressive talipes deformities), skin features (fine or acrogeria‐like palmar creases), and ocular refractive errors. Homozygous pathogenic variants in DSE were found: c.960T>A/p.Tyr320* in patient 1 and c.996dupT/p.Val333Cysfs*4 in patients 2 and 3. No dermatan sulfate was detected in the urine sample from patient 1, suggesting a complete depletion of DS. Conclusion McEDS‐DSE is a congenital multisystem disorder with progressive symptoms involving craniofacial, skeletal, cutaneous, and cardiovascular systems, similar to the symptoms of mcEDS‐CHST14. However, the burden of symptoms seems lower in patients with mcEDS‐DSE.

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