PMID:28087245

Citation	Hossain, MA, Yanagisawa, H, Miyajima, T, Wu, C, Takamura, A, Akiyama, K, Itagaki, R, Eto, K, Iwamoto, T, Yokoi, T, Kurosawa, K, Numabe, H and Eto, Y (2017) The severe clinical phenotype for a heterozygous Fabry female patient correlates to the methylation of non-mutated allele associated with chromosome 10q26 deletion syndrome. Mol. Genet. Metab. 120:173-179
Abstract	Heterozygous Fabry females usually have an attenuated form of Fabry disease, causing them to be symptomatic; however, in rare cases, they can present with a severe phenotype. In this study, we report on a 37-year-old woman with acroparesthesia, a dysmorphic face, left ventricular hypertrophy, and intellectual disability. Her father had Fabry disease and died due to chronic renal and congestive cardiac failure. Her paternal uncle had chronic renal failure and intellectual disability, and her paternal aunt was affected with congestive cardiac failure. The patient has two sisters with no significant medical illness. However, her nephew has acroparesthesia, anhidrosis, and school phobia, and her niece shows mild phenotypes. The patient's enzyme analysis showed very low α-galactosidase A (α-gal A) activity in dried blood spot (DBS), lymphocytes, and skin fibroblasts with massive excretion of Gb3 and Gb2 in urine and lyso-Gb3 in DBS and plasma. Electron microscopic examination showed a large accumulation of sphingolipids in vascular endothelial cells and keratinocytes. Chromosomal analysis and comparative genomic hybridization microarray showed 10q26 terminal deletion. Molecular data showed a novel heterozygous stop codon mutation in exon 1 of the GLA gene in her sisters and niece, and a hemizygous state in her nephew. When we checked the methylation status, we found her non-mutated allele in the GLA gene was methylated. However, the non-mutated alleles of her sisters were non-methylated, and those of her niece were partially methylated. The chromosomal and methylation study may speculate the severity of her clinical phenotypes.
Links	PubMed Online version:10.1016/j.ymgme.2017.01.002
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Annotations

Gene product	Qualifier	GO Term	Evidence Code	with/from	Aspect	Extension	Notes	Status
HUMAN:CALY	Contributes to	GO:0003824: alpha-1,3-mannosyltransferase activity	ECO:0000247:	UniProtKB:P06280	F		Figure 6. Non mutated allele in the GLA gene was methylated, compared to the non-mutated allele in the GLA gene in related patients which was not methylated resulting in more severe clinical phenotypes	complete CACAO 12781

References

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