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Highly variable penetrance in subjects affected with cavernous cerebral angiomas (CCM) carrying novel CCM1 and CCM2 mutations
Author(s) -
Gianfrancesco Fernando,
Cannella Milena,
Martino Tiziana,
Maglione Vittorio,
Esposito Teresa,
Innocenzi Gualtiero,
Vitale Emilia,
Liquori Christina L.,
Marchuk Douglas A.,
Squitieri Ferdinando
Publication year - 2007
Publication title -
american journal of medical genetics part b: neuropsychiatric genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.393
H-Index - 126
eISSN - 1552-485X
pISSN - 1552-4841
DOI - 10.1002/ajmg.b.30381
Subject(s) - penetrance , headaches , medicine , mutation , family history , migraine , asymptomatic , asymptomatic carrier , pathology , hemangioma , spinal cord , genetics , gene , biology , phenotype , surgery , psychiatry
Cavernous vascular malformations may affect brain and out‐of‐brain tissues. In most cases, cerebral cavernous malformations (CCMs) involve the brain alone, and are rarely associated with skin hemangiomas, spinal cord, retinal, hepatic or vertebral lesions. CCMs can cause seizures, intracranial and spinal haemorrhages, focal neurological deficits, and migraine‐like headaches. After collecting CCM families of Italian origin and investigating the genetic basis of the disorder we disclosed two novel molecular variations in the KRIT1 and MGC4607 genes. We found a novel CCM1 gene mutation (Q66X) in a family with apparently asymptomatic old‐aged mutation carriers and patients who either had skin angiomas alone or the full association of cerebral, spinal, and skin lesions. In this family we report the highest variability in mutation penetrance so far described, including the presence of CCM in one subject since birth (surgery at 19 months of age), a condition to our knowledge so far unreported. In a CCM2 affected family, we also report a novel causative mutation, (54_55delAC) in exon 2 of the MGC4607 gene, that produces a truncated protein containing only 22 amino acids. These data describe novel CCM mutations associated with a particularly high variability of the penetrance causing, in some cases, reduced expression of clinical symptoms and sporadic cases with apparent negative family history. Hence they emphasize the importance of DNA‐based diagnostics and genetic counseling to identify unaffected mutation carriers subjects, even at advanced age. © 2007 Wiley‐Liss, Inc.