Open AccessMaple syrup urine disease due to a paracentric inversion of chr 19 that disrupts BCKDHA : A case report
Author(s) -
Yokoi Katsuyuki,
Nakajima Yoko,
Sudo Yuta,
Mariya Tasuku,
Kawamura Rie,
Tsutsumi Makiko,
Inagaki Hidehito,
Yoshikawa Tetsushi,
Ito Tetsuya,
Kurahashi Hiroki
Publication year - 2022
Publication title -
jimd reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.412
H-Index - 25
ISSN - 2192-8312
DOI - 10.1002/jmd2.12333
Subject(s) - maple syrup urine disease , genetics , missense mutation , biology , inborn error of metabolism , phenotype , breakpoint , gene , amino acid , biochemistry , chromosomal translocation , leucine
Maple syrup urine disease (MSUD) is a rare autosomal recessive inherited disorder of branched‐chain amino acid metabolism caused by mutations in BCKDHA , BCKDHB , and DBT that encode the E1α, E1β, and E2 subunits of the branched‐chain α‐ketoacid dehydrogenase (BCKD) complex. Various MSUD‐causing variants have been described; however, no structural rearrangements in BCKDHA have been reported to cause the classic MSUD phenotype. Here, we describe the classic patient with MSUD with compound heterozygous pathogenic variants in BCKDHA : a missense variant (NM_000709.3:c.757G > A, NP_000700.1:p.Ala253Thr) and a paracentric inversion disrupting Intron 1 of BCKDHA , which was identified by whole‐genome sequencing and validated by fluorescence in situ hybridization. Using the sequence information of the breakpoint junction, we gained mechanistic insight into the development of this structural rearrangement. Furthermore, the establishment of junction‐specific polymerase chain reaction could facilitate identification of the variant in case carrier or future prenatal/preimplantation tests are necessary.