A rare form of ankyloblepharon filiforme adnatum associated with the Hay-Wells syndrome and a c.1709T>C mutation on the TP63 gene

Ophthalmic Genet. 2018 Apr;39(2):251-254. doi: 10.1080/13816810.2017.1401091. Epub 2017 Nov 15.

Abstract

Introduction: Ankyloblepharon filiforme adnatum associated with Hay-Wells syndrome is a rare congenital disease caused by mutations in TP63 gene on the 3q27 chromosome. Here, we report a case of a new-born suffering from this syndrome in whom we detected a mutation c.1709T>C not previously included in the Ensemble database.

Case description: A girl delivered in the 34th week of gestation from a physiological pregnancy was born with extensive burn-like skin defects, ankyloblepharon filiforme adnatum, palate cleft, onychodystrophy of all limbs and syndactyly of toes. Hay-Wells syndrome was suspected and confirmed by genetic examination. A heterozygous missense change c.1709T>C was found in the TP63 gene. This variant leads to a 570th codon exchange of leucine for proline (p.Leu570Pro) on the protein level. The eyelid separation was performed surgically, burns were treated locally and cosmetic surgeries correcting other defects are planned for the near future. The girl is still monitored by a multidisciplinary team.

Conclusions: The mutation was not previously described in the literature or databases and should be included into these as probably pathogenic. A multidisciplinary approach is necessary to care for a patient with Hay-Wells syndrome, such care however can provide good results.

Keywords: Ankyloblepharon filiforme adnatum; Hay–Wells syndrome; TP63 gene; congenital eyelids disorders; ectodermal dysplasia; p63 protein.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cleft Lip / diagnosis
  • Cleft Lip / genetics*
  • Cleft Lip / surgery
  • Cleft Palate / diagnosis
  • Cleft Palate / genetics*
  • Cleft Palate / surgery
  • Ectodermal Dysplasia / diagnosis
  • Ectodermal Dysplasia / genetics*
  • Ectodermal Dysplasia / surgery
  • Eye Abnormalities / diagnosis
  • Eye Abnormalities / genetics*
  • Eye Abnormalities / surgery
  • Eyelids / abnormalities*
  • Eyelids / surgery
  • Female
  • Genetic Testing
  • Gestational Age
  • Heterozygote
  • Humans
  • Infant, Newborn
  • Mutation, Missense / genetics*
  • Ophthalmologic Surgical Procedures
  • Transcription Factors / genetics*
  • Tumor Suppressor Proteins / genetics*
  • Young Adult

Substances

  • TP63 protein, human
  • Transcription Factors
  • Tumor Suppressor Proteins

Supplementary concepts

  • Ankyloblepharon filiforme adnatum
  • Hay-Wells syndrome