Nonsense variants in STAG2 result in distinct sex-dependent phenotypes

J Hum Genet. 2019 May;64(5):487-492. doi: 10.1038/s10038-019-0571-y. Epub 2019 Feb 14.

Abstract

We herein report two individuals with novel nonsense mutations in STAG2 on Xq25, encoding stromal antigen 2, a component of the cohesion complex. A male fetus (Case 1) clinically presented with holoprosencephaly, cleft palate and lip, blepharophimosis, nasal bone absence, and hypolastic left heart by ultrasonography at 15 gestational weeks. Another female patient (Case 2) showed a distinct phenotype with white matter hypoplasia, cleft palate, developmental delay (DD), and intellectual disability (ID) at 7 years. Whole-exome sequencing identified de novo nonsense mutations in STAG2: c.3097C>T, p.(Arg1033*) in Case 1 and c.2229G>A, p.(Trp743*) in Case 2. X-inactivation was highly skewed in Case 2. To date, only 10 STAG2 pathogenic variants (four nonsense, four missense, and two frameshift) have been reported in patients with multiple congenital anomalies, ID, and DD. Although Case 2 showed similar clinical features to the reported female patients with STAG2 abnormalities, Case 1 showed an extremely severe phenotype, which could be explained by the first detected truncating variant in males.

Publication types

  • Case Reports
  • Retracted Publication

MeSH terms

  • Abnormalities, Multiple / genetics*
  • Abnormalities, Multiple / pathology
  • Antigens, Nuclear / genetics*
  • Cell Cycle Proteins
  • Child
  • Codon, Nonsense*
  • Female
  • Humans
  • Male
  • Mutation, Missense*
  • Sex Factors

Substances

  • Antigens, Nuclear
  • Cell Cycle Proteins
  • Codon, Nonsense
  • STAG2 protein, human