Autosomal recessive cutis laxa type 1C with a homozygous LTBP4 splicing variant: a case report and update of literature

Mol Biol Rep. 2022 May;49(5):4135-4140. doi: 10.1007/s11033-022-07454-6. Epub 2022 Apr 20.

Abstract

Background: Autosomal recessive cutis laxa (ARCL) is a heterogeneous disorder with three primary forms (ARCL 1, ARCL 2 and ARCL 3). Latent transforming growth factor beta binding protein 4 (LTBP4) anomalies cause ARCL1C and are connected to different problems in the skin and other organs. Herein, we present a seven month old Iranian boy with a clinical manifestation of ARCL1 with literature review of previous cases with attributes of ARCL1C.

Methods: Considering the craniofacial characteristics and respiratory distress of the proband, cutis laxa (CL) was expected and whole-exome sequencing (WES) was performed.

Results: In the proband, signs of CL were mainly located in the face, thorax, and abdomen. The prenatal investigation revealed a diaphragmatic hernia and certain uncommon signs, such as an atrial septal defect and pyloric stenosis. The WES showed a novel homozygous mutation (c.533-1G > A) in exon six of the LTBP4 gene.

Conclusion: This report showed a new variant with uncommon clinical features, such as a stenosis atrial septal defect and pyloric stenosis, which causes ARCL1C. Unfortunately, the proband developed several heart problems and died at the age of seven months and seven days. Thus, a more in-depth evaluation is needed to clarify the different aspects of CL related to LTBP4 disorder.

Keywords: Autosomal recessive cutis laxa; Homozygous mutation; LTBP4; Whole-exome sequencing.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cartilage Diseases
  • Cutis Laxa* / genetics
  • Gastrointestinal Diseases
  • Heart Septal Defects, Atrial*
  • Humans
  • Infant
  • Iran
  • Latent TGF-beta Binding Proteins / genetics
  • Male
  • Pyloric Stenosis*
  • Respiratory Tract Diseases
  • Urologic Diseases

Substances

  • LTBP4 protein, human
  • Latent TGF-beta Binding Proteins

Supplementary concepts

  • Cutis Laxa With Severe Pulmonary, Gastrointestinal, And Urinary Abnormalities
  • Cutis Laxa, Autosomal Recessive, Type I