Vitamin A deficiency due to bi-allelic mutation of RBP4: There's more to it than meets the eye

Ophthalmic Genet. 2017 Sep-Oct;38(5):465-466. doi: 10.1080/13816810.2016.1227453. Epub 2016 Nov 28.

Abstract

Vitamin A deficiency is the leading cause of preventable blindness in children worldwide and results in a well-recognized ocular phenotype. Herein we describe a patient presenting to the eye clinic with a retinal dystrophy and ocular colobomata. This combination of clinical signs and consanguineous pedigree structure suggested a genetic basis for the disease, a hypothesis that was tested using whole genome sequencing. Bi-allelic mutations in RBP4 were identified (c.248+1G>A), consistent with a diagnosis of inherited vitamin A deficiency. We describe a constellation of signs that appear to be characteristic for this disease, increasing clinical awareness of this rare condition.

Keywords: Iris coloboma; RBP4; microphthalmia; serum retinol level; vitamin A deficiency; whole genome sequencing.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alleles
  • Coloboma / blood
  • Coloboma / genetics*
  • Consanguinity
  • Female
  • Humans
  • Iris / abnormalities*
  • Microphthalmos / blood
  • Microphthalmos / genetics*
  • Mutation*
  • Retinitis Pigmentosa / blood
  • Retinitis Pigmentosa / genetics*
  • Retinol-Binding Proteins, Plasma / genetics*
  • Tomography, Optical Coherence
  • Vitamin A / blood
  • Vitamin A Deficiency / blood
  • Vitamin A Deficiency / genetics*
  • Whole Genome Sequencing

Substances

  • RBP4 protein, human
  • Retinol-Binding Proteins, Plasma
  • Vitamin A