A homozygous mutation in the lamin A/C gene associated with a novel syndrome of arthropathy, tendinous calcinosis, and progeroid features.
BACKGROUND
Mutations in the lamin A/C (LMNA) gene have been reported in a wide variety of disorders, including lipodystrophies, cardiomyopathy, muscular dystrophies, neuropathy, mandibuloacral dysplasia, restrictive dermopathy, and progeria.


OBJECTIVE
The objective of this study was to carry out mutational analysis of LMNA in a patient with a novel syndrome of arthropathy, tendinous calcinosis, and progeroid features.


METHODS
The study design was a descriptive case report.


METHODS
The study was performed at a referral center.


METHODS
A 44-yr-old male of European descent with an autosomal recessive arthropathy syndrome affecting predominantly the distal femora and proximal tibia in the knee with tendinous calcifications was studied. He also had progeroid features, such as pinched nose and micrognathia, cataract, alopecia, generalized lipodystrophy, and sclerodermatous skin.


METHODS
The main outcome measures were mutational analysis of lamin A/C (LMNA) and its processing enzyme, zinc metalloproteinase (ZMPSTE24), as candidate genes.


RESULTS
We found a homozygous nucleotide substitution, 1718C>T, in exon 11 of the LMNA gene, resulting in substitution of a well-conserved residue serine at position 573 with leucine (S573L). This missense mutation only affects lamin A, not lamin C, because the alternative splicing site is located in exon 10. Immunofluorescence staining of the nuclei from his skin fibroblasts showed occasional misshapen morphology.


CONCLUSIONS
The S573L homozygous LMNA mutation is associated with a novel phenotype of arthropathy, tendinous calcifications, and progeroid features distinct from the acroosteolysis previously reported in patients with mandibuloacral dysplasia caused by LMNA or ZMPSTE24 mutations. Thus, arthropathy with tendinous calcifications can be added to the growing list of disorders associated with LMNA mutations.
Van Esch
Hilde
H
Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9052, USA.
Agarwal
Anil K
AK
Debeer
Philippe
P
Fryns
Jean-Pierre
JP
Garg
Abhimanyu
A
D000328:Adult; D002114:Calcinosis / Q000235:genetics* / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D007592:Joint Diseases / Q000235:genetics* / Q000473:pathology; D034904:Lamin Type A / Q000235:genetics*; D008297:Male; D020125:Mutation, Missense; D010375:Pedigree; D013577:Syndrome; D014898:Werner Syndrome / Q000235:genetics* / Q000473:pathology
C494847:LMNA protein, human; D034904:Lamin Type A