De novo three-way chromosome translocation 46,XY,t(4;6;21)(p16;p21.1;q21) in a male with cleidocranial dysplasia.
Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal dysplasia associated with cranial, clavicular, and dental anomalies. It is caused by mutations in the RUNX2 gene, which encodes an osteoblast-specific transcription factor and maps to chromosome 6p21. We report clinical and molecular cytogenetic studies in a patient with clinical features of CCD including wormian bones, delayed fontanel closure, hypoplastic clavicles and pubic rami, and supernumerary dentition. Additional abnormalities of bone growth and connective tissue, including easy bruisability, scarring, bleeding, joint hypermobility, and developmental delay were also observed. Molecular cytogenetic studies identified a de novo apparently balanced three-way translocation 46,XY,t(4;6;21)(p16;p21.1;q21). Further mapping revealed the breakpoint on 6p21 to be approximately 50 kb upstream of exon 1 of the RUNX2 gene, with RUNX2 being intact on the derivative chromosome 6. We hypothesize that the proband's CCD has arisen from disruption of the developmentally regulated gene RUNX2 at the 6p21 breakpoint, due to a position effect mutation which may have altered the expression of the gene. Further studies might unravel a new regulatory element for RUNX2.
Purandare
Smita M
SM
Section of Genetics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
Mendoza-Londono
Roberto
R
Yatsenko
Svetlana A
SA
Napierala
Dobrawa
D
Scott
Daryl A
DA
Sibai
Tarek
T
Casas
Kari
K
Wilson
Patrick
P
Lee
Jiyun
J
Muneer
Razia
R
Leonard
Joe C
JC
Ramji
Faridali G
FG
Lachman
Ralph
R
Li
Shibo
S
Stankiewicz
Pawel
P
Lee
Brendan
B
Mulvihill
John J
JJ
D000293:Adolescent; D002891:Chromosomes, Human, Pair 21; D002894:Chromosomes, Human, Pair 4; D002896:Chromosomes, Human, Pair 6; D002973:Cleidocranial Dysplasia / Q000235:genetics*; D020732:Cytogenetic Analysis; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D014178:Translocation, Genetic