Assessing pathogenicity for novel mutation/sequence variants: the value of healthy older individuals.
Improvement in DNA technology is increasingly revealing unexpected/unknown mutations in healthy persons and generating anxiety due to their still unknown health consequences. We report a 44-year-old healthy father of a 10-year-old daughter with bilateral coloboma and hearing loss, but without muscle weakness, in whom a whole-genome CGH revealed a deletion of exons 38-44 in the dystrophin gene. This mutation was inherited from her asymptomatic father, who was further clinically and molecularly evaluated for prognosis and genetic counseling (GC). This deletion was never identified by us in 982 Duchenne/Becker patients. To assess whether the present case represents a rare case of non-penetrance, and aiming to obtain more information for prognosis and GC, we suggested that healthy older relatives submit their DNA for analysis, to which several complied. Mutation analysis revealed that his mother, brother, and 56-year-old maternal uncle also carry the 38-44 deletion, suggesting it an unlikely cause of muscle weakness. Genome sequencing will disclose mutations and variants whose health impact are still unknown, raising important problems in interpreting results, defining prognosis, and discussing GC. We suggest that, in addition to family history, keeping the DNA of older relatives could be very informative, in particular for those interested in having their genome sequenced.
Departamento de Genética e Biologia Evolutiva, Centro de Estudos do Genoma Humano, Universidade de São Paulo, Rua do Matão, 106, Cidade Universitária, São Paulo, SP, 05508-090, Brazil. mayazatz@usp.br
Mayana
M
Zatz
Rita de Cassia M
Rde C
Pavanello
Naila Cristina V
NC
Lourenço
Antonia
A
Cerqueira
Monize
M
Lazar
Mariz
M
Vainzof
D000328:Adult; D058070:Asymptomatic Diseases; D018070:Biological Specimen Banks; D001706:Biopsy; D015984:Causality; D002648:Child; D002653:Child Behavior Disorders / Q000235:genetics; D041321:Chromosomes, Human, X / Q000235:genetics*; D003072:Cognition Disorders / Q000235:genetics; D003103:Coloboma / Q000235:genetics*; D055028:Comparative Genomic Hybridization; D004247:DNA / Q000235:genetics*; D016189:Dystrophin / Q000235:genetics* / Q000502:physiology; D005091:Exons / Q000235:genetics; D019066:Facies; D005260:Female; D014644:Genetic Variation / Q000235:genetics*; D006312:Hearing Loss, Bilateral / Q000235:genetics*; D006319:Hearing Loss, Sensorineural / Q000235:genetics*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D010375:Pedigree; D017384:Sequence Deletion
C484258:DMD protein, human; D016189:Dystrophin; D004247:DNA