Late diagnosis of a truncating WISP3 mutation entails a severe phenotype of progressive pseudorheumatoid dysplasia

  1. Sebahattin Cirak3,4
  1. 1Cologne Center for Genomics (CCG), 50931 Cologne, Germany;
  2. 2Institute of Biochemistry I, University of Cologne, 50931 Cologne, Germany;
  3. 3Center for Molecular Medicine Cologne (CMMC), 50931 Cologne, Germany;
  4. 4University Children's Hospital of Cologne, 50931 Cologne, Germany
  1. Corresponding author: sebahattin.cirak{at}uk-koeln.de

Abstract

Rare diseases are often misdiagnosed or receive a delayed diagnosis; thus, unfortunately, affected individuals may not receive optimal medical management. Here, we report a case of two siblings with a severe phenotype of progressive pseudorheumatoid dysplasia (PPD). Their onset of symptoms began at the age of 3 yr. Both were neglected in the past, and the patients presented with a very severe phenotype and unmitigated natural history. PPD is a rare autosomal recessive skeletal dysplasia characterized by progressive joint stiffness, swelling, and pain. Because of observed muscle wasting, weakness, and the lack of laboratory testing, the case had been initially misdiagnosed by the local physicians. We aimed to provide diagnostic support by a targeted next-generation sequencing gene panel (Illumina TruSight One) for Mendelian diseases (Mendeliome), and we identified a homozygous frameshift mutation in the gene WISP3 (c.868_869delAG, p.Ser290Leufs*12). Thus, early diagnosis and intervention may have decreased the severity and complication of the disease.

Footnotes

  • [Supplemental material is available for this article.]

  • Received May 13, 2017.
  • Accepted November 20, 2017.

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