Abstract
Genetic defect of phosphatase and tensin homolog (PTEN) gene might play a role in B cell hyperactivity and result in the development of systemic lupus erythematosus (SLE), while transaldolase deficiency has a spectrum of clinical features including autoimmune endocrinopathy. Herein, we identified a novel phenotype in a girl presenting with clinical and laboratory findings consistent with SLE. Exome sequencing identified pathogenic heterozygous variant in PTEN gene (NM_000314: exon 6: c.518G > C: p. R173P) and homozygous variant in TALDO1 gene (NM_006755: exon 6: c.793C del: p. Q265f). Our report highlights the association of PTEN mutation and autoimmunity and the possibility that transaldolase deficiency may be indirectly involved in the development of SLE.
Similar content being viewed by others
References
Hiraki L, Silverman E (2017) Genomics of systemic lupus erythematosus: insights gained by studying monogenic young-onset systemic lupus erythematosus. Rheum Dis Clin N Am 43:415–434
Hu Z, Zou Q, Su B (2018) Regulation of T cell immunity by cellular metabolism. Front Med 12:463–472
Taylor H, Laurence A, Uhlig H (2019) The role of PTEN in innate and adaptive immunity. Cold Spring Harb Perspect Med 9(12). https://doi.org/10.1101/cshperspect.a036996
Wu S, Wang J, Li F (2018) Dysregulation of PTEN caused by the underexpression of microRNA130b is associated with the severity of lupus nephritis. Mol Med Rep 17:7966–7972
Shrinath M, Walter J, Haeney M, Couriel J, Lewis M, Herrick A (1997) Prolidase deficiency and systemic lupus erythematosus. Arch Dis Child 76:441–444
Aoki M, Fukao T, Fujita Y, Watanabe M, Teramoto T, Kato Y, Suzuki Y, Kondo N (2001) Lysinuric protein intolerance in siblings: complication of systemic lupus erythematosus in the elder sister. Eur J Pediatr 160:522–523
Urushihara M, Kagami S, Yasutomo K, Ito M, Kondo S, Kitamura A, Malm D, Klenow H, Nilssen O, Kuroda Y (2004) Sisters with alpha-mannosidosis and systemic lupus erythematosus. Eur J Pediatr 163:192–195
Williams M, Valayannopoulos V, Altassan R, Chung W, Heijboer A, Keng W et al (2019) Clinical, biochemical, and molecular overview of transaldolase deficiency and evaluation of the endocrine function: update of 34 patients. J Inherit Metab Dis 42:147–158
Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J et al (2015) Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 17:405–424
Eyaid W, Al Harbi T, Anazi S, Wamelink M, Jakobs C, Al Salammah M et al (2013) Transaldolase deficiency: report of 12 new cases and further delineation of the phenotype. J Inherit Metab Dis 36:997–1004
Kirches E, Steiner J, Schneider T, Vorwerk C, Scherlach C, Holtkamp N, Keilhoff G, Eng C, Mawrin C (2010) Lhermitte-Duclos disease caused by a novel germline PTEN mutation R173P in a patient presenting with psychosis. Neuropathol Appl Neurobiol 36:86–89
Omarjee O, Picard C, Frachette C, Moreews M, Rieux-Laucat F, Soulas-Sprauel P, Belot A et al (2019) Monogenic lupus: Dissecting heterogeneity. Autoimmun Rev 18(10):102361. https://doi.org/10.1016/j.autrev.2019.102361
Tirosh I, Spielman S, Barel O, Ram R, Stauber T, Paret G et al (2019) Whole exome sequencing in childhood-onset lupus frequently detects single gene etiologies. Pediatr Rheumatol Online J 17(1):52. https://doi.org/10.1186/s12969-019-0349-y
Petri M, Orbai A, Alarcón G, Gordon C, Merrill J, Fortin P et al (2012) Derivation and validation of the Systemic Lupus International Collaborating Clinic classification criteria for systemic lupus erythematosus. Arthritis Rheum 64:2677–2686
Tan M, Mester J, Peterson C, Yang Y, Chen J, Rybicki L et al (2011) A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands. Am J Hum Genet 88:42–56
Wu X, Ye Y, Niu J, Li Y, Li X, You X et al (2014) Defective PTEN regulation contributes to B cell hyperresponsiveness in systemic lupus erythematosus. Sci Transl Med 6(246):246ra99. https://doi.org/10.1126/scitranslmed.3009131
Lee T, Le E, Glass D II, Bowen C, Dominguez A (2014) Systemic lupus erythematosus in a patient with PTEN hamartoma tumor syndrome. Br J Dermatol 170:990–992
Banki K, Hutter E, Colombo E, Gonchoroff NJ, Perl A (1996) Glutathione levels and sensitivity to apoptosis are regulated by changes in transaldolase expression. J Biol Chem 271:32994–33001
Perl A, Hanczko R, Telarico T, Oaks Z, Landas S (2011) Oxidative stress, inflammation and carcinogenesis are controlled through the pentose phosphate pathway by transaldolase. Trends Mol Med 17:395–403
Oaks Z, Winans T, Caza T, Fernandez D, Liu Y, Landas SK, Banki K, Perl A (2016) Mitochondrial dysfunction in the liver and antiphospholipid antibody production precede disease onset and respond to A. rapamycin in lupus-prone mice. Arthritis Rheum 68:2728–2739
Acknowledgments
We thank our patient and her family for collaboration in this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics statement
All procedures described in this manuscript were performed in accordance with the ethical standards. Informed consent was obtained from the patient’s parents for blood and urine tests. Furthermore, informed consent has been obtained from the parents to access and collect data from the medical record to be used in scientific publications.
Disclosures
None.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Al-Mayouf, S.M., AlTassan, R.S. & AlOwain, M.A. Systemic lupus erythematosus in a girl with PTEN variant and transaldolase deficiency: a novel phenotype. Clin Rheumatol 39, 3511–3515 (2020). https://doi.org/10.1007/s10067-020-05205-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-020-05205-1