A novel variant in the 3' UTR of the TCF4 gene likely causes Pitt-Hopkins syndrome: a case report

Orphanet J Rare Dis. 2024 Oct 7;19(1):368. doi: 10.1186/s13023-024-03383-8.

Abstract

Background: Pitt-Hopkins syndrome (PTHS) is a rare neurodevelopmental disorder that results from variants of TCF4 gene. PTHS follows an autosomal dominant inheritance pattern and the underlying pathological mechanisms of this disease are still unclear.

Methods: Whole-genome sequencing (WGS) was conducted to screen for potential pathogenic variant in a boy highly suspected of having a genetic disorder. PCR and Sanger sequencing were used to verify the effects of the variant. Serum TCF4 levels were measured by ELISA.

Results: We present a 4-year and 3-month-old Chinese boy clinically and molecularly diagnosed with PTHS. The proband experienced global development delay, and the preliminary clinical diagnosis was cerebral palsy. WGS identified a de novo heterozygous variant: c.*1A > G in the 3'UTR of the TCF4 gene as a potential cause of his condition. The variant was verified to cause aberrant mRNA splicing by PCR and the aberrant splicing was confirmed by Sanger sequencing.

Conclusion: The study identified and demonstrated the pathogenicity of a novel 3'UTR site TCF4 variant for the first time. This research enhances understanding of pathogenetic mechanisms of PTHS and aids genetic counseling and diagnosis.

Keywords: TCF4; Clinically diagnosed; Molecularly diagnosed; Pitt-Hopkins syndrome; Whole-genome sequencing.

Publication types

  • Case Reports

MeSH terms

  • 3' Untranslated Regions* / genetics
  • Child, Preschool
  • Facies
  • Humans
  • Hyperventilation* / genetics
  • Intellectual Disability* / genetics
  • Male
  • Mutation / genetics
  • Transcription Factor 4* / genetics

Substances

  • Transcription Factor 4
  • TCF4 protein, human
  • 3' Untranslated Regions

Supplementary concepts

  • Pitt-Hopkins syndrome