Mutation analysis of the motor neuron and pancreas homeobox 1 (MNX1, former HLXB9) gene in Swedish patients with Currarino syndrome

J Pediatr Surg. 2011 Jul;46(7):1390-5. doi: 10.1016/j.jpedsurg.2011.02.039.

Abstract

Background: Currarino syndrome (CS) is a triad consisting of partial sacral agenesis, presacral mass, and anorectal malformations, typically anal stenosis but the phenotype varies. The main cause of this monogenic disorder is mutations in the motor neuron and pancreas homeobox 1 gene. We describe the clinical and genetic findings in 4 unrelated Swedish cases with CS and their relatives.

Methods: We performed mutation analysis of the motor neuron and pancreas homeobox 1 gene in 4 cases with CS by DNA sequence analysis as well as multiplex ligation-dependent probe amplification. In addition, array comparative genome hybridization was performed in 2 cases. Including relatives, totally, 14 individuals were analyzed.

Results: We found 2 previously described mutations, 1 de novo nonsense mutation (p.Gln212X) and 1 maternally inherited frameshift mutation (p.Pro18ProfsX38). In the family with the frameshift mutation, we also detected the same maternally inherited mutation in 3 of the proband's 4 brothers, who displayed varying symptoms. All mutation carriers had presacral tumors, although 2 were asymptomatic.

Conclusion: Our findings emphasize the need for genetic counseling and mutation analysis in patients with CS to detect tumors early. It shows the importance of evaluation of the sacrum and the presacral region in patients with anal stenosis with or without funnel anus. Family members of index cases should be considered for evaluation even if they are asymptomatic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / epidemiology
  • Abnormalities, Multiple / genetics*
  • Adolescent
  • Anal Canal / abnormalities
  • Base Sequence
  • Child
  • Child, Preschool
  • Codon, Nonsense
  • Comparative Genomic Hybridization
  • DNA Mutational Analysis
  • Delayed Diagnosis
  • Digestive System Abnormalities / diagnosis
  • Digestive System Abnormalities / epidemiology
  • Digestive System Abnormalities / genetics*
  • Female
  • Frameshift Mutation
  • Homeodomain Proteins / genetics*
  • Humans
  • Male
  • Meningocele / genetics
  • Molecular Sequence Data
  • Pedigree
  • Rectum / abnormalities
  • Sacrum / abnormalities
  • Sweden / epidemiology
  • Syringomyelia / diagnosis
  • Syringomyelia / epidemiology
  • Syringomyelia / genetics*
  • Teratoma / genetics
  • Transcription Factors / genetics*
  • Young Adult

Substances

  • Codon, Nonsense
  • Homeodomain Proteins
  • MNX1 protein, human
  • Transcription Factors

Supplementary concepts

  • Currarino triad