关键词: Loeys-Dietz syndrome TGFB3 aortic dilatation aortic dissection connective tissue disorder transforming growth factor beta 3

Mesh : Adolescent Adult Arachnodactyly / genetics pathology Child Child, Preschool Connective Tissue Diseases / genetics pathology Female Genetic Predisposition to Disease Genotype Heterozygote Homozygote Humans Loeys-Dietz Syndrome / genetics pathology Male Middle Aged Mutation / genetics Pedigree Phenotype Transforming Growth Factor beta3 / deficiency genetics Young Adult

来  源:   DOI:10.1111/cge.13700   PDF(Sci-hub)

Abstract:
Disease-causing variants in TGFB3 cause an autosomal dominant connective tissue disorder which is hard to phenotypically delineate because of the small number of identified cases. The purpose of this retrospective cross-sectional multicenter study is to elucidate the genotype and phenotype in an international cohort of TGFB3 patients. Eleven (eight novel) TGFB3 disease-causing variants were identified in 32 patients (17 families). Aortic root dilatation and mitral valve disease represented the most common cardiovascular findings, reported in 29% and 32% of patients, respectively. Dissection involving distal aortic segments occurred in two patients at age 50 and 52 years. A high frequency of systemic features (65% high-arched palate, 63% arachnodactyly, 57% pectus deformity, 52% joint hypermobility) was observed. In familial cases, incomplete penetrance and variable clinical expressivity were noted. Our cohort included the first described homozygous patient, who presented with a more severe phenotype compared to her heterozygous relatives. In conclusion, TGFB3 variants were associated with a high percentage of systemic features and aortic disease (dilatation/dissection) in 35% of patients. No deaths occurred from cardiovascular events or pregnancy-related complications. Nevertheless, homozygosity may be driving a more severe phenotype.
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