Abstract
Contiguous microdeletions of the Norrie disease pseudoglioma (NDP) region on chromosome Xp11.3 have been widely confirmed as contributing to the typical clinical features of Norrie disease (ND). However, the precise relation between genotype and phenotype could vary. The contiguous deletion of NDP and its neighbouring genes, MAOA/B and EFHC2, reportedly leads to syndromic clinical features such as microcephaly, intellectual disability, and epilepsy. Here we report a novel contiguous microdeletion of the NDP region containing the MAOB and EFHC2 genes, which causes eye defects but no cognitive disability. We detected a deletion of 494.6 kb at Xp11.3 in both the proband and carrier mother. This deletion was then used as the molecular marker in prenatal diagnosis for two subsequent pregnancies. The deletion was absent in one of the foetuses, who remain without any abnormalities at 2 years of age. The proband shows the typical ocular clinical features of ND including bilateral retinal detachment, microphthalmia, atrophic irides, corneal opacification, and cataracts, but no symptoms of microcephaly, intellectual disability, and epilepsy. This familial study demonstrates that a deficiency in one of two MAO genes may not lead to psychomotor delay, and deletion of EFHC2 may not cause epilepsy. Our observations provide new information on the genotype–phenotype relations of \({\textit{MAOA/B}}\) and EFHC2 genes involved in the contiguous deletions of ND.




Similar content being viewed by others
Explore related subjects
Discover the latest articles and news from researchers in related subjects, suggested using machine learning.References
Aponte E. P., Pulido J. S., Ellison J. W., Quiram P. A. and Mohney B. G. 2009 A novel NDP mutation in an infant with unilateral persistent fetal vasculature and retinal vasculopathy. Ophthalmic Genet. 30, 99–102.
Berger W., Meindl A., van de Pol T. J., Cremers F. P., Ropers H. H., Doerner C. et al. 1992 Isolation of a candidate gene for Norrie disease by positional cloning. Nat. Genet. 1, 199–203.
Berrin T., Hikmet Y., Gülşen V., Ferda B., Erdal B. and Ece O. 2015 No relation between EFHC2 gene polymorphism and idiopathic generalized epilepsy. Afr. Health Sci. 15, 1204–1210.
Bortolato M., Godar S. C., Alzghoul L., Zhang J., Darling R. D., Simpson K. L. et al. 2013 Monoamine oxidase A and A/B knockout mice display autistic-like features. Int. J. Neuropsychopharmacol. 16, 869–888.
Chen Z. Y., Sims K. B., Coleman M., Donnai D., Monaco A., Breakefield X. O. et al. 1992 Characterization of a YAC containing part or all of the Norrie disease locus. Hum. Mol. Genet. 1, 161–164.
Chen Z. Y., Battinelli E. M., Fielder A., Bundey S., Sims K., Breakefield X. O. and Craig I. W. 1993 A mutation in the Norrie disease gene (NDP) associated with X-linked familial exudative vitreoretinopathy. Nat. Genet. 5, 180–183.
Chen Z. Y., Denney R. M. and Breakefield X. O. 1995 Norrie disease and MAO genes: nearest neighbors. Hum. Mol. Genet. 4, 1729–1737.
Collins F. A., Murphy D. L., Reiss A. L., Sims K. B., Lewis J. G., Freund L. et al. 1992 Clinical, biochemical, and neuropsychiatric evaluation of a patient with a contiguous gene syndrome due to a microdeletion Xp11.3 including the Norrie disease locus and monoamine oxidase (MAOA and MAOB) genes. Am. J. Med. Genet. 42, 127–134.
Deng C., Reddy P., Cheng Y., Luo C. W., Hsiao C. L. and Hsueh A. J. 2013 Multi-functional norrin is a ligand for the LGR4 receptor. J. Cell. Sci. 126, 2060–2080.
Donnai D., Mountford R. C. and Read A. P. 1988 Norrie disease resulting from a gene deletion: clinical features and DNA studies. J. Med. Genet. 25, 73–78.
Fuchs S., Xu S. Y., Caballero M., Salcedo M., La O. A., Wedemann H. and Gal A. 1994 A missense point mutation (Leu13Arg) of the Norrie disease gene in a large Cuban kindred with Norrie disease. Hum. Mol. Genet. 3, 655–656.
Gal A., Wieringa B., Smeets D. F., Bleeker-Wagemakers L. and Ropers H. H. 1986 Submicroscopic interstitial deletion of the X chromosome explains a complex genetic syndrome dominated by Norrie disease. Cytogenet. Cell Genet. 42, 219–224.
Gu W., Sander T., Heils A., Lenzen K. P. and Steinlein O. K. 2005 A new EF-hand containing gene EFHC2 on Xp11.4: tentative evidence for association with juvenile myoclonic epilepsy. Epilepsy Res. 66, 91–98.
Lenders J. W., Eisenhofer G., Abeling N. G., Berger W., Murphy D. L., Konings C. H. et al. 1996 Specific genetic deficiencies of the A and B isoenzymes of monoamine oxidase are characterized by distinct neurochemical and clinical phenotypes. J. Clin. Invest. 97, 1010–1019.
Nikopoulos K., Venselaar H., Collin R. W., Riveiro-Alvarez R., Boonstra F. N., Hooymans J. M. et al. 2010 Overview of the mutation spectrum in familial exudative vitreoretinopathy and Norrie disease with identification of 21 novel variants in FZD4, LRP5, and NDP. Hum. Mutat. 31, 656–666.
Pelcastre E. L., Villanueva-Mendoza C. and Zenteno J. C. 2010 Novel and recurrent NDP gene mutations in familial cases of Norrie disease and X-linked exudative vitreoretinopathy. Clin. Experiment. Ophthalmol. 38, 367–374.
Rodriguez-Revenga L., Madrigal I., Alkhalidi L. S., Armengol L., Gonzalez E., Badenas C. et al. 2007 Contiguous deletion of the NDP, MAOA, MAOB, and EFHC2 genes in a patient with Norrie disease, severe psychomotor retardation and myoclonic epilepsy. Am. J. Med. Genet. A 143, 916–920.
Saito M., Yamagata T., Matsumoto A., Shiba Y., Nagashima M., Taniguchi S. et al. 2014 MAOA/B deletion syndrome in male siblings with severe developmental delay and sudden loss of muscle tonus. Brain Dev. 36, 64–69.
Schuback D. E., Chen Z. Y., Craig I. W., Breakefield X. O. and Sims K. B. 1995 Mutations in the Norrie disease gene. Hum. Mutat. 5, 285–292.
Sims K. B., de la Chapelle A., Norio R., Sankila E. M., Hsu Y. P., Rinehart W. B. et al. 1989 Monoamine oxidase deficiency in males with an X chromosome deletion. Neuron 2, 1069–1076.
Smith S. E., Mullen T. E., Graham D., Sims K. B. and Rehm H. L. 2012 Norrie disease: extraocular clinical manifestations in 56 patients. Am. J. Med. Genet. A 158, 1909–1917.
Staropoli J. F., Xin W. and Sims K. B. 2010 Co-segregation of Norrie disease and idiopathic pulmonary hypertension in a family with a microdeletion of the NDP region at Xp11.3-p11.4. J. Med. Genet. 47, 786–790.
Suarez-Merino B., Bye J., McDowall J., Ross M. and Craig I. W. 2001 Sequence analysis and transcript identification within 1.5 MB of DNA deleted together with the NDP and MAO genes in atypical Norrie disease patients presenting with a profound phenotype. Hum. Mutat. 17, 523.
Suzuki T., Delgado-Escueta A. V., Aguan K., Alonso M. E., Shi J., Hara Y. et al. 2004 Mutations in EFHC1 cause juvenile myoclonic epilepsy. Nat. Genet. 36, 842–849.
Wang Y., Rattner A., Zhou Y., Williams J., Smallwood P. M. and Nathans J. 2012 Norrin/Frizzled4 signaling in retinal vascular development and blood brain barrier plasticity. Cell 151, 1332–1344.
Whibley A., Urquhart J., Dore J., Willatt L., Parkin G., Gaunt L. et al. 2010 Deletion of MAOA and MAOB in a male patient causes severe developmental delay, intermittent hypotonia and stereotypical hand movements. Eur. J. Hum. Genet. 18, 1095–1099.
Wu W. C., Drenser K., Trese M., Capone Jr A. and Dailey W 2007 Retinal phenotype-genotype correlation of pediatric patients expressing mutations in the Norrie disease gene. Arch. Ophthalmol. 125, 225–230.
Zhu D. P., Antonarakis S. E., Schmeckpeper B. J., Diergaarde P. J., Greb A. E. and Maumenee I. H. 1989 Microdeletion in the X-chromosome and prenatal diagnosis in a family with Norrie disease. Am. J. Med. Genet. 33, 485–488.
Zuercher J., Fritzsche M., Feil S., Mohn L. and Berger W. 2012 Norrin stimulates cell proliferation in the superficial retinal vascular plexus and is pivotal for the recruitment of mural cells. Hum. Mol. Genet. 21, 2619–2630.
Acknowledgements
We thank the family members who accepted to participate in this study. This work was supported by Science and Technology Programme of Guangdong Province (no. 2015B050501006), Chinese National Science Foundation (no. 81571097), The Ph.D. Start-up Fund of Natural Science Foundation of Guangdong Province (no. 2015A030310026), President Foundation of Nanfang Hospital, Southern Medical University (no. 2013C013, 2015Z004) and Academy Foundation of Nanfang Hospital, Southern Medical University (no. 2013018, 2013044).
Author information
Authors and Affiliations
Corresponding authors
Additional information
Bei Jia and Liping Huang contributed equally to this work.
Corresponding editor: S. Ganesh
Rights and permissions
About this article
Cite this article
Jia, B., Huang, L., Chen, Y. et al. A novel contiguous deletion involving \(\varvec{NDP},\) MAOB and EFHC2 gene in a patient with familial Norrie disease: bilateral blindness and leucocoria without other deficits. J Genet 96, 1015–1020 (2017). https://doi.org/10.1007/s12041-017-0869-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12041-017-0869-5


