Skip to main content
Log in

A novel homozygous missense mutation in FGF23 causes Familial Tumoral Calcinosis associated with disseminated visceral calcification

  • Original Investigation
  • Published:
Human Genetics Aims and scope Submit manuscript

Abstract

Hyperphosphatemic Familial Tumoral Calcinosis (HFTC; MIM211900) is a rare autosomal recessive disorder characterized by the progressive deposition of calcified masses in cutaneous and subcutaneous tissues, associated with elevated circulating levels of phosphate. The disease was initially found to result from mutations in GALNT3 encoding a glycosyltransferase. However, more recently, the S71G missense mutation in FGF23, encoding a potent phosphaturic protein, was identified in two families. In the present report, we describe a second mutation in FGF23 underlying a severe case displaying calcifications of cutaneous and numerous extracutaneous tissues. The mutation (M96T) was found to affect a highly conserved methionine residue at position 96 of the protein. These observations illustrate the extent of genetic and phenotypic heterogeneity in HFTC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • ADHR consortium (2000) Autosomal dominant hypophosphataemic rickets is associated with mutations in FGF23. Nat Genet 26:345–348

    Google Scholar 

  • Benet-Pagès A, Orlik P, Strom TM, Lorenz-Depiereux B (2005) An FGF-23 missense mutation causes familial tumoral calcinosis with hyperphosphatemia. Hum Mol Genet 14:385–390

    Article  PubMed  CAS  Google Scholar 

  • Frishberg Y, Topaz O, Bergman R et al (2005) Identification of a recurrent mutation in GALNT3 demonstrates that hyperostosis-hyperphosphatemia syndrome and familial tumoral calcinosis are allelic disorders. J Mol Med 83:33–38

    Google Scholar 

  • Giard A (1898) Sur la calcification tibernale. CR Soc Biol 10:1015–1021

    Google Scholar 

  • Ichikawa S, Lyles KW, Econs MJ (2005) A novel GALNT3 mutation in a pseudo-autosomal dominant form of tumoral calcinosis: evidence that the disorder is autosomal recessive. J Clin Endocrinol Metab 90:2420–2423

    Article  PubMed  CAS  Google Scholar 

  • Jan de Beur SM, Levine MA (2002) Molecular pathogenesis of hypophosphatemic rickets. J Clin Endocrinol Metab 87:2467–2473

    Article  PubMed  Google Scholar 

  • Larsson T, Yu X, Davis SI, Draman MS, Mooney SD, Cullen MJ, White KE (2005) A novel recessive mutation in Fibroblast growth factor-23 (FGF23) causes familial tumoral calcinosis. J Clin Endocrinol Metab. 90:2424–2427

    Article  PubMed  CAS  Google Scholar 

  • McClatchie S, Bremner AD (1969) Tumoural calcinosis–an unrecognized disease. Brit Med J 1:153–155

    Article  PubMed  CAS  Google Scholar 

  • Metzker A, Eisenstein B, Oren J, Samuel R (1988) Tumoral calcinosis revisited–common and uncommon features. Report of ten cases and review. Eur J Pediatr 147:128–132

    Article  PubMed  CAS  Google Scholar 

  • Neu CM, Manz F, Rauch F et al (2001) Bone densities and bone size at the distal radius in healthy children and adolescents: a study using peripheral quantitative CT. Bone 28:227–232

    Google Scholar 

  • Polykandriotis EP, Beutel FK, Horch RE, Grunert J (2004) A case of familial tumoral calcinosis in a neonate and review of the literature. Arch Orthop Trauma Surg 124:563–567

    Article  PubMed  Google Scholar 

  • Prince MJ, Schaeffer PC, Goldsmith RS, Chausmer AB (1982) Hyperphosphatemic tumoral calcinosis: association with elevation of serum 1,25-dihydroxycholecalciferol concentrations. Ann Intern Med 96:586–591

    PubMed  CAS  Google Scholar 

  • Schiavi SC, Kumar R (2004) The phosphatonin pathway: new insights in phosphate homeostasis. Kidney Int 65:1–14

    Article  PubMed  CAS  Google Scholar 

  • Shimada T, Kakitani M, Yamazaki Y et al (2004) Targeted ablation of FGF23 demonstrates an essential physiological role of FGF23 in phosphate and vitamin D metabolism. J Clin Invest 113:561–568

    Google Scholar 

  • Smack D, Norton SA, Fitzpatrick JE (1996) Proposal for a pathogenesis-based classification of tumoral calcinosis. Int J Dermatol 35:265–271

    Article  PubMed  CAS  Google Scholar 

  • Ten Hagen KG, Fritz TA, Tabak LA (2003) All in the family: the UDP-GalNAc:polypeptide N-acetylgalactosaminyltransferases. Glycobiology 13:1R–16R

    Article  PubMed  CAS  Google Scholar 

  • Topaz O, Bergman R, Mandel U et al (2005) Absence of intraepidermal glycosyltransferase ppGalNAc-T3 expression in familial tumoral calcinosis. Am J Dermatopathol, in press

  • Topaz O, Shurman D, Bergman R et al (2004) Mutations in GALNT3, encoding a protein involved in O-linked glycosylation, cause familial tumoral calcinosis. Nat Genet 36:579–581

    Google Scholar 

  • Touart DM, Sau P (1998) Cutaneous deposition diseases. Part II. J Am Acad Dermatol 39:527–544

    Article  PubMed  CAS  Google Scholar 

  • Walton, Bijvoet (1975) Nomogram for derivation of renal threshold phosphate concentration. Lancet 2(7929):309–310

    Google Scholar 

  • Yamashita T, Konishi M, Miyake A et al (2002) Fibroblast growth factor (FGF)-23 inhibits renal phosphate reabsorption by activation of the mitogen-activated protein kinase pathway. J Biol Chem 277:28265–28270

    Google Scholar 

Download references

Ackowledgements

We acknowledge the family for having participated in the present study. We are grateful to V. Friedman for DNA sequencing services. This study was supported in part by grants provided by The Israeli Ministry of Health-Chief Scientist Office and by the General Trustee Fund.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eli Sprecher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chefetz, I., Heller, R., Galli-Tsinopoulou, A. et al. A novel homozygous missense mutation in FGF23 causes Familial Tumoral Calcinosis associated with disseminated visceral calcification. Hum Genet 118, 261–266 (2005). https://doi.org/10.1007/s00439-005-0026-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00439-005-0026-8

Key words

Navigation