Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses

BackgroundGenomic or exome sequencing is beneficial for identifying more than one pathogenic variation causing blended atypical and/or severe phenotypes. Herein, we are the first to report a 5-year-old boy with the blended phenotypes of infantile hypotonia, severe neurodevelopmental disorder, patent...

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Main Authors: Yuying Zhu, Ke Wu, Hanying Wen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1494530/full
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author Yuying Zhu
Ke Wu
Hanying Wen
author_facet Yuying Zhu
Ke Wu
Hanying Wen
author_sort Yuying Zhu
collection DOAJ
description BackgroundGenomic or exome sequencing is beneficial for identifying more than one pathogenic variation causing blended atypical and/or severe phenotypes. Herein, we are the first to report a 5-year-old boy with the blended phenotypes of infantile hypotonia, severe neurodevelopmental disorder, patent ductus arteriosus, cryptorchidism, obesity, distinctive facial features, and elevated isovaleryl carnitine.MethodsTrio-based whole-exome sequencing was performed on genomic DNA from peripheral blood samples from the boy and his parents. Functional analysis of the IVD variant in vitro was performed. Mutant IVD gene pcDNA3.1(+)-MUT-3xFlag and control pcDNA3.1(+)-WT-3xFlag mammalian expression vectors were constructed. Both vectors were transformed into HEK293T cells. The assays of relative IVD gene mRNA expression, IVD protein expression, and enzymatic activity were used.ResultsWhole-exome sequencing identified a novel homozygous missense variant in the IVD gene (NM_002225.5) c.1006T>C (p.Cys336Arg) within a region of homozygosity of 15q11.2-q21.3. Our in vitro functional and computer simulation findings revealed that this variant was associated with haploinsufficiency, which resulted in dramatically reducing the formation of IVD protein due to unstable mutant protein and not a lack of mRNA expression.ConclusionThe boy was diagnosed with the dual genetic disorders of Prader–Willi syndrome and isovaleric acidemia. This case provides a useful reference for genetic counseling for complex and diverse clinical phenotypes. The presence of two or more likely pathogenic or pathogenic variations in an individual with neurodevelopmental phenotypes is not an “exceptional” phenomenon.
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spelling doaj-art-28d0f33868ee471880ae2986ee6f07142025-02-10T05:16:14ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-02-011310.3389/fped.2025.14945301494530Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnosesYuying Zhu0Ke Wu1Hanying Wen2Prenatal Diagnosis Center, Quzhou Maternal and Child Health Care Hospital, Quzhou, Zhejiang, ChinaLaboratory of Prenatal Diagnosis Center, Quzhou Maternal and Child Health Care Hospital, Quzhou, Zhejiang, ChinaPrenatal Diagnosis Center, Quzhou Maternal and Child Health Care Hospital, Quzhou, Zhejiang, ChinaBackgroundGenomic or exome sequencing is beneficial for identifying more than one pathogenic variation causing blended atypical and/or severe phenotypes. Herein, we are the first to report a 5-year-old boy with the blended phenotypes of infantile hypotonia, severe neurodevelopmental disorder, patent ductus arteriosus, cryptorchidism, obesity, distinctive facial features, and elevated isovaleryl carnitine.MethodsTrio-based whole-exome sequencing was performed on genomic DNA from peripheral blood samples from the boy and his parents. Functional analysis of the IVD variant in vitro was performed. Mutant IVD gene pcDNA3.1(+)-MUT-3xFlag and control pcDNA3.1(+)-WT-3xFlag mammalian expression vectors were constructed. Both vectors were transformed into HEK293T cells. The assays of relative IVD gene mRNA expression, IVD protein expression, and enzymatic activity were used.ResultsWhole-exome sequencing identified a novel homozygous missense variant in the IVD gene (NM_002225.5) c.1006T>C (p.Cys336Arg) within a region of homozygosity of 15q11.2-q21.3. Our in vitro functional and computer simulation findings revealed that this variant was associated with haploinsufficiency, which resulted in dramatically reducing the formation of IVD protein due to unstable mutant protein and not a lack of mRNA expression.ConclusionThe boy was diagnosed with the dual genetic disorders of Prader–Willi syndrome and isovaleric acidemia. This case provides a useful reference for genetic counseling for complex and diverse clinical phenotypes. The presence of two or more likely pathogenic or pathogenic variations in an individual with neurodevelopmental phenotypes is not an “exceptional” phenomenon.https://www.frontiersin.org/articles/10.3389/fped.2025.1494530/fullPrader–Willi syndromeisovaleric acidemiagenetic counselingcase reportIVD gene
spellingShingle Yuying Zhu
Ke Wu
Hanying Wen
Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses
Frontiers in Pediatrics
Prader–Willi syndrome
isovaleric acidemia
genetic counseling
case report
IVD gene
title Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses
title_full Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses
title_fullStr Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses
title_full_unstemmed Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses
title_short Functional analysis of a novel homozygous missense IVD gene variant: a case report with dual genetic diagnoses
title_sort functional analysis of a novel homozygous missense ivd gene variant a case report with dual genetic diagnoses
topic Prader–Willi syndrome
isovaleric acidemia
genetic counseling
case report
IVD gene
url https://www.frontiersin.org/articles/10.3389/fped.2025.1494530/full
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