A homozygous Y443C variant in the RNPC3 is associated with severe syndromic congenital hypopituitarism and diffuse brain atrophy

• Published in: American journal of medical genetics. Part A 2022-09, Vol.188 (9), p.2701-2706
• Main Authors: Bezen, Diğdem, Kutlu, Orkide, Mouilleron, Stephane, Rizzoti, Karine, Dattani, Mehul, Guran, Tulay, Yeşil, Gözde
• Format: Article
• Language: English
• Subjects: Atrophy; Bone dysplasia; brain atrophy; Cerebellum; Female; Growth Hormone - genetics; Growth hormones; Homozygote; Human Growth Hormone; Humans; Hypogonadism; Hypopituitarism; Hypopituitarism - diagnosis; Hypopituitarism - genetics; Hypoplasia; Hypothyroidism; Hypothyroidism - genetics; Intellectual disabilities; neurodegeneration; Neuropathy; Nuclear Proteins - genetics; Patients; Phenotypes; Pituitary (anterior); Pituitary Gland - abnormalities; Prolactin; RNA-Binding Proteins - genetics; RNPC3; Skeleton; Spasticity; syndromic congenital hypopituitarism; Thyroid
• ISSN: 1552-4825; 1552-4833
• DOI: 10.1002/ajmg.a.62888

Biallelic RNPC3 variants have been reported in a few patients with growth hormone deficiency, either in isolation or in association with central hypothyroidism, congenital cataract, neuropathy, developmental delay/intellectual disability, hypogonadism, and pituitary hypoplasia. To describe a new patient with syndromic congenital hypopituitarism and diffuse brain atrophy due to RNPC3 mutations and to compare her clinical and molecular characteristics and pituitary functions with previously published patients. A 20‐year‐old female presented with severe growth, neuromotor, and developmental delay. Her weight, height, and head circumference were 5135 gr (−25.81 SDS), 68 cm (−16.17 SDS), and 34 cm (−17.03 SDS), respectively. She was prepubertal, and had dysmorphic facies, contractures, and spasticity in the extremities, and severe truncal hypotonia. There were no radiological signs of a skeletal dysplasia. The bone age was extremely delayed at 2 years. Investigation of pituitary function revealed growth hormone, prolactin, and thyroid‐stimulating hormone deficiencies. Whole‐exome sequencing revealed a novel homozygous missense (c.1328A > G; Y443C) variant in RNPC3. Cranial MRI revealed a hypoplastic anterior pituitary with diffuse cerebral and cerebellar atrophy. The Y443C variant in RNPC3 associated with syndromic congenital hypopituitarism and abnormal brain development. This report extends the RNPC3‐related hypopituitarism phenotype with a severe neurodegenerative presentation.