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Defining the Clinical, Molecular and Ultrastructural Characteristics in Occipital Horn Syndrome: Two New Cases and Review of the Literature.

Abstract
Occipital horn syndrome (OHS) is a rare connective tissue disorder caused by pathogenic variants in ATP7A, encoding a copper transporter. The main clinical features, including cutis laxa, bony exostoses, and bladder diverticula are attributed to a decreased activity of lysyl oxidase (LOX), a cupro-enzyme involved in collagen crosslinking. The absence of large case series and natural history studies precludes efficient diagnosis and management of OHS patients. This study describes the clinical and molecular characteristics of two new patients and 32 patients previously reported in the literature. We report on the need for long-term specialized care and follow-up, in which MR angiography, echocardiography and spirometry should be incorporated into standard follow-up guidelines for OHS patients, next to neurodevelopmental, orthopedic and urological follow-up. Furthermore, we report on ultrastructural abnormalities including increased collagen diameter, mild elastic fiber abnormalities and multiple autophagolysosomes reflecting the role of lysyl oxidase and defective ATP7A trafficking as pathomechanisms of OHS.
AuthorsAude Beyens, Kyaran Van Meensel, Lore Pottie, Riet De Rycke, Michiel De Bruyne, Femke Baeke, Piet Hoebeke, Frank Plasschaert, Bart Loeys, Sofie De Schepper, Sofie Symoens, Bert Callewaert
JournalGenes (Genes (Basel)) Vol. 10 Issue 7 (07 12 2019) ISSN: 2073-4425 [Electronic] Switzerland
PMID31336972 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • Collagen
  • Protein-Lysine 6-Oxidase
  • ATP7A protein, human
  • Copper-Transporting ATPases
Topics
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Collagen (metabolism)
  • Copper-Transporting ATPases (genetics)
  • Cutis Laxa (enzymology, genetics, pathology)
  • Diverticulum (pathology)
  • Ehlers-Danlos Syndrome (enzymology, genetics, pathology)
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Protein-Lysine 6-Oxidase (metabolism)
  • Urinary Bladder (abnormalities, pathology)
  • Young Adult

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