Bibliographic Details
| Title: |
Inflammatory Arthritis as a Possible Feature of Coffin-Siris Syndrome. |
| Authors: |
Gomes, Sonia Melo, Dias, Cristina, Omoyinmi, Ebun, Compeyrot-Lacassagne, Sandrine, Klein, Nigel, Sebire, Neil J., Brogan, Paul |
| Source: |
Pediatrics. Jul2019, Vol. 144 Issue 1, p1-6. 6p. |
| Subjects: |
Rheumatoid arthritis risk factors, Human abnormalities, Brain, Developmental disabilities, Genes, Magnetic resonance imaging, People with intellectual disabilities, Microcephaly, Genetic mutation, Early diagnosis, Sequence analysis, Multiple human abnormalities, Genotypes, Disease complications |
| Abstract: |
Coffin-Siris syndrome (CSS) and Nicolaides-Baraitser syndrome (NBS) are 2 overlapping syndromes caused by mutations in genes of the BRG1/BRMassociated factor chromatin-remodeling complex, presenting with multiple malformations and intellectual disability. Musculoskeletal changes such as noninflammatory prominence of interphalangeal joints in hands, feet, and, to a lesser extent, knee joints are common in NBS (up to 85%) and also reported in CSS. We present the case of a 7-year-old boy with polyarthritis of several years' duration (without uveitis), developmental delay, microcephaly, and dysmorphic features reminiscent of NBS. Sanger sequencing of the SMARCA2 gene revealed no mutations. Laboratory test results were normal. With synovial biopsy, we confirmed a chronic inflammatory synovitis. Brain MRI revealed dysgenesis of the corpus callosum. Treatment with methotrexate and, subsequently, etanercept led to significant clinical improvement. Wholeexome sequencing revealed a de novo heterozygous nonsense mutation in the ARID1B gene, resulting in a premature stop codon (c.C5404T; p.R1802 x), a genotype consistent with CSS. The absence of significantly raised inflammatory markers and a clinical diagnosis of a genetic syndrome associated with noninflammatory joint changes may have contributed to this patient's polyarthritis being missed for several years. We propose that some patients with CSS may have inflammatory arthritis (with or without coexisting skeletal dysplasia), which may be helped by treatment as described herein. Early recognition and treatment of inflammatory arthritis in CSS would have a significant impact on reducing disease burden and improving quality of life for patients with this rare genetic syndrome. [ABSTRACT FROM AUTHOR] |
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| Database: |
Psychology and Behavioral Sciences Collection |
