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J Med Genet 2007;44:327-333 doi:10.1136/jmg.2006.046698
  • Letters to JMG

Genetic heterogeneity in Rubinstein–Taybi syndrome: delineation of the phenotype of the first patients carrying mutations in EP300

  1. Deborah Bartholdi1,
  2. Jeroen H Roelfsema2,
  3. Francesco Papadia3,
  4. Martijn H Breuning2,
  5. Dunja Niedrist1,
  6. Raoul C Hennekam4,
  7. Albert Schinzel1,
  8. Dorien J M Peters2
  1. 1Institute of Medical Genetics, University of Zurich, Schwerzenbach, Switzerland
  2. 2Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Department of Metabolic Diseases and Clinical Genetics, Pediatric Hospital Giovanni XXIII, Bari, Italy
  4. 4Department of Pediatrics, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to:
 Dr D Bartholdi
 Institute of Medical Genetics, University of Zurich, Schorenstrasse 16, 8603 Schwerzenbach, Switzerland; bartholdi{at}medgen.unizh.ch
  • Received 28 September 2006
  • Accepted 23 December 2006
  • Revised 29 November 2006
  • Published Online First 12 January 2007

Abstract

Background: Rubinstein–Taybi syndrome (RSTS) is a congenital disorder characterised by growth retardation, facial dysmorphisms, skeletal abnormalities and mental retardation. Broad thumbs and halluces are the hallmarks of the syndrome. RSTS is associated with chromosomal rearrangements and mutations in the CREB-binding protein gene (CREBBP), also termed CBP, encoding the CREB-binding protein. Recently, it was shown that mutations in EP300, coding for the p300 protein, also cause RSTS. CBP and EP300 are highly homologous genes, which play important roles as global transcriptional coactivators.

Objective: To report the phenotype of the presently known patients with RSTS (n = 4) carrying germline mutations of EP300.

Results: The patients with EP300 mutations displayed the typical facial gestalt and malformation pattern compatible with the diagnosis of RSTS. However, three patients exhibited much milder skeletal findings on the hands and feet than typically observed in patients with RSTS.

Conclusions: Part of the clinical variability in RSTS is explained by genetic heterogeneity. The diagnosis of RSTS must be expanded to include patients without broad thumbs or halluces.

Footnotes

  • Competing interests: None.

  • Informed consent from the patients (patients 1 and 4) or their parents (patients 2 and 3) was obtained for publication of the photographs.

  • Published Online First 12 January 2007

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