One case of arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome featuring an incomplete and mild phenotype
One case of arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome featuring an incomplete and mild phenotype
Abstract Background Arthrogryposis-renal dysfunction-cholestasis (ARC) syndrome is a rare disease with a high mortality rate caused by VPS33B or VIPAS39 mutations. ARC syndrome typically presents with arthrogryposis, renal tubular leak and neonatal cholestatic jaundice, and most patients with this disease do not survive beyond one year. Case presentation Here, we report the case of a 13-year-old girl with ARC featuring an incomplete and mild phenotype with novel compound heterozygous mutations of VPS33B. The patient presented with arthrogryposis (claw-shaped limbs), ichthyosis, jaundice, and pruritus. Laboratory tests revealed highly evaluated levels of total bilirubin (TB), direct bilirubin (DB), and total bile acid (TBA) as well as normal levels of gamma-glutamyltransferase (GGT). However, signs of renal dysfunction, as well as other manifestations of ARC syndrome, including nervous system abnormalities, deafness, and failure to thrive, were not observed. The patient’s clinical symptoms of jaundice and pruritus were significantly alleviated by administration of ursodeoxycholic acid. Whole-exome sequencing (WES) revealed novel compound heterozygous mutations of VPS33B, c.1081 C > T (p.Q361X,257)/c.244 T > C (p.C82R). Both variants were predicted to be pathogenic in silico and have never been reported previously. To date, the patients’ cholestatic jaundice has been well controlled with continuous treatment of ursodeoxycholic acid. Conclusions We report the case of a Chinese female with ARC including novel compound heterozygous mutations of VPS33B and an incomplete and mild phenotype. Early diagnosis and suitable symptomatic therapies are critical for the management of ARC patients with mild manifestations and prolonged lifespan.
- Shanghai Children's Hospital China (People's Republic of)
- Shanghai Jiao Tong University China (People's Republic of)
Autosomal recessive disorder, Arthrogryposis, Compound heterozygote mutations, Cholestasis, Pruritus, Ursodeoxycholic Acid, Vesicular Transport Proteins, Case Report, Bilirubin, Diseases of the genitourinary system. Urology, Jaundice, Obstructive, ARC syndrome, Phenotype, Mutation, VPS33B, Humans, Female, RC870-923, Renal Insufficiency, Child
Autosomal recessive disorder, Arthrogryposis, Compound heterozygote mutations, Cholestasis, Pruritus, Ursodeoxycholic Acid, Vesicular Transport Proteins, Case Report, Bilirubin, Diseases of the genitourinary system. Urology, Jaundice, Obstructive, ARC syndrome, Phenotype, Mutation, VPS33B, Humans, Female, RC870-923, Renal Insufficiency, Child
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