Heterogeneous clinical presentation in ICF syndrome: correlation with underlying gene defects

Eur J Hum Genet. 2013 Nov;21(11):1219-25. doi: 10.1038/ejhg.2013.40. Epub 2013 Mar 13.

Abstract

Immunodeficiency with centromeric instability and facial anomalies (ICF) syndrome is a primary immunodeficiency, predominantly characterized by agammaglobulinemia or hypoimmunoglobulinemia, centromere instability and facial anomalies. Mutations in two genes have been discovered to cause ICF syndrome: DNMT3B and ZBTB24. To characterize the clinical features of this syndrome, as well as genotype-phenotype correlations, we compared clinical and genetic data of 44 ICF patients. Of them, 23 had mutations in DNMT3B (ICF1), 13 patients had mutations in ZBTB24 (ICF2), whereas for 8 patients, the gene defect has not yet been identified (ICFX). While at first sight these patients share the same immunological, morphological and epigenetic hallmarks of the disease, systematic evaluation of all reported informative cases shows that: (1) the humoral immunodeficiency is generally more pronounced in ICF1 patients, (2) B- and T-cell compartments are both involved in ICF1 and ICF2, (3) ICF2 patients have a significantly higher incidence of intellectual disability and (4) congenital malformations can be observed in some ICF1 and ICF2 cases. It is expected that these observations on prevalence and clinical presentation will facilitate mutation-screening strategies and help in diagnostic counseling.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Child
  • DNA (Cytosine-5-)-Methyltransferases / genetics*
  • DNA Methyltransferase 3B
  • Demography
  • Face / abnormalities*
  • Female
  • Genetic Heterogeneity*
  • Genetic Predisposition to Disease*
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunoglobulin G / blood
  • Immunologic Deficiency Syndromes / blood
  • Immunologic Deficiency Syndromes / genetics*
  • Immunologic Deficiency Syndromes / therapy
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Mutation / genetics*
  • Primary Immunodeficiency Diseases
  • Repressor Proteins / genetics*
  • Young Adult

Substances

  • Immunoglobulin G
  • Repressor Proteins
  • ZBTB24 protein, human
  • DNA (Cytosine-5-)-Methyltransferases

Supplementary concepts

  • Immunodeficiency syndrome, variable