Description
This individual is compound heterozygous for two likely pathogenic changes in the MYO18B gene. These frameshift alterations encode a premature stop of translation (ACMG: PVS1). The first, p.Arg2220SerfsTer74, occurs at an amino acid position 86% of the way through the full length protein, and the second, p.Leu2257SerfsTer16, occurs 88% of the way through the full length protein. These alterations occur within exon 43 of the transcript, NM_032608.5, within the penultimate exon of the gene (also representing the final coding exon of the transcript). These variants are very rare (p.Arg2220SerfsTer74) or absent (p.Leu2257SerfsTer16) from population databases (gnomAD) (ACMG: PM2). MYO18B is associated with autosomal recessive Klippel-Feil syndrome-4 with nemaline myopathy and facial dysmorphism (OMIM: 616549). Limited phenotypic data have been described in the literature and medical databases, however MYO18B variants encoding a premature stop of translation have been previously documented in association with myopathy, mild short stature, microcephaly, cardiomyopathy, pectus deformity, digit anomalies and distinctive facies (PMID: 25748484; 27858739). Characterization of the effect of a premature stop of translation within MYO18B has been described in the setting of in-vitro analyses. Examination of an affected patient's lymphocytes harboring a nonsense alteration (p.Ser2303Ter) demonstrated markedly diminished MYO18B transcript by quantitative PCR in comparison to a control, therefore hypothesized to be consistent with nonsense-mediated decay (PMID: 25748484). Moreover, western blot analysis and immunostaining of skeletal muscle in another patient harboring a nonsense alteration (p.Glu2166Ter) demonstrated the absence of the C-terminus of the protein hypothesized to be consistent with protein truncation (PMID: 27858739).
# | Sample | Method | Observation |
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Origin | Affected | Number tested | Tissue | Purpose | Method | Individuals | Allele frequency | Families | Co-occurrences |
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1 | germline | yes | not provided | not provided | not provided | | 1 | not provided | not provided | not provided |