De novo variant in the COL1A1 gene associated with orphan genetic disease: Osteogenesis Imperfecta type I

Open Access
Jhonatan Alzate Valencia1,2,3,
Lina-Johanna Moreno-Giraldo4,5,6

Authors

DOI:

https://doi.org/10.37980/im.journal.ggcl.20242363

Keywords:

Osteogenesis imperfecta, collagen type I, de novo variant, orphan disease, precesion medicine

Abstract

Introduction: Osteogenesis Imperfecta (OI), is known as a disorder characterized by bone weakness and high risk of fractures, of genetic origin, known as brittle bone disease. It has a high burden of morbidity and mortality, associated with the presence of pain and functional limitation for those who present it. Fragility in the bones has been described by structural variants of the Collagen 1 genes (COL1A1 and COL1A2) among others, with an estimated prevalence between 1/15,000 and 1/20,000 cases in live newborns. The timely diagnosis of the disease allows to initiate targeted therapeutic alternatives, prevent complications, provide genetic counseling on risk of heritability, follow-up guidelines, prognosis approaching personalized medicine. Case Presentation: Female patient 8 years old, with clinical history of several fractures secondary to mild trauma (metatarsal left foot, right hand finger and ipsilateral foot), with other diagnoses of bilateral otosclerosis requiring hearing aids, precocious puberty, on physical examination with facial dysmorphias given by prominent broad forehead, mild blue tint sclerae, irregular teeth with dentin wear, ligament hyperlaxity, no cognitive-behavioral compromise and no other alterations.Within the paraclinical approach with hypercalcemia, hypercalciuria and hyperphosphatemia, other paraclinical evaluation of bone metabolism in normal reference range, within the imaging studies with total spine radiography with mild lumbar dextro convex dextro scoliosis, and anterolisthesis of L5 over S1, and radiographs showing areas of consolidation by fractures previously described, renal and urinary tract ultrasound with mild bilateral ectasia and 15% residue in bladder emptying. The patient was the product of non-consanguineous parents, with no known family history of genetic connective tissue diseases. Due to the clinical history and physical examination, a molecular sequencing + CNVs (Copy Number Variations) study was requested by NGS (Next-Generation Sequencing) for genes related to collagenopathies. Results: Molecular study sequencing + CNVs by NGS for genes related to collagenopathies in which a heterozygous pathogenic variant c.3652G>A; p.Ala1218Thr in the COL1A1 gene is detected, which supports the diagnosis of osteogenesis imperfecta type I of autosomal dominant inheritance. Conclusion: Osteogenesis imperfecta is a disease of genetic origin, rare, reported for many years, with phenotypic, endotypic and genotypic variability, so that undertake early identification strategies impact on the natural history of the disease contributing to the development of preventive medicine, personalized, predictive, accurate, participatory in order to be performed at the population level; through this case it is intended to raise awareness of the importance of early diagnosis and genotype-phenotype correlation that allows to establish targeted actions, to know specific pathophysiological mechanisms, to sub-classify collagenopathies, contributing to the increase of medical-scientific knowledge about the expression of the disease and the tendency to hyper-personalization.

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