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      Three Siblings With Woodhouse-Sakati Syndrome: A Case Report of A New Saudi Family

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          Abstract

          Woodhouse-Sakati syndrome (WSS) is a rare autosomal recessive multi-system genetic disease caused by loss of function mutations in the DCAF17 gene on chromosome 2q31.1. The disease is characterized by gradual neurologic degeneration and polyendocrinopathy, particularly noteworthy for hypogonadism, beginning in early adolescence. Clinical features show wide variability with no clear genotype-phenotype correlation. The pathophysiology of WSS is unclear at present and no specific treatment is available other than hormone replacement which is administered in the course of individualized symptomatic multidisciplinary care. Genetic testing helps in confirming the diagnosis along with genetic counseling of the patient and family members. Here we report multiple cases of WSS in three siblings from a new Saudi Arabia family who were diagnosed with WSS as a consequence of a common founder mutation in the DCAF17 gene with DNA analysis showing a homozygous single nucleotide frameshift deletion (c.436delC) in exon 4 of the gene.

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          Most cited references18

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          Laron syndrome (primary growth hormone resistance or insensitivity): the personal experience 1958-2003.

          Zvi Laron (2004)
          Clinical and laboratory investigations starting in 1958 of a group of dwarfed children resembling isolated GH deficiency but who had very high serum levels of GH led to the description of the syndrome of primary GH resistance or insensitivity (Laron syndrome) and subsequently to the discovery of its molecular defects residing in the GH receptor and leading to an inability of IGF-I generation. With the biosynthesis of IGF-I in 1986, therapeutic trials started. Continuously more and more patients are being diagnosed in many parts of the world with a variety of molecular defects. This syndrome proved to be a unique model that enables the study of the consequences of GH receptor defects, the physiopathology of GH-IGF-I disruption, and comparison of the GH-independent IGF-I effects. This review presents the personal experience gained from the study follow-up and treatment of the 60 patients followed up for many years in the Israeli cohort.
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            Mutations in C2orf37, encoding a nucleolar protein, cause hypogonadism, alopecia, diabetes mellitus, mental retardation, and extrapyramidal syndrome.

            Hypogonadism, alopecia, diabetes mellitus, mental retardation, and extrapyramidal syndrome (also referenced as Woodhouse-Sakati syndrome) is a rare autosomal recessive multisystemic disorder. We have identified a founder mutation consisting of a single base-pair deletion in C2orf37 in eight families of Saudi origin. Three other loss-of-function mutations were subsequently discovered in patients of different ethnicities. The gene encodes a nucleolar protein of unknown function, and the cellular phenotype observed in patient lymphoblasts implicates a role for the nucleolus in the pathogenesis of this disease. Our findings expand the list of human disorders linked to the nucleolus and further highlight the developmental and/or maintenance functions of this organelle.
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              A syndrome of hypogonadism, alopecia, diabetes mellitus, mental retardation, deafness, and ECG abnormalities.

              A distinct and previously undescribed syndrome has been observed in six Saudi Arabian patients from two highly inbred families. The parents were normal, indicating an autosomal recessive pattern of inheritance. All the patients have a distinctive facial appearance, hypogonadism, sparse or absent hair, diabetes mellitus, mental retardation, mild deafness, and variable S-T and T wave abnormalities on the electrocardiograph.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                5 December 2022
                December 2022
                : 14
                : 12
                : e32225
                Affiliations
                [1 ] Diabetes and Endocrinology, Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, SAU
                [2 ] Endocrinology, Diabetes and Metabolism, Nera Medical Specialist & Day Surgery Center, Riyadh, SAU
                [3 ] Internal Medicine, College of Medicine, University of Bisha, Riyadh, SAU
                [4 ] Neurology, National Neuroscience Institute, King Fahad Medical City, Riyadh, SAU
                [5 ] Oncology, Department of Basic Medical Science, Faculty of Medicine, Academic and Training Affairs, King Fahad Medical City, Riyadh, SAU
                Author notes
                Article
                10.7759/cureus.32225
                9812427
                36620807
                7fcf1ce4-e0cd-4d78-b598-b4679f65f7a7
                Copyright © 2022, Alhuzaim et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 December 2022
                Categories
                Endocrinology/Diabetes/Metabolism
                Genetics
                Neurology

                hypogonadism,diabetes,autosomal recessive genetic disorder,omim: 80067,dcaf17,woodhouse-sakati syndrome

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