
CLINICAL NEXT GENERATION SEQUENCING REVEALS AN
H3F3A GENE AS A NEW POTENTIAL GENE CANDIDATE
FOR MICROCEPHALY ASSOCIATED WITH SEVERE
DEVELOPMENTAL DELAY, INTELLECTUAL DISABILITY
AND GROWTH RETARDATION Maver A1, Čuturilo G2,3, Ruml Stojanović J3, Peterlin B1,* *Corresponding Author: Professor Borut Peterlin, Clinical Institute of Genomic Medicine, University
Medical Center Ljubljana, Šlajmerjeva 4, 1000 Ljubljana, Slovenia. Tel: +38615401137. E-mail:
borut.peterlin@kclj.si page: 65
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INTRODUCTION
The clinical sign of abnormally small head, usually
defined as head circumference below the third percentile,
or at least two standard deviations below the mean from an
age-and sex-matched reference population, affects approximately
2.0-3.0% of the world population [1,2]. It is classified
into primary if present at birth and secondary if developing
thereafter [2]. Microcephaly can be an isolated sign or present
as one of the associated features defining various genetic
syndromes. Over 900 distinct phenotypes and about 800
genes have so far been recorded in the OMIM database [3],
which implies significant clinical and genetic heterogeneity.
Consequently, establishing genetic etiology is challenging;
genetic pathogenesis was reported in about 29.0%
of cases based on metabolic and classical genetic testing
[4], while using next generation sequencing (NGS) improved
diagnostic yield. A recent study [3], employing molecular
karyotyping and exome sequencing, improved diagnostic
rates to 58.0% with primary microcephaly, 27.0%
with secondary microcephaly, and to 15.0% in patients
with unknown onset. Moreover, whole exome sequencing
in the clinical setting may identify not only mutations in
genes already known to be associated with investigated
phenotypes, but also discover new potential genes and
mechanisms for human disorders [5,6]. In this study, we
describe a new association between microcephaly accompanied
with severe developmental delay and intellectual
disability and a potentially new gene H3F3A involved
in maintaining heterochromatin and telomeric integrity.
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