From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges

Autores
Giliberto, Florencia; Buonfiglio, Paula Inés; Capellino, Gabriel; Llames Massini, Carmen; Dalamon, Viviana Karina; Luce, Leonela Natalia; Carcione, María Micaela
Año de publicación
2024
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Pompe disease is an autosomal recessive disorder caused by GAA variants leading to acid alpha-glucosidase deficiency. Diagnosis is challenging due to the variable phenotypic presentation and overlap with other conditions. Traditionally, diagnosis relies on measuring enzyme activity, but next-generation sequencing (NGS) advancements have improved accuracy. However, interpreting variants is complex, especially because pseudodeficiency alleles mimic disease-causing variants. We present two patients harboring the pseudodeficiency allele NM_000152.5(GAA):c.271G>A, p.Asp91Asn, which is confusing due to inaccurate reports and results related to enzymatic activity. The first case was a recently published controversial case of a 700-year-old mummy in which the authors classified the variant as pathogenic. The second patient had symptoms compatible with late-onset Pompe disease and was homozygous for the variant. We aimed to determine the correct variant classification using GAA:c.271G>A as a model and to achieve a genetic diagnosis of the second patient. This variant was analyzed following international guidelines (ACMG-AMP) and reviewed with the Lysosomal Diseases Variant Curation Expert Panel. The second patient underwent NGS. We demonstrated that GAA:c.271G>A meets the criterion of being classified as benign for Pompe. Additionally, the second patient carried a heterozygous pathogenic PABPN1 variant associated with oculopharyngeal muscular dystrophy, which better explained the clinical features. This underscores the importance of expanding the genetic analysis in the presence of pseudodeficiency alleles that can mask the true cause of the disease and highlights the fact that an accurate diagnosis should adhere to guidelines on variant curation to reduce the risk of misdiagnosis, which could result in inadequate care and risky medical decisions.
Fil: Giliberto, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina
Fil: Buonfiglio, Paula Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentina
Fil: Capellino, Gabriel. Centro Médico Roentgen; Argentina
Fil: Llames Massini, Carmen. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
Fil: Dalamon, Viviana Karina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentina
Fil: Luce, Leonela Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. John Walton Muscular Dystrophy Research Centre; Reino Unido. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina
Fil: Carcione, María Micaela. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
Materia
POMPE
PSEUDODEFICIENCY
DIAGNOSTIC
GENETIC VARIANTS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/264627
Acceder
id CONICETDig_36dda1243816162ddbf4a1b4bdf5f5d4
oai_identifier_str oai:ri.conicet.gov.ar:11336/264627
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic ChallengesGiliberto, FlorenciaBuonfiglio, Paula InésCapellino, GabrielLlames Massini, CarmenDalamon, Viviana KarinaLuce, Leonela NataliaCarcione, María MicaelaPOMPEPSEUDODEFICIENCYDIAGNOSTICGENETIC VARIANTShttps://purl.org/becyt/ford/3.1https://purl.org/becyt/ford/3Pompe disease is an autosomal recessive disorder caused by GAA variants leading to acid alpha-glucosidase deficiency. Diagnosis is challenging due to the variable phenotypic presentation and overlap with other conditions. Traditionally, diagnosis relies on measuring enzyme activity, but next-generation sequencing (NGS) advancements have improved accuracy. However, interpreting variants is complex, especially because pseudodeficiency alleles mimic disease-causing variants. We present two patients harboring the pseudodeficiency allele NM_000152.5(GAA):c.271G>A, p.Asp91Asn, which is confusing due to inaccurate reports and results related to enzymatic activity. The first case was a recently published controversial case of a 700-year-old mummy in which the authors classified the variant as pathogenic. The second patient had symptoms compatible with late-onset Pompe disease and was homozygous for the variant. We aimed to determine the correct variant classification using GAA:c.271G>A as a model and to achieve a genetic diagnosis of the second patient. This variant was analyzed following international guidelines (ACMG-AMP) and reviewed with the Lysosomal Diseases Variant Curation Expert Panel. The second patient underwent NGS. We demonstrated that GAA:c.271G>A meets the criterion of being classified as benign for Pompe. Additionally, the second patient carried a heterozygous pathogenic PABPN1 variant associated with oculopharyngeal muscular dystrophy, which better explained the clinical features. This underscores the importance of expanding the genetic analysis in the presence of pseudodeficiency alleles that can mask the true cause of the disease and highlights the fact that an accurate diagnosis should adhere to guidelines on variant curation to reduce the risk of misdiagnosis, which could result in inadequate care and risky medical decisions.Fil: Giliberto, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; ArgentinaFil: Buonfiglio, Paula Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Capellino, Gabriel. Centro Médico Roentgen; ArgentinaFil: Llames Massini, Carmen. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; ArgentinaFil: Dalamon, Viviana Karina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Luce, Leonela Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. John Walton Muscular Dystrophy Research Centre; Reino Unido. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; ArgentinaFil: Carcione, María Micaela. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; ArgentinaCold Spring Harbor Laboratory Press2024-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/264627Giliberto, Florencia; Buonfiglio, Paula Inés; Capellino, Gabriel; Llames Massini, Carmen; Dalamon, Viviana Karina; et al.; From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges; Cold Spring Harbor Laboratory Press; bioRxiv; 10-2024; 1-202692-8205CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.medrxiv.org/content/10.1101/2024.10.03.24314698v1info:eu-repo/semantics/altIdentifier/doi/10.1101/2024.10.03.24314698info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-15T14:41:46Zoai:ri.conicet.gov.ar:11336/264627instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-15 14:41:46.878CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
title From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
spellingShingle From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
Giliberto, Florencia
POMPE
PSEUDODEFICIENCY
DIAGNOSTIC
GENETIC VARIANTS
title_short From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
title_full From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
title_fullStr From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
title_full_unstemmed From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
title_sort From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges
dc.creator.none.fl_str_mv Giliberto, Florencia
Buonfiglio, Paula Inés
Capellino, Gabriel
Llames Massini, Carmen
Dalamon, Viviana Karina
Luce, Leonela Natalia
Carcione, María Micaela
author Giliberto, Florencia
author_facet Giliberto, Florencia
Buonfiglio, Paula Inés
Capellino, Gabriel
Llames Massini, Carmen
Dalamon, Viviana Karina
Luce, Leonela Natalia
Carcione, María Micaela
author_role author
author2 Buonfiglio, Paula Inés
Capellino, Gabriel
Llames Massini, Carmen
Dalamon, Viviana Karina
Luce, Leonela Natalia
Carcione, María Micaela
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv POMPE
PSEUDODEFICIENCY
DIAGNOSTIC
GENETIC VARIANTS
topic POMPE
PSEUDODEFICIENCY
DIAGNOSTIC
GENETIC VARIANTS
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.1
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Pompe disease is an autosomal recessive disorder caused by GAA variants leading to acid alpha-glucosidase deficiency. Diagnosis is challenging due to the variable phenotypic presentation and overlap with other conditions. Traditionally, diagnosis relies on measuring enzyme activity, but next-generation sequencing (NGS) advancements have improved accuracy. However, interpreting variants is complex, especially because pseudodeficiency alleles mimic disease-causing variants. We present two patients harboring the pseudodeficiency allele NM_000152.5(GAA):c.271G>A, p.Asp91Asn, which is confusing due to inaccurate reports and results related to enzymatic activity. The first case was a recently published controversial case of a 700-year-old mummy in which the authors classified the variant as pathogenic. The second patient had symptoms compatible with late-onset Pompe disease and was homozygous for the variant. We aimed to determine the correct variant classification using GAA:c.271G>A as a model and to achieve a genetic diagnosis of the second patient. This variant was analyzed following international guidelines (ACMG-AMP) and reviewed with the Lysosomal Diseases Variant Curation Expert Panel. The second patient underwent NGS. We demonstrated that GAA:c.271G>A meets the criterion of being classified as benign for Pompe. Additionally, the second patient carried a heterozygous pathogenic PABPN1 variant associated with oculopharyngeal muscular dystrophy, which better explained the clinical features. This underscores the importance of expanding the genetic analysis in the presence of pseudodeficiency alleles that can mask the true cause of the disease and highlights the fact that an accurate diagnosis should adhere to guidelines on variant curation to reduce the risk of misdiagnosis, which could result in inadequate care and risky medical decisions.
Fil: Giliberto, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina
Fil: Buonfiglio, Paula Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentina
Fil: Capellino, Gabriel. Centro Médico Roentgen; Argentina
Fil: Llames Massini, Carmen. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
Fil: Dalamon, Viviana Karina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; Argentina
Fil: Luce, Leonela Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina. John Walton Muscular Dystrophy Research Centre; Reino Unido. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina
Fil: Carcione, María Micaela. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología y Biotecnología. Cátedra de Genética y Biología Molecular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentina
description Pompe disease is an autosomal recessive disorder caused by GAA variants leading to acid alpha-glucosidase deficiency. Diagnosis is challenging due to the variable phenotypic presentation and overlap with other conditions. Traditionally, diagnosis relies on measuring enzyme activity, but next-generation sequencing (NGS) advancements have improved accuracy. However, interpreting variants is complex, especially because pseudodeficiency alleles mimic disease-causing variants. We present two patients harboring the pseudodeficiency allele NM_000152.5(GAA):c.271G>A, p.Asp91Asn, which is confusing due to inaccurate reports and results related to enzymatic activity. The first case was a recently published controversial case of a 700-year-old mummy in which the authors classified the variant as pathogenic. The second patient had symptoms compatible with late-onset Pompe disease and was homozygous for the variant. We aimed to determine the correct variant classification using GAA:c.271G>A as a model and to achieve a genetic diagnosis of the second patient. This variant was analyzed following international guidelines (ACMG-AMP) and reviewed with the Lysosomal Diseases Variant Curation Expert Panel. The second patient underwent NGS. We demonstrated that GAA:c.271G>A meets the criterion of being classified as benign for Pompe. Additionally, the second patient carried a heterozygous pathogenic PABPN1 variant associated with oculopharyngeal muscular dystrophy, which better explained the clinical features. This underscores the importance of expanding the genetic analysis in the presence of pseudodeficiency alleles that can mask the true cause of the disease and highlights the fact that an accurate diagnosis should adhere to guidelines on variant curation to reduce the risk of misdiagnosis, which could result in inadequate care and risky medical decisions.
publishDate 2024
dc.date.none.fl_str_mv 2024-10
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/264627
Giliberto, Florencia; Buonfiglio, Paula Inés; Capellino, Gabriel; Llames Massini, Carmen; Dalamon, Viviana Karina; et al.; From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges; Cold Spring Harbor Laboratory Press; bioRxiv; 10-2024; 1-20
2692-8205
CONICET Digital
CONICET
url http://hdl.handle.net/11336/264627
identifier_str_mv Giliberto, Florencia; Buonfiglio, Paula Inés; Capellino, Gabriel; Llames Massini, Carmen; Dalamon, Viviana Karina; et al.; From Past to Present: Pompe Disease, Pseudodeficiency Alleles, and Diagnostic Challenges; Cold Spring Harbor Laboratory Press; bioRxiv; 10-2024; 1-20
2692-8205
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.medrxiv.org/content/10.1101/2024.10.03.24314698v1
info:eu-repo/semantics/altIdentifier/doi/10.1101/2024.10.03.24314698
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Cold Spring Harbor Laboratory Press
publisher.none.fl_str_mv Cold Spring Harbor Laboratory Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1846082916468129792
score 13.22299

Publicaciones similares