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WTX R353X mutation in a family with osteopathia striata and cranial sclerosis (OS-CS): case report and literature review of the disease clinical, genetic and radiological features

Anna Maria Zicari1*, Luigi Tarani1, Daniela Perotti2, Laura Papetti1, Francesco Nicita1, Natascia Liberati1, Alberto Spalice1, Guglielmo Salvatori3, Federica Guaraldi4 and Marzia Duse1

Author Affiliations

1 Department of Pediatrics, Policlinico Umberto I, Sapienza University, Rome, Italy

2 Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

3 NICU- Department of Medical and Surgical Neonatology, IRCCS Bambino Gesu’ Children’s Hospital, Rome, Italy

4 Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, S. Giovanni Battista Hospital, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy

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Italian Journal of Pediatrics 2012, 38:27  doi:10.1186/1824-7288-38-27

Published: 20 June 2012

Abstract

Osteopathia striata with cranial sclerosis (OS-CS) or Horan-Beighton syndrome is a rare X-linked dominant inherited bone dysplasia, characterized by longitudinal striations of long bones and cranial sclerosis. Patients can be asymptomatic or present with typical facial dysmorphism, sensory defects, internal organs anomalies, growth and mental retardation, depending on the severity of the disease. WTX gene (Xq11) has been recently identified as the disease causing gene. Aim of this article is to present the case of a 6 year old girl initially evaluated for bilateral hearing loss. Patient’s head CT scan pointed out sclerosis of skull base and mastoid cells, and abnormal middle-ear ossification. Clinical examination of the patient and her mother were suspicious for OS-CS. The diagnosis was confirmed by X-rays examination showing typical longitudinal striation. Genetic analysis allowed the identification of maternally transmitted heterozygous nonsense c.1057C>T (p.R353X) WTX gene mutation. We also provide a systematic review of currently available knowledge about clinical, radiologic and genetic features typical of the OS-CS.

Keywords:
Osteopathia striata; Cranial sclerosis; Horan-Beighton syndrome; WTX; Bone dysplasia