A Chinese Boy with Mowat–Wilson Syndrome Caused by a 10 bp Deletion in the ZEB2 Gene

Lin Wei,1 Xiao Han,2 Xue Li,1 Bingjuan Han,1 Wenying Nie1 1Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan Maternal and Child Care Hospital, Jinan, 250001, Shandong Province, People’s Republic of China; 2Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong Province, People’s Republic of ChinaCorrespondence: Bingjuan Han; Wenying Nie No. 2, Jianguo Xiaojing 3rd Road, Shizhong District, Jinan, Shandong Province, People’s Republic of ChinaTel/Fax +86 531-82060983; +86 531-8902957Email hbj208@163.com; goodddd@163.comPurpose: Mowat–Wilson syndrome (MWS) is a rare complex malformation syndrome which is characterized by typical facial dysmorphism, moderate to severe intellectual disability, global developmental delay, and multiple congenital anomalies. Here, we summarize the clinical characteristics and gene mutation analysis of a Chinese boy with MWS.Patients and Methods: The clinical features of the patient were monitored. DNA extracted from peripheral blood was subjected to sequencing analysis. Then, the whole-exome sequencing was performed.Results: A novel deletion mutation (c.1137_1146del TAGTATGTCT) was identified in exon 8 of the ZEB2 gene. The deletion mutation was predicted to produce a truncated protein (p.S380Nfs*13), resulting in haploinsufficiency. The patient presented with short stature, microcephaly, congenital heart defects, cryptorchidism, corpus callosum agenesis, global developmental delay, and intellectual disability. Furthermore, he demonstrated bilateral sensorineural hearing loss. This manifestation is less common in MWS. It is first reported in Chinese patients with MWS. Clinical follow-up showed that the facial features of MWS developed with time. The facial features of the patient were not obvious except for the uplifted ear lobes at the age of 3 months. At the age of 22 months, the facial characteristics of the patient included ocular hypertelorism, frontal bossing, rounded nasal tip, sparse eyebrows, prominent chin, widely spaced teeth, and uplifted ear lobes with a central depression.Conclusion: A novel deletion mutation of the ZEB2 gene was identified. This work contributes to expanding the mutation spectra of MWS. Our results may reflect the variability of the phenotype in MWS.Keywords: Mowat–Wilson syndrome, ZEB2, gene mutation, phenotyp