A novel mutation in PIGW causes glycosylphosphatidylinositol deficiency without hyperphosphatasia.

Authors

Hogrebe M1, Murakami Y2, Wild M3, Ahlmann M4, Biskup S5, Hörtnagel K5, Grüneberg M1, Reunert J1, Linden T6, Kinoshita T2, Marquardt T1.
  1. Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin, Albert-Schweitzer-Campus 1, Münster, Germany.
  2. Department of Immunoregulation, Research Institute for Microbial Diseases and Laboratory of Immunoglycobiology, WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan.
  3. Max Planck Institute for Molecular Biomedicine, Muenster, Germany.
  4. Universitätsklinikum Münster, Pädiatrische Hämatologie und Onkologie, Albert-Schweitzer-Campus 1, Münster, Germany.
  5. CeGaT GmbH, Tübingen, Germany.
  6. Kinderklinik Oldenburg, Klinik für Neuropädiatrie und angeborene Stoffwechselerkrankungen, Oldenburg, Germany.

Abstract

In recent years, many mutations have been identified that affect the biosynthesis of the glycosylphosphatidylinositol anchor, a biomolecule that attaches surface molecules to cell membranes. Here, we present two second-degree cousins with unexplained patterns of seizures. Next-generation sequencing identified the homozygous c.460A>G; p.(R154G) PIGW mutation in both patients. Transfection of the mutated allele into Pigw-defective CHO cells indicated impaired enzymatic activity of the mutated PIGW product. Alkaline phosphatase did not exceed the upper normal range and flow cytometry of CD16, CD24, and CD66c on granulocytes showed subtle changes of the cellular expression of the glycosylphosphatidylinositol-anchored proteins. The patients‘ phenotype is therefore remarkably different from the phenotype of the only other described individual with PIGW mutations. Patients might therefore be missed when relying on traditional flow cytometry of glycosylphosphatidylinositol-anchored proteins only and we suggest that glycosylphosphatidylinositoldeficiency should be considered even with patients not showing the typical clinical phenotypes.