Evidence for digenic inheritance in some cases of Antley-Bixler syndrome?
Open accessAbstract
The Antley-Bixler syndrome has been thought to be caused by an autosomal recessive gene. However, patients with this phenotype have been reported with a new dominant mutation at the FGFR2 locus as well as in the offspring of mothers taking the antifungal agent fluconazole during early pregnancy. In addition to the craniosynostosis and joint ankylosis which are the clinical hallmarks of the condition, many patients, especially females, have genital abnormalities. We now report abnormalities of steroid biogenesis in seven of 16 patients with an Antley-Bixler phenotype. Additionally, we identify FGFR2 mutations in seven of these 16 patients, including one patient with abnormal steroidogenesis. These findings, suggesting that some cases of Antley-Bixler syndrome are the outcome of two distinct genetic events, allow a hypothesis to be formulated under which we may explain all the differing and seemingly contradictory circumstances in which the Antley-Bixler phenotype has been recognised.
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In 1985, Peterson RE et al. described a case of congenital adrenal hyperplasia with combined features of 21-hydroxylase deficiency and 17α-hydroxylase deficiency, yet no pathogenic variants were identified in CYP21A2 or CYP17A1.
“In 1985, Peterson RE et al. described a case of congenital adrenal hyperplasia (CAH) exhibiting combined features of 21-hydroxylase deficiency (21-OHD) and 17α-hydroxylase deficiency (17-OHD), yet no pathogenic variants were identified in CYP21A2 or CYP17A1 (3, 56).”
From Case Report: Integrating clinical presentation and genetic analysis in P450 oxidoreductase deficiency: a novel mutation and systematic review (2026) · cites this paper as [56]
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- Authors
- Reardon, W., Smith, A., Honour, J. W., Hindmarsh, P., Das, D., Rumsby, G., Nelson, I., Malcolm, S., Adès, L., Sillence, D., Kumar, D., DeLozier-Blanchet, C., McKee, S., Kelly, T., McKeehan, W. L., Baraitser, M., & Winter, R. M.
- Affiliations
- University of Geneva (CH)
- Corresponding author
- Reardon, William
- Venue
- Journal of Medical Genetics
- Publisher
- BMJ
- Published
- 2000-01-01
- Volume
- 37
- Issue
- 1
- Pages
- 26-32
- ISSN
- 0022-2593 (ISSN-L)
- 1468-6244
- PMC
- PMC1734444
- OpenAlex
- W2101981888
- Cited by
- 123
- References
- 66
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 2 · 2019: 1 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 7 · 2012: 2
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Medical Genetics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Developmental Biology › Congenital limb and hand anomalies
- Keywords
- Antley-Bixler syndrome, digenic inheritance, FGFR2 mutations, autosomal dominant inheritance, autosomal recessive inheritance, congenital adrenal hyperplasia, craniosynostosis, joint ankylosis, genital anomalies, fluconazole, genotype-phenotype correlation
- MeSH terms
- Abnormalities, Drug-Induced, Abnormalities, Multiple, Ankle Joint, Ankylosis, Craniosynostoses, Eye Abnormalities, Female, Genitalia, Female, Humans, Infant, Karyotyping, Male, Pregnancy, Prenatal Exposure Delayed Effects, Sex Characteristics, Syndrome, Fluconazole, Receptors, Fibroblast Growth Factor, Receptor Protein-Tyrosine Kinases, Receptor, Fibroblast Growth Factor, Type 2
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