Mowat-Wilson syndrome (MWS) is a rare autosomal dominant syndrome characterized by distinctive facial features, congenital heart defects, Hirschsprung disease, genitourinary anomalies, various structural brain anomalies, and intellectual disability. Pathogenic mutations that result in haploinsufficiency in the ZEB2 gene cause MWS. In this study, we aimed to evaluate the clinical features and molecular analysis results of 4 MWS patients. All patients were examined by an expert clinical geneticist. Dysmorphological abnormalities were recorded. Data including demographic, clinical, and laboratory findings were obtained from hospital records. ZEB2 gene analysis was performed using a Sanger sequencing method. All patients had typical facial features of MWS such as widely spaced eyes, broad eyebrows with a medial flare, low-hanging columella, prominent or pointed chin, open-mouth expression, and uplifted earlobes. Four different heterozygous mutations were identified; 2 mutations were frameshift (c.246_247delGGinsC, c.980_980delG), 1 was nonsense (c.2083C>T), and 1 was splice site (c.808–2A>G). Two of them (c.246_247delGGinsC, c.980_980delG) have not been previously reported in the literature. By defining 2 novel mutations, this study contributes to the molecular spectrum of MWS, while also providing a further insight for genetic counseling. It also demonstrates the importance of dysmorphological examination in clinical diagnosis.

1.
Adam MP, Conta J, Bean LJH: Mowat-Wilson syndrome. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, et al (eds): GeneReviews® [Internet] (University of Washington, Seattle 1993–2020). Initial posting: March 28, 2007; last update: July 25, 2019.
2.
Cooper
DN
,
Ball
EV
,
Stenson
PD
,
Phillips
AD
,
Evans
K
,
Heywood
S
, et al.
Human Gene Mutation Database (HGMD). Human Mutat
.
2017
;
21
(
6
):
577
81
.
3.
Cordelli
DM
,
Garavelli
L
,
Savasta
S
,
Guerra
A
,
Pellicciari
A
,
Giordano
L
, et al.
Epilepsy in Mowat–Wilson syndrome: Delineation of the electroclinical phenotype
.
Am J Med Genet A
.
2013
;
161A
:
273
84
.
4.
Coyle
D
,
Puri
P
.
Hirschsprung's disease in children with Mowat-Wilson syndrome
.
Pediatr Surg Int
.
2015
;
31
(
8
):
711
7
.
5.
Dastot‐Le Moal
F
,
Wilson
M
,
Mowat
D
,
Collot
N
,
Niel
F
,
Goossens
M
.
ZFHX1B mutations in patients with Mowat‐Wilson syndrome
.
Hum Mutat
.
2007
;
28
:
313
21
().
6.
Evans
E
,
Einfeld
S
,
Mowat
D
,
Taffe
J
,
Tonge
B
,
Wilson
M
.
The behavioral phenotype of Mowat-Wilson syndrome
.
Am J Med Genet A
.
2012
;
158A
(
2
):
358
66
.
7.
Garavelli
L
,
Zollino
M
,
Mainardi
PC
,
Gurrieri
F
,
Rivieri
F
,
Soli
F
, et al.
Mowat–Wilson syndrome: facial phenotype changing with age: study of 19 Italian patients and review of the literature
.
Am J Med Genet A
.
2009
;1
49A
:
417
26
.
8.
Garavelli
L
,
Ivanovski
I
,
Caraffi
SG
,
Santodirocco
D
,
Pollazzon
M
,
Cordelli
D
, et al.
Neuroimaging findings in Mowat–Wilson syndrome: a study of 54 patients
.
Genet Med
.
2017
;
19
:
691
700
.
9.
Ho
S
,
Luk
HM
,
Chung
BHY
,
Fung
JLF
,
Mak
HHY
,
Lo
IF
.
Mowat–Wilson syndrome in a Chinese population: A case series
.
Am J Med Genet A
.
2020
;
182
:
1336
41
.
10.
Ivanovski
I
,
Djuric
O
,
Caraffi
SG
,
Santodirocco
D
,
Pollazzon
M
,
Rosato
S
, et al.
Phenotype and genotype of 87 patients with Mowat-Wilson syndrome and recommendations for care
.
Genet Med
.
2018
;
20
(
9
):
965
75
.
11.
Ivanovski
I
,
Djuric
O
,
Broccoli
S
,
Caraffi
SG
,
Accorsi
P
,
Adam
MP
, et al.
Mowat-Wilson Syndrome: Growth Charts
.
Orphanet J Rare Dis
.
2020
;
15
(
1
):
151
.
12.
Kilic
E
,
Cetinkaya
A
,
Utine
E
,
Boduroglu
K
.
A Diagnosis to Consider in Intellectual Disability: Mowat-Wilson Syndrome
.
J Child Neurol
.
2016
;
31
(
7
):
913
17
. .
13.
Saunders
CJ
,
Zhao
W
,
Ardinger
HH
.
Comprehensive ZEB2 gene analysis for Mowat–Wilson syndrome in a North American cohort: a suggested approach to molecular diagnostics
.
Am J Med Genet A
.
2009
;
149A
:
2527
31
.
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