Introduction: Ellis-Van Creveld syndrome is a rare genetic disorder characterised by skeletal abnormalities, cardiac anomalies, and findings of hidrotic ectodermal dysplasia. Cardiac anomalies are common in this syndrome and usually include an atrial septal defect when present. The disorder is caused by homozygous or compound heterozygous pathogenic variants in the EVC and EVC2 genes. A small number of patients with Ellis-Van Creveld syndrome have also been found to have copy number variants associated with these two genes. Case Presentation: A 13-year-old girl patient was referred to the paediatric genetic department with short stature, short extremities, operated post-axial polydactyly, nail hypoplasia, and severe mitral valve insufficiency. Chromosomal microarray analysis identified a 45 kb homozygous deletion encompassing exons 3–11 of the EVC gene at 4p16.2. Conclusion: Herein, we present a case with an intragenic deletion of the EVC gene and expand the clinical and genetic spectrum of Ellis-Van Creveld syndrome.

1.
Unger
S
,
Ferreira
CR
,
Mortier
GR
,
Ali
H
,
Bertola
DR
,
Calder
A
, et al
.
Nosology of genetic skeletal disorders: 2023 revision
.
Am J Med Genet A
.
2023
;
191
(
5
):
1164
209
.
2.
Spranger
JW
,
Brill
PW
,
Hall
C
,
Nishimura
G
,
Superti-Furga
A
,
Unger
S
.
Bone dysplasias: an atlas of genetic disorders of skeletal development
.
USA
:
Oxford University Press
;
2018
.
3.
Da Silva JD
TN
,
Soares
AR
.
Ellis-Van Creveld syndrome
. In:
GeneReviews® [Internet]
.
Seattle (WA)
:
University of Washington
;
2023
. p.
1993
2024
.
4.
Aubert-Mucca
M
,
Huber
C
,
Baujat
G
,
Michot
C
,
Zarhrate
M
,
Bras
M
, et al
.
Ellis-van Creveld syndrome: clinical and molecular analysis of 50 individuals
.
J Med Genet
.
2023
;
60
(
4
):
337
45
.
5.
Handa
A
,
Voss
U
,
Hammarsjö
A
,
Grigelioniene
G
,
Nishimura
G
.
Skeletal ciliopathies: a pattern recognition approach
.
Jpn J Radiol
.
2020
;
38
(
3
):
193
206
.
6.
Da Silva
JD
,
Soares
AR
,
Fortuna
AM
,
Tkachenko
N
.
Establishing an objective clinical spectrum, genotype-phenotype correlations and CRMP1 as a modifier in the Ellis-van Creveld syndrome: the first systematic review of EVC and EVC2-associated conditions
.
Genet Med Open
.
2023
;
1
(
1
):
100781
.
7.
Riggs
ER
,
Andersen
EF
,
Cherry
AM
,
Kantarci
S
,
Kearney
H
,
Patel
A
, et al
.
Technical standards for the interpretation and reporting of constitutional copy-number variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen)
.
Genet Med
.
2020
;
22
(
2
):
245
57
.
8.
Wang
J
,
Wang
X
,
Jia
Y
,
Li
X
,
Liu
G
,
Sa
R
, et al
.
A homozygous EVC mutation in a prenatal fetus with Ellis-van Creveld syndrome
.
Mol Genet Genomic Med
.
2023
;
11
(
8
):
e2183
.
9.
Kamal
R
,
Dahiya
P
,
Kaur
S
,
Bhardwaj
R
,
Chaudhary
K
.
Ellis-van Creveld syndrome: a rare clinical entity
.
J Oral Maxillofac Pathol
.
2013
;
17
(
1
):
132
5
.
10.
Tompson
SW
,
Ruiz-Perez
VL
,
Blair
HJ
,
Barton
S
,
Navarro
V
,
Robson
JL
, et al
.
Sequencing EVC and EVC2 identifies mutations in two-thirds of Ellis-van Creveld syndrome patients
.
Hum Genet
.
2007
;
120
(
5
):
663
70
.
11.
Negrete-Torres
N
,
Chima-Galán
MDC
,
Sierra-López
EA
,
Sánchez-Ramos
J
,
Álvarez-González
I
,
Reyes-Reali
J
, et al
.
Identification of compound heterozygous EVC2 gene variants in two Mexican families with Ellis-van Creveld syndrome
.
Genes
.
2023
;
14
(
4
):
887
.
12.
Ruiz-Perez
VL
,
Ide
SE
,
Strom
TM
,
Lorenz
B
,
Wilson
D
,
Woods
K
, et al
.
Mutations in a new gene in Ellis-van Creveld syndrome and Weyers acrodental dysostosis
.
Nat Genet
.
2000
;
24
(
3
):
283
6
.
13.
Galdzicka
M
,
Patnala
S
,
Hirshman
M
,
Cai
JF
,
Nitowsky
H
,
A Egeland
J
, et al
.
A new gene, EVC2, is mutated in Ellis-van Creveld syndrome
.
Mol Genet Metab
.
2002
;
77
(
4
):
291
5
.
14.
Caparrós-Martín
JA
,
De Luca
A
,
Cartault
F
,
Aglan
M
,
Temtamy
S
,
Otaify
GA
, et al
.
Specific variants in WDR35 cause a distinctive form of Ellis-van Creveld syndrome by disrupting the recruitment of the EvC complex and SMO into the cilium
.
Hum Mol Genet
.
2015
;
24
(
14
):
4126
37
.
15.
Barbeito
P
,
Martin-Morales
R
,
Palencia-Campos
A
,
Cerrolaza
J
,
Rivas-Santos
C
,
Gallego-Colastra
L
, et al
.
EVC-EVC2 complex stability and ciliary targeting are regulated by modification with ubiquitin and SUMO
.
Front Cell Dev Biol
.
2023
;
11
:
1190258
.
16.
Ohashi
I
,
Enomoto
Y
,
Naruto
T
,
Tsurusaki
Y
,
Kuroda
Y
,
Ishikawa
H
, et al
.
A severe form of Ellis-van Creveld syndrome caused by novel mutations in EVC2
.
Hum Genome Var
.
2019
;
6
:
40
.
17.
Shen
W
,
Han
D
,
Zhang
J
,
Zhao
H
,
Feng
H
.
Two novel heterozygous mutations of EVC2 cause a mild phenotype of Ellis-van Creveld syndrome in a Chinese family
.
Am J Med Genet A
.
2011
;
155
(
9
):
2131
6
.
18.
D'Asdia
MC
,
Torrente
I
,
Consoli
F
,
Ferese
R
,
Magliozzi
M
,
Bernardini
L
, et al
.
Novel and recurrent EVC and EVC2 mutations in Ellis-van Creveld syndrome and Weyers acrofacial dyostosis
.
Eur J Med Genet
.
2013
;
56
(
2
):
80
7
.
19.
Altunoglu
U
,
Palencia-Campos
A
,
Güneş
N
,
Turgut
GT
,
Nevado
J
,
Lapunzina
P
, et al
.
Variant characterisation and clinical profile in a large cohort of patients with Ellis-van Creveld syndrome and a family with Weyers acrofacial dysostosis
.
J Med Genet
.
2024
;
61
(
7
):
633
44
.
20.
Hills
CB
,
Kochilas
L
,
Schimmenti
LA
,
Moller
JH
.
Ellis-van Creveld syndrome and congenital heart defects: presentation of an additional 32 cases
.
Pediatr Cardiol
.
2011
;
32
(
7
):
977
82
.
21.
Liu
F
,
Liu
X
,
Xu
Z
,
Yuan
P
,
Zhou
Q
,
Jin
J
, et al
.
Molecular mechanisms of Ellis-van Creveld gene variations in ventricular septal defect
.
Mol Med Rep
.
2018
;
17
(
1
):
1527
36
.
22.
Sund
KL
,
Roelker
S
,
Ramachandran
V
,
Durbin
L
,
Benson
DW
.
Analysis of Ellis van Creveld syndrome gene products: implications for cardiovascular development and disease
.
Hum Mol Genet
.
2009
;
18
(
10
):
1813
24
.
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