Entry - *614297 - CHROMOSOME 19 OPEN READING FRAME 12; C19ORF12 - OMIM
* 614297

CHROMOSOME 19 OPEN READING FRAME 12; C19ORF12


HGNC Approved Gene Symbol: C19orf12

Cytogenetic location: 19q12   Genomic coordinates (GRCh38) : 19:29,698,886-29,715,789 (from NCBI)


Gene-Phenotype Relationships
Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
19q12 ?Spastic paraplegia 43, autosomal recessive 615043 AR 3
Neurodegeneration with brain iron accumulation 4 614298 AD, AR 3

TEXT

Cloning and Expression

By searching for genes in a region of chromosome 19 linked to neurodegeneration with brain iron accumulation (NBIA4; 614298), followed by RT-PCR of fibroblasts and blood, Hartig et al. (2011) cloned 2 splice variants of C19ORF12. The transcripts differ in their first exons, and the deduced 152- and 141-amino acid proteins differ only at their N termini. Both proteins contain a central transmembrane domain. Orthologs of the long isoform were detected in chimpanzee and chicken only, but close orthologs of the short isoform were detected in diverse animal species. Endogenous or fluorescence-tagged C19ORF12 protein localized to mitochondria. Hartig et al. (2011) stated that C19ORF12 is ubiquitously expressed.

Landoure et al. (2013) found that the C19ORF12 protein had a complex intracellular localization to the mitochondria or endoplasmic reticulum (ER) when expressed in cultured COS-7 cells.


Gene Function

Hartig et al. (2011) found that expression of C19ORF12 increased with differentiation in adipocytes along with genes involved in valine, leucine, and isoleucine degradation and fatty acid metabolism.


Gene Structure

Hartig et al. (2011) determined that the C19ORF12 gene spans 17 kb and contains 4 exons, including 2 alternative first exons.


Mapping

By genomic sequence analysis, Hartig et al. (2011) mapped the C19ORF12 gene to chromosome 19q12.


Molecular Genetics

Neurodegeneration with Brain Iron Accumulation 4, Autosomal Recessive

In 24 Polish patients with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified homozygous or compound heterozygous mutations in the C19ORF12 gene (see, e.g., 614297.0001-614297.0004). Eighteen patients carried the same 11-bp deletion (c.201_214del; 614297.0001), and haplotype analysis indicated a founder effect. The mutation was initially found after genomewide linkage analysis of an affected family. Two unrelated patients who were compound heterozygous for 2 missense mutations (614297.0003 and 614297.0004) had a milder phenotype. One had only impairment of fine motor skills at age 19 years, and the other presented in his forties with parkinsonism and dystonia. Hartig et al. (2011) suggested the designation 'mitochondrial membrane protein associated neurodegeneration (MPAN)' for this disorder.

In 23 of 161 individuals with NBIA, Hogarth et al. (2013) identified pathogenic mutations in the C19ORF12 gene. Seventeen patients from 16 families had biallelic mutations, whereas 6 patients from 4 families had heterozygous mutations; however, the authors considered a second occult deleterious mutation likely to be present in these patients. The 11-bp deletion (614297.0001) identified by Hartig et al. (2011) was recurrent in individuals of Eastern European origin.

Deschauer et al. (2012) identified 3 different mutations in the C19ORF12 gene (614297.0001; 614297.0002; 614296.0007) in 3 patients from 2 unrelated families with NBIA4. All mutations occurred in compound heterozygosity. The patients had onset in the first or second decades of upper and lower motor neuron signs reminiscent of juvenile-onset amyotrophic lateral sclerosis (ALS). Clinical features included pes cavus, difficulty walking, hypo- and hyperreflexia, muscle weakness and atrophy, and variable cognitive impairment with neuropsychologic abnormalities. One patient had optic atrophy. Extrapyramidal signs, such as parkinsonism, were not present. Brain MRI of all 3 patients showed T2-weighted hypointensities in the globus pallidus with some hypointensities also in the substantia nigra and cerebral peduncles, consistent with iron deposition.

In a 19-year-old Turkish girl with NBIA4, Kasapkara et al. (2019) identified a homozygous 11-bp deletion (c.171_181del) in the C19ORF12 gene. Her consanguineous parents were heterozygous for the mutation.

Gregory et al. (2019) reported 22 individuals from 19 families with homozygous or compound heterozygous mutation in the C19ORF12 gene.

Neurodegeneration with Brain Iron Accumulation 4, Autosomal Dominant

In a girl with NBIA4, born of unrelated Italian parents, Monfrini et al. (2018) identified a de novo heterozygous 2-bp deletion in the C19ORF12 gene (c.265_266delAT; 614297.0009). Sequencing of all exons and intron-exon boundaries of other known NBIA-associated genes did not detect other pathogenic variants. Quantitative reverse-transcription PCR in lymphocytes showed that mRNA quantity in the proband was not reduced compared to that of the parents and controls, suggesting absence of degradation through nonsense-mediated decay. The authors hypothesized that the heterozygous variant is pathogenic and suggested that the mutation may have a dominant-negative effect. They also noted the possibility that the patient has a mutation in an unidentified causative gene. They further noted that 5 previous heterozygous mutations had been reported (e.g., Hogarth et al., 2013), all involving exon 3, but that those authors considered that a second mutation was likely to be present.

Gregory et al. (2019) identified 18 patients with MPAN (NBIA4) from 13 families who carried heterozygous mutations in the C19ORF12 gene, all in exon 3 (e.g., 614297.0010-614297.0012). The authors proposed a mechanism to explain how MPAN can display both autosomal recessive and autosomal dominant inheritance. In autosomal recessive MPAN, a mutation resulting in premature termination of the protein occurring in the first or second exon would be predicted to undergo nonsense-mediated decay (NMD). From parental studies, partial C19ORF12 loss of function from one such allele causes no neurologic problems. Therefore, 2 such mutant alleles are required to manifest disease. The homozygous and compound heterozygous cases presented by Gregory et al. (2019) comprised a mix of frameshift mutations predicted to undergo NMD, and missense and splicing mutations throughout the gene that were predicted to result in loss of function. On the other hand, truncating mutations occurring in the final exon of a gene or near the 3-prime end of the penultimate exon typically escape NMD; all heterozygous MPAN mutations reported by Gregory et al. (2019) were frameshift or nonsense mutations in the third and final exon of C19ORF12. Gregory et al. (2019) proposed a dominant-negative mechanism for these heterozygous mutant alleles based on homomultimerization of the C19ORF12 protein. Additionally, Gregory et al. (2019) identified individuals from 5 families who carried an 11-bp deletion in exon 3 (614297.0001), in homozygosity or compound heterozygosity with another pathogenic mutation. No heterozygous parent showed features of MPAN. Both this mutation and another found in a large family showing autosomal dominant inheritance (614297.0010) truncate the protein at the same codon (79); the difference in the mutant proteins is the identity of the 9 terminal amino acids. Gregory et al. (2019) hypothesized that a normal sequence of residues 69-76 may be necessary and sufficient for the heterozygous mutant protein to homomultimerize with the wildtype protein from the other allele, which could damage the function of the protein complex or induce its degradation. Gregory et al. (2019) also considered haploinsufficiency as an alternate disease mechanism for heterozygous mutations.

Spastic Paraplegia 43

In 2 sisters, born of consanguineous Malian parents, originally reported by Meilleur et al. (2010) as having autosomal recessive spastic paraplegia-43 (SPG43; 615043), Landoure et al. (2013) identified a homozygous missense mutation in the C19ORF12 gene (A63P; 614297.0006). The mutation was found by exome sequencing of 1 of the sisters. Sequencing of the coding region of C19ORF12 in 16 Australians, 46 French, 195 Americans, and 170 Japanese presenting with hereditary spastic paraplegia did not identify any other variants, suggesting that C19ORF12 mutation is likely a rare cause of this phenotype. Landoure et al. (2013) identified the same homozygous A63P mutation in 2 sibs from a consanguineous Brazilian family with NBIA4, and haplotype analysis indicated a founder effect between the Malian and Brazilian families. Landoure et al. (2013) suggested that the phenotypic differences between the 2 families may be due to other genetic or environmental factors or stochastic effects, and concluded that C19ORF12 mutations cause a neurologic disease spectrum that may or may not include brain iron deposition.


ALLELIC VARIANTS ( 12 Selected Examples):

.0001 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, 11-BP DEL, NT204
  
RCV000024151...

In 13 of 24 Polish probands with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified a homozygous 11-bp deletion (c.204_214del, NM_001031726.2) in the C19ORF12 gene, resulting in a frameshift and premature stop codon (Gly69ArgfsTer10) leading to a predicted truncation of more than 50% of the protein. Immunoblot analysis showed absence of the protein in patient fibroblasts, consistent with a loss of function. Haplotype analysis suggested a founder effect, with the mutation occurring at least 50 to 100 generations earlier. The mutation was not found in 750 control chromosomes. Three additional probands were compound heterozygous for the 11-bp deletion and another missense mutation in the C19ORF12 gene (see, e.g., T11M, 614297.0002). The mean age at onset was 9.2 years (range, 4 to 20), but most presented before age 11. The most common presenting symptom was gait or speech difficulty, followed by extrapyramidal signs, oromandibular and generalized dystonia, and parkinsonism. Most had progressive involvement of the corticospinal tract, with spasticity, hyperreflexia, and extensor plantar responses. Other features included motor axonal neuropathy, optic atrophy, and cognitive decline. Brain MRI showed hypointensities in the globus pallidus.

Hogarth et al. (2013) identified the homozygous 11-bp deletion in 3 unrelated patients with NBIA4 of Bosnian, Ukrainian, and mixed Eastern European ancestry, respectively. Four additional NBIA4 patients, including a pair of sibs, were compound heterozygous for the 11-bp deletion and another pathogenic C19ORF12 mutation. All of these patients were of Polish or other Eastern European ancestry.


.0002 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, THR11MET
  
RCV000024152...

In a Polish patient with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified a homozygous c.32C-T transition (c.32C-T, NM_001031726.2) in the C19ORF12 gene, resulting in a thr11-to-met (T11M) substitution upstream of the initiation codon of the shorter isoform, thus only affecting the longer isoform. Another patient was compound heterozygous for T11M and the founder 11-bp deletion (614297.0001). Neither mutation was found in 750 control chromosomes.

Dogu et al. (2013) identified a homozygous T11M mutation in 3 affected individuals from 2 unrelated consanguineous Turkish families with NBIA4. The mutation was found by homozygosity mapping and candidate gene sequencing. All patients had a relatively late onset of the disorder, between 25 and 29 years of age, and 2 showed very rapid progression leading to death 12 and 36 months after admission, respectively. The features were typical of the disorder, with progressive parkinsonism unresponsive to L-DOPA therapy, pyramidal signs, and tremor. Two of the 3 patients had cognitive impairment with behavioral abnormalities. Dogu et al. (2013) suggested that the phenotypic variation in these patients compared to previously reported NBIA4 patients may be due to the involvement of other genetic, epigenetic, or environmental factors.


.0003 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, GLY69ARG
  
RCV000024153...

In a Polish patient with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified a homozygous c.205G-A transition (c.205G-A, NM_001031726.2) in the C19ORF12 gene, resulting in a gly69-to-arg (G69R) substitution in a highly conserved residue in the transmembrane domain. Another patient was compound heterozygous for G69R and K142E (614297.0004). Neither mutation was found in 750 control chromosomes.


.0004 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, LYS142GLU
  
RCV000024154...

In a Polish patient with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified compound heterozygosity for 2 mutations in the C19ORF12 gene: a c.424A-G transition (c.424A-G, NM_001031726.2), resulting in a lys142-to-glu (K142E) substitution and G69R (614297.0003). Neither mutation was found in 750 control chromosomes. This patient had a relatively mild form of the disorder, with only impairment of fine motor skills beginning at age 14 years. MRI performed at age 12 for a pituitary adenoma showed brain iron accumulation as an incidental finding. This same genotype (G69R and K142E) was found in 1 of 676 patients with parkinsonism. This patient presented with paranoid hallucinations at age 25 years. By age 49, he was diagnosed with Parkinson disease, with rigidity, akinesia, and mild tremor. He also had axial signs, dystonia of the legs with muscle cramps, hypophonia, hypomimia, vivid dreams, sleep disturbance, optic hallucinations, and cognitive decline. CT scan showed marked cerebral atrophy, but MRI was not performed. Both of these patients had a milder form of the disorder compared to patients with other C19ORF12 mutations.


.0005 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, LEU121GLN
  
RCV000024323

In 2 brothers, born of consanguineous Turkish parents, with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Horvath et al. (2012) identified a homozygous c.362T-A transversion in the C19ORF12 gene, resulting in a leu121-to-gln (L121Q) substitution in a conserved residue. Each unaffected parent was heterozygous for the mutation, which was not found in 200 control chromosomes.


.0006 SPASTIC PARAPLEGIA 43, AUTOSOMAL RECESSIVE (1 family)

NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE, INCLUDED
C19ORF12, ALA63PRO
  
RCV000074453...

In 2 sisters, born of consanguineous Malian parents, originally reported by Meilleur et al. (2010) as having autosomal recessive spastic paraplegia-43 (SPG43; 615043), Landoure et al. (2013) identified a homozygous c.187G-C transversion in the C19ORF12 gene, resulting in an ala63-to-pro (A63P) substitution at a highly conserved residue in the membrane domain. The mutation was found by exome sequencing of 1 of the sisters. The homozygous mutation was not found in 298 Malian controls or in 951 samples in the ClinSeq cohort. The A63P variant was present in 3 of 3,836 African American alleles in the NHLBI Exome Sequencing Project database, but not in 8,222 European American alleles in this database. Sequencing of the coding region of C19ORF12 in 16 Australians, 46 French, 195 Americans, and 170 Japanese presenting with hereditary spastic paraplegia did not identify any other variants, suggesting that C19ORF12 mutation is likely a rare cause of this phenotype. Reexamination of the older sister 5 years after the original report showed that she had severe atrophy and decreased sensation in the arms and legs and decreased reflexes, but no cognitive decline, facial or bulbar weakness, or vision loss. Brain MRI showed no abnormalities and no iron deposition. Landoure et al. (2013) identified the same homozygous A63P mutation in 2 sibs from a consanguineous Brazilian family with onset of walking difficulties due to spastic paraplegia in their second decade. They had distal muscle wasting and weakness, axonal sensorimotor neuropathy, and visual loss with optic atrophy. Both became wheelchair-bound in their thirties. Brain MRI showed evidence of brain iron deposits in the globus pallidus, consistent with a diagnosis of neurodegeneration with brain iron accumulation-4 (NBIA4; 614298). One of the sibs had memory loss and depression. Haplotype analysis indicated a founder effect between the Malian and Brazilian families. Landoure et al. (2013) suggested that the phenotypic differences between the 2 families may be due to other genetic or environmental factors or stochastic effects, and concluded that C19ORF12 mutations cause a neurologic disease spectrum that may or may not include brain iron deposition. In vitro functional expression studies in COS-7 cells showed that the A63P mutant protein had a different intracellular localization compared to wildtype, with more generalized distribution throughout the cytoplasm rather than normal localization to the mitochondria or endoplasmic reticulum.


.0007 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, 3-BP DEL, NT197
  
RCV000074455...

In 2 sibs with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Deschauer et al. (2012) identified compound heterozygous mutations in the C19ORF12 gene: a 3-bp in-frame deletion (c.197_199del), resulting in the deletion of a highly conserved residue (Gly33) in the predicted transmembrane domain, and a T11M substitution (614297.0002). The mother was heterozygous for the T11M mutation; DNA from the father was not available. The 3-bp deletion was not found in 1,000 control chromosomes and was absent from 80 HapMap individuals and the 1000 Genomes Project database. The patients were 27 and 17 years of age at the time of the report. Both had upper and lower motor neuron signs with pes cavus, winged scapula, and calf atrophy, and some difficulty walking. One had hyporeflexia with extensor plantar responses, whereas the other had hyperreflexia with clonus. Nerve studies showed reduced amplitudes with normal conduction times, consistent with axonal neuropathy. Both patients also had cognitive impairment with disinhibited and impulsive behavior; the younger sib had a history of global developmental delay since age 3 years. A third unrelated patient with a similar disorder was found to be compound heterozygous for the 3-bp deletion and an 11-bp deletion (614297.0001). Each unaffected parent was heterozygous for 1 of the mutations. This patient had onset of gait difficulties at age 9 years, distal muscle weakness, hyperreflexia, pes cavus, atrophy of the thenar muscles, learning difficulties, visual impairment due to optic atrophy, and emotional lability. Brain MRI of all 3 patients showed T2-weighted hypointensities in the global pallidus with some hypointensities also in the substantia nigra and cerebral peduncles, consistent with iron deposition. Deschauer et al. (2012) noted that the phenotype was reminiscent of juvenile-onset amyotrophic lateral sclerosis (ALS).

Landoure et al. (2013) identified a homozygous c.197_199del in a patient with NBIA4. He presented at age 4 years with speech difficulty followed by progressive spasticity and impaired walking. Other features included psychomotor slowness, weakness and atrophy of the distal extremities, and small, pale optic discs. EMG showed denervation consistent with a motor neuropathy, and brain MRI showed iron deposition in the globus pallidus. In vitro functional expression studies in COS-7 cells showed that the mutant protein had a different intracellular localization compared to wildtype, with more generalized distribution throughout the cytoplasm rather than normal localization to the mitochondria or endoplasmic reticulum.


.0008 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, PRO83LEU (rs201987973)
  
RCV000211114

In 2 sisters, born of consanguineous Turkish parents, with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Kleffner et al. (2015) identified a homozygous c.248C-T transition (rs201987973) in the C19ORF12 gene, resulting in a pro83-to-leu (P83L) substitution at a highly conserved residue. The mutation segregated with the disorder in the family and was not found in the Exome Variant Server or 1000 Genomes Project databases, or in 96 control individuals. Functional studies of the variant and studies of patient cells were not performed, but Kleffner et al. (2015) noted that the same variant had previously been identified in 2 other families with the disorder by Hogarth et al. (2013). The phenotype in the sisters included progressive optic atrophy, spastic tetraparesis, cerebellar signs, and cognitive decline, reminiscent of Behr syndrome (210000).


.0009 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, 2-BP DEL, 265AT
  
RCV000788048

In a girl with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), born of nonconsanguineous Italian parents, Monfrini et al. (2018) detected a heterozygous de novo 2-bp deletion (c.265_266delAT, NM_001031726) in exon 3 of the C19ORF12 gene that resulted in frameshift and premature termination of the protein (Met89GlyfsTer12). Sanger sequencing of other genes mutant in neurodegeneration with brain iron accumulation did not detect other pathogenic mutations or rearrangements. Quantitative RT-PCR in lymphocytes showed that mRNA quantity in the proband was not reduced compared to that of the parents and controls, suggesting absence of degradation through nonsense-mediated decay. Sequence analysis of the C19ORF12 transcripts revealed presence of the mutation in the proband and ruled out aberrant splicing. Several other tissues (hair, saliva, and urine) in addition to lymphocytes were examined and no evidence of mosaicism was seen. Monfrini et al. (2018) hypothesized that the heterozygous variant is pathogenic and suggested that the mutation may have a dominant-negative effect, although they also noted the possibility that the patient has a mutation in an unidentified causative gene.


.0010 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, 11-BP DEL, NT227
  
RCV000788049

In a large 3-generation family (family 18) with 9 affected individuals with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298) transmitted in an autosomal dominant pattern, Gregory et al. (2019) identified an 11-basepair deletion (c.227_237del11, NM_001031726.3) in exon 3 of the C19ORF12 gene resulting in a methionine-to-threonine substitution followed by a frameshift and premature termination codon 3 amino acids later (Met76ThrfsTer3). The mutation occurred in the third (last) exon of the C19ORF12 gene. The mutation was present in 1 individual (18-205) who was healthy at 80 years of age. Individual 18-310, an obligate carrier with an affected mother and son, appeared to have no clinical features of the disorder.


.0011 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, TRP112TER
  
RCV000504170...

In the proband (748-402) and her mother (748-301) from a 4-generation family (family 748) with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Gregory et al. (2019) detected a heterozygous c.336G-A transition (c.336G-A, NM_001031726.3) in exon 3 of the C19ORF12 gene that resulted in a trp112-to-ter (W112X) substitution.


.0012 NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, GLN80TER
  
RCV000488270...

In 2 adopted sibs (family 691) and an unrelated proband (family 698) with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Gregory et al. (2019) identified a C-to-T transition at nucleotide 238 (c.238C-T, NM_001031726.3) in exon 3 of the C19ORF12 gene resulting in a premature termination codon replacing the glutamine at codon 80 of the C19ORF12 gene (Q80X). The mutation was shown to have occurred de novo in family 698; biological parents were not available for analysis in family 691. The sibs both presented at age 10 years and shared progressive spastic tetraparesis and optic disc pallor. They differed in dysphagia and cognitive decline. The unrelated proband experienced disease onset at age 5 years with gait disturbance, optic atrophy, and neuropsychiatric symptoms.


REFERENCES

  1. Deschauer, M., Gaul, C., Behrmann, C., Prokisch, H., Zierz, S., Haack, T. B. C19orf12 mutations in neurodegeneration with brain iron accumulation mimicking juvenile amyotrophic lateral sclerosis. J. Neurol. 259: 2434-2439, 2012. [PubMed: 22584950, related citations] [Full Text]

  2. Dogu, O., Krebs, C. E., Kaleagasi, H., Demirtas, Z., Oksuz, N., Walker, R. H., Paisan-Ruiz, C. Rapid disease progression in adult-onset mitochondrial membrane protein-associated neurodegeneration. Clin. Genet. 84: 350-355, 2013. [PubMed: 23278385, related citations] [Full Text]

  3. Gregory, A., Lotia, M., Jeong, S. Y., Fox. R., Zhen, D., Sanford, L., Hamada, J., Jahic, A., Beetz, C., Freed, A., Kurian, M. A., Cullup, T., and 13 others. Autosomal dominant mitochondrial membrane protein-associated neurodegeneration (MPAN). Molec. Genet. Genomic Med. 7: e00736, 2019. Note: Electronic Article. [PubMed: 31087512, images, related citations] [Full Text]

  4. Hartig, M. B., Iuso, A., Haack, T., Kmiec, T., Jurkiewicz, E., Heim, K., Roeber, S., Tarabin, V., Dusi, S., Krajewska-Walasek, M., Jozwiak, S., Hempel, M., and 13 others. Absence of an orphan mitochondrial protein, C19orf12, causes a distinct clinical subtype of neurodegeneration with brain iron accumulation. Am. J. Hum. Genet. 89: 543-550, 2011. [PubMed: 21981780, images, related citations] [Full Text]

  5. Hogarth, P., Gregory, A., Kruer, M. C., Sanford, L., Wagoner, W., Natowicz, M. R., Egel, R. T., Subramony, S. H., Goldman, J. G., Berry-Kravis, E., Foulds, N. C., Hammans, S. R., and 9 others. New NBIA subtype: genetic, clinical, pathologic, and radiographic features of MPAN. Neurology 80: 268-275, 2013. [PubMed: 23269600, images, related citations] [Full Text]

  6. Horvath, R., Holinski-Feder, E., Neeve, V. C. M., Pyle, A., Griffin, H., Ashok, D., Foley, C., Hudson, G., Rautensstrauss, B., Nurnberg, G., Nurnberg, P., Kortler, J., and 10 others. A new phenotype of brain iron accumulation with dystonia, optic atrophy, and peripheral neuropathy. Mov. Disord. 27: 789-793, 2012. [PubMed: 22508347, related citations] [Full Text]

  7. Kasapkara, C. S., Tumer, L., Gregory, A., Ezgu, F., Inci, A., Derinkuyu, B. E., Fox, R., Rogers, C., Hayflick, S. A new NBIA patient from Turkey with homozygous C19ORF12 mutation. Acta Neurol. Belg. 119: 623-625, 2019. [PubMed: 30298423, related citations] [Full Text]

  8. Kleffner, I., Wessling, C., Gess, B., Korsukewitz, C., Allkemper, T., Schirmacher, A., Young, P., Senderek, J., Husstedt, I. W. Behr syndrome with homozygous C19ORF12 mutation. J. Neurol. Sci. 357: 115-118, 2015. [PubMed: 26187298, related citations] [Full Text]

  9. Landoure, G., Zhu, P.-P., Lourenco, C. M., Johnson, J. O., Toro, C., Bricceno, K. V., Rinaldi, C., Melleur, K. G., Sangare, M., Diallo, O., Pierson, T. M., Ishiura, H., and 19 others. Hereditary spastic paraplegia type 43 (SPG43) is caused by mutation in C19orf12. Hum. Mutat. 34: 1357-1360, 2013. [PubMed: 23857908, images, related citations] [Full Text]

  10. Meilleur, K. G., Traore, M., Sangare, M., Britton, A., Landoure, G., Coulibaly, S., Niare, B., Mochel, F., La Pean, A., Rafferty, I., Watts, C., Shriner, D., Littleton-Kearney, M. T., Blackstone, C., Singleton, A., Fischbeck, K. H. Hereditary spastic paraplegia and amyotrophy associated with a novel locus on chromosome 19. Neurogenetics 11: 313-318, 2010. [PubMed: 20039086, images, related citations] [Full Text]

  11. Monfrini, E., Melzi, V., Buongarzone, G., Franco, G., Ronchi, D., Dilena, R., Scola, E., Vizziello, P., Bordoni, A., Bresolin, N., Comi, G. P., Corti, S., Di Fonzo, A. A de novo C19orf12 heterozygous mutation in a patient with MPAN. Parkinsonism Relat. Disord. 48: 109-111, 2018. [PubMed: 29295770, related citations] [Full Text]


Ada Hamosh - updated : 07/19/2019
Sonja A. Rasmussen - updated : 06/17/2019
Sonja A. Rasmussen - updated : 01/10/2019
Cassandra L. Kniffin - updated : 5/10/2016
Cassandra L. Kniffin - updated : 11/12/2013
Cassandra L. Kniffin - updated : 11/4/2013
Cassandra L. Kniffin - updated : 5/23/2013
Cassandra L. Kniffin - updated : 5/29/2012
Cassandra L. Kniffin - updated : 10/20/2011
Creation Date:
Patricia A. Hartz : 10/19/2011
alopez : 03/08/2022
carol : 11/21/2019
carol : 11/21/2019
carol : 11/20/2019
alopez : 07/19/2019
carol : 06/17/2019
carol : 01/10/2019
carol : 01/10/2019
carol : 10/20/2017
carol : 10/24/2016
joanna : 07/01/2016
carol : 5/11/2016
ckniffin : 5/10/2016
carol : 11/20/2013
ckniffin : 11/12/2013
carol : 11/6/2013
ckniffin : 11/4/2013
alopez : 6/12/2013
alopez : 6/12/2013
ckniffin : 5/23/2013
terry : 7/5/2012
carol : 5/31/2012
ckniffin : 5/29/2012
carol : 10/21/2011
ckniffin : 10/20/2011
mgross : 10/19/2011

* 614297

CHROMOSOME 19 OPEN READING FRAME 12; C19ORF12


HGNC Approved Gene Symbol: C19orf12

SNOMEDCT: 764736001;  


Cytogenetic location: 19q12   Genomic coordinates (GRCh38) : 19:29,698,886-29,715,789 (from NCBI)


Gene-Phenotype Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
19q12 ?Spastic paraplegia 43, autosomal recessive 615043 Autosomal recessive 3
Neurodegeneration with brain iron accumulation 4 614298 Autosomal dominant; Autosomal recessive 3

TEXT

Cloning and Expression

By searching for genes in a region of chromosome 19 linked to neurodegeneration with brain iron accumulation (NBIA4; 614298), followed by RT-PCR of fibroblasts and blood, Hartig et al. (2011) cloned 2 splice variants of C19ORF12. The transcripts differ in their first exons, and the deduced 152- and 141-amino acid proteins differ only at their N termini. Both proteins contain a central transmembrane domain. Orthologs of the long isoform were detected in chimpanzee and chicken only, but close orthologs of the short isoform were detected in diverse animal species. Endogenous or fluorescence-tagged C19ORF12 protein localized to mitochondria. Hartig et al. (2011) stated that C19ORF12 is ubiquitously expressed.

Landoure et al. (2013) found that the C19ORF12 protein had a complex intracellular localization to the mitochondria or endoplasmic reticulum (ER) when expressed in cultured COS-7 cells.


Gene Function

Hartig et al. (2011) found that expression of C19ORF12 increased with differentiation in adipocytes along with genes involved in valine, leucine, and isoleucine degradation and fatty acid metabolism.


Gene Structure

Hartig et al. (2011) determined that the C19ORF12 gene spans 17 kb and contains 4 exons, including 2 alternative first exons.


Mapping

By genomic sequence analysis, Hartig et al. (2011) mapped the C19ORF12 gene to chromosome 19q12.


Molecular Genetics

Neurodegeneration with Brain Iron Accumulation 4, Autosomal Recessive

In 24 Polish patients with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified homozygous or compound heterozygous mutations in the C19ORF12 gene (see, e.g., 614297.0001-614297.0004). Eighteen patients carried the same 11-bp deletion (c.201_214del; 614297.0001), and haplotype analysis indicated a founder effect. The mutation was initially found after genomewide linkage analysis of an affected family. Two unrelated patients who were compound heterozygous for 2 missense mutations (614297.0003 and 614297.0004) had a milder phenotype. One had only impairment of fine motor skills at age 19 years, and the other presented in his forties with parkinsonism and dystonia. Hartig et al. (2011) suggested the designation 'mitochondrial membrane protein associated neurodegeneration (MPAN)' for this disorder.

In 23 of 161 individuals with NBIA, Hogarth et al. (2013) identified pathogenic mutations in the C19ORF12 gene. Seventeen patients from 16 families had biallelic mutations, whereas 6 patients from 4 families had heterozygous mutations; however, the authors considered a second occult deleterious mutation likely to be present in these patients. The 11-bp deletion (614297.0001) identified by Hartig et al. (2011) was recurrent in individuals of Eastern European origin.

Deschauer et al. (2012) identified 3 different mutations in the C19ORF12 gene (614297.0001; 614297.0002; 614296.0007) in 3 patients from 2 unrelated families with NBIA4. All mutations occurred in compound heterozygosity. The patients had onset in the first or second decades of upper and lower motor neuron signs reminiscent of juvenile-onset amyotrophic lateral sclerosis (ALS). Clinical features included pes cavus, difficulty walking, hypo- and hyperreflexia, muscle weakness and atrophy, and variable cognitive impairment with neuropsychologic abnormalities. One patient had optic atrophy. Extrapyramidal signs, such as parkinsonism, were not present. Brain MRI of all 3 patients showed T2-weighted hypointensities in the globus pallidus with some hypointensities also in the substantia nigra and cerebral peduncles, consistent with iron deposition.

In a 19-year-old Turkish girl with NBIA4, Kasapkara et al. (2019) identified a homozygous 11-bp deletion (c.171_181del) in the C19ORF12 gene. Her consanguineous parents were heterozygous for the mutation.

Gregory et al. (2019) reported 22 individuals from 19 families with homozygous or compound heterozygous mutation in the C19ORF12 gene.

Neurodegeneration with Brain Iron Accumulation 4, Autosomal Dominant

In a girl with NBIA4, born of unrelated Italian parents, Monfrini et al. (2018) identified a de novo heterozygous 2-bp deletion in the C19ORF12 gene (c.265_266delAT; 614297.0009). Sequencing of all exons and intron-exon boundaries of other known NBIA-associated genes did not detect other pathogenic variants. Quantitative reverse-transcription PCR in lymphocytes showed that mRNA quantity in the proband was not reduced compared to that of the parents and controls, suggesting absence of degradation through nonsense-mediated decay. The authors hypothesized that the heterozygous variant is pathogenic and suggested that the mutation may have a dominant-negative effect. They also noted the possibility that the patient has a mutation in an unidentified causative gene. They further noted that 5 previous heterozygous mutations had been reported (e.g., Hogarth et al., 2013), all involving exon 3, but that those authors considered that a second mutation was likely to be present.

Gregory et al. (2019) identified 18 patients with MPAN (NBIA4) from 13 families who carried heterozygous mutations in the C19ORF12 gene, all in exon 3 (e.g., 614297.0010-614297.0012). The authors proposed a mechanism to explain how MPAN can display both autosomal recessive and autosomal dominant inheritance. In autosomal recessive MPAN, a mutation resulting in premature termination of the protein occurring in the first or second exon would be predicted to undergo nonsense-mediated decay (NMD). From parental studies, partial C19ORF12 loss of function from one such allele causes no neurologic problems. Therefore, 2 such mutant alleles are required to manifest disease. The homozygous and compound heterozygous cases presented by Gregory et al. (2019) comprised a mix of frameshift mutations predicted to undergo NMD, and missense and splicing mutations throughout the gene that were predicted to result in loss of function. On the other hand, truncating mutations occurring in the final exon of a gene or near the 3-prime end of the penultimate exon typically escape NMD; all heterozygous MPAN mutations reported by Gregory et al. (2019) were frameshift or nonsense mutations in the third and final exon of C19ORF12. Gregory et al. (2019) proposed a dominant-negative mechanism for these heterozygous mutant alleles based on homomultimerization of the C19ORF12 protein. Additionally, Gregory et al. (2019) identified individuals from 5 families who carried an 11-bp deletion in exon 3 (614297.0001), in homozygosity or compound heterozygosity with another pathogenic mutation. No heterozygous parent showed features of MPAN. Both this mutation and another found in a large family showing autosomal dominant inheritance (614297.0010) truncate the protein at the same codon (79); the difference in the mutant proteins is the identity of the 9 terminal amino acids. Gregory et al. (2019) hypothesized that a normal sequence of residues 69-76 may be necessary and sufficient for the heterozygous mutant protein to homomultimerize with the wildtype protein from the other allele, which could damage the function of the protein complex or induce its degradation. Gregory et al. (2019) also considered haploinsufficiency as an alternate disease mechanism for heterozygous mutations.

Spastic Paraplegia 43

In 2 sisters, born of consanguineous Malian parents, originally reported by Meilleur et al. (2010) as having autosomal recessive spastic paraplegia-43 (SPG43; 615043), Landoure et al. (2013) identified a homozygous missense mutation in the C19ORF12 gene (A63P; 614297.0006). The mutation was found by exome sequencing of 1 of the sisters. Sequencing of the coding region of C19ORF12 in 16 Australians, 46 French, 195 Americans, and 170 Japanese presenting with hereditary spastic paraplegia did not identify any other variants, suggesting that C19ORF12 mutation is likely a rare cause of this phenotype. Landoure et al. (2013) identified the same homozygous A63P mutation in 2 sibs from a consanguineous Brazilian family with NBIA4, and haplotype analysis indicated a founder effect between the Malian and Brazilian families. Landoure et al. (2013) suggested that the phenotypic differences between the 2 families may be due to other genetic or environmental factors or stochastic effects, and concluded that C19ORF12 mutations cause a neurologic disease spectrum that may or may not include brain iron deposition.


ALLELIC VARIANTS 12 Selected Examples):

.0001   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, 11-BP DEL, NT204
SNP: rs515726204, gnomAD: rs515726204, ClinVar: RCV000024151, RCV001044832, RCV001781311, RCV003155040, RCV003904862, RCV005016293

In 13 of 24 Polish probands with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified a homozygous 11-bp deletion (c.204_214del, NM_001031726.2) in the C19ORF12 gene, resulting in a frameshift and premature stop codon (Gly69ArgfsTer10) leading to a predicted truncation of more than 50% of the protein. Immunoblot analysis showed absence of the protein in patient fibroblasts, consistent with a loss of function. Haplotype analysis suggested a founder effect, with the mutation occurring at least 50 to 100 generations earlier. The mutation was not found in 750 control chromosomes. Three additional probands were compound heterozygous for the 11-bp deletion and another missense mutation in the C19ORF12 gene (see, e.g., T11M, 614297.0002). The mean age at onset was 9.2 years (range, 4 to 20), but most presented before age 11. The most common presenting symptom was gait or speech difficulty, followed by extrapyramidal signs, oromandibular and generalized dystonia, and parkinsonism. Most had progressive involvement of the corticospinal tract, with spasticity, hyperreflexia, and extensor plantar responses. Other features included motor axonal neuropathy, optic atrophy, and cognitive decline. Brain MRI showed hypointensities in the globus pallidus.

Hogarth et al. (2013) identified the homozygous 11-bp deletion in 3 unrelated patients with NBIA4 of Bosnian, Ukrainian, and mixed Eastern European ancestry, respectively. Four additional NBIA4 patients, including a pair of sibs, were compound heterozygous for the 11-bp deletion and another pathogenic C19ORF12 mutation. All of these patients were of Polish or other Eastern European ancestry.


.0002   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, THR11MET
SNP: rs397514477, gnomAD: rs397514477, ClinVar: RCV000024152, RCV000426086, RCV001004003, RCV003743545, RCV004700277, RCV005016294

In a Polish patient with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified a homozygous c.32C-T transition (c.32C-T, NM_001031726.2) in the C19ORF12 gene, resulting in a thr11-to-met (T11M) substitution upstream of the initiation codon of the shorter isoform, thus only affecting the longer isoform. Another patient was compound heterozygous for T11M and the founder 11-bp deletion (614297.0001). Neither mutation was found in 750 control chromosomes.

Dogu et al. (2013) identified a homozygous T11M mutation in 3 affected individuals from 2 unrelated consanguineous Turkish families with NBIA4. The mutation was found by homozygosity mapping and candidate gene sequencing. All patients had a relatively late onset of the disorder, between 25 and 29 years of age, and 2 showed very rapid progression leading to death 12 and 36 months after admission, respectively. The features were typical of the disorder, with progressive parkinsonism unresponsive to L-DOPA therapy, pyramidal signs, and tremor. Two of the 3 patients had cognitive impairment with behavioral abnormalities. Dogu et al. (2013) suggested that the phenotypic variation in these patients compared to previously reported NBIA4 patients may be due to the involvement of other genetic, epigenetic, or environmental factors.


.0003   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, GLY69ARG
SNP: rs515726205, gnomAD: rs515726205, ClinVar: RCV000024153, RCV000414809, RCV000528859, RCV001781312, RCV003230372, RCV005016295

In a Polish patient with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified a homozygous c.205G-A transition (c.205G-A, NM_001031726.2) in the C19ORF12 gene, resulting in a gly69-to-arg (G69R) substitution in a highly conserved residue in the transmembrane domain. Another patient was compound heterozygous for G69R and K142E (614297.0004). Neither mutation was found in 750 control chromosomes.


.0004   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, LYS142GLU
SNP: rs146170087, gnomAD: rs146170087, ClinVar: RCV000024154, RCV000415210, RCV000509226, RCV000553096, RCV000714889, RCV001083182, RCV001844017, RCV001847623

In a Polish patient with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Hartig et al. (2011) identified compound heterozygosity for 2 mutations in the C19ORF12 gene: a c.424A-G transition (c.424A-G, NM_001031726.2), resulting in a lys142-to-glu (K142E) substitution and G69R (614297.0003). Neither mutation was found in 750 control chromosomes. This patient had a relatively mild form of the disorder, with only impairment of fine motor skills beginning at age 14 years. MRI performed at age 12 for a pituitary adenoma showed brain iron accumulation as an incidental finding. This same genotype (G69R and K142E) was found in 1 of 676 patients with parkinsonism. This patient presented with paranoid hallucinations at age 25 years. By age 49, he was diagnosed with Parkinson disease, with rigidity, akinesia, and mild tremor. He also had axial signs, dystonia of the legs with muscle cramps, hypophonia, hypomimia, vivid dreams, sleep disturbance, optic hallucinations, and cognitive decline. CT scan showed marked cerebral atrophy, but MRI was not performed. Both of these patients had a milder form of the disorder compared to patients with other C19ORF12 mutations.


.0005   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, LEU121GLN
SNP: rs387907173, gnomAD: rs387907173, ClinVar: RCV000024323

In 2 brothers, born of consanguineous Turkish parents, with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Horvath et al. (2012) identified a homozygous c.362T-A transversion in the C19ORF12 gene, resulting in a leu121-to-gln (L121Q) substitution in a conserved residue. Each unaffected parent was heterozygous for the mutation, which was not found in 200 control chromosomes.


.0006   SPASTIC PARAPLEGIA 43, AUTOSOMAL RECESSIVE (1 family)

NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE, INCLUDED
C19ORF12, ALA63PRO
SNP: rs376103979, gnomAD: rs376103979, ClinVar: RCV000074453, RCV000074454, RCV000493663, RCV005025116

In 2 sisters, born of consanguineous Malian parents, originally reported by Meilleur et al. (2010) as having autosomal recessive spastic paraplegia-43 (SPG43; 615043), Landoure et al. (2013) identified a homozygous c.187G-C transversion in the C19ORF12 gene, resulting in an ala63-to-pro (A63P) substitution at a highly conserved residue in the membrane domain. The mutation was found by exome sequencing of 1 of the sisters. The homozygous mutation was not found in 298 Malian controls or in 951 samples in the ClinSeq cohort. The A63P variant was present in 3 of 3,836 African American alleles in the NHLBI Exome Sequencing Project database, but not in 8,222 European American alleles in this database. Sequencing of the coding region of C19ORF12 in 16 Australians, 46 French, 195 Americans, and 170 Japanese presenting with hereditary spastic paraplegia did not identify any other variants, suggesting that C19ORF12 mutation is likely a rare cause of this phenotype. Reexamination of the older sister 5 years after the original report showed that she had severe atrophy and decreased sensation in the arms and legs and decreased reflexes, but no cognitive decline, facial or bulbar weakness, or vision loss. Brain MRI showed no abnormalities and no iron deposition. Landoure et al. (2013) identified the same homozygous A63P mutation in 2 sibs from a consanguineous Brazilian family with onset of walking difficulties due to spastic paraplegia in their second decade. They had distal muscle wasting and weakness, axonal sensorimotor neuropathy, and visual loss with optic atrophy. Both became wheelchair-bound in their thirties. Brain MRI showed evidence of brain iron deposits in the globus pallidus, consistent with a diagnosis of neurodegeneration with brain iron accumulation-4 (NBIA4; 614298). One of the sibs had memory loss and depression. Haplotype analysis indicated a founder effect between the Malian and Brazilian families. Landoure et al. (2013) suggested that the phenotypic differences between the 2 families may be due to other genetic or environmental factors or stochastic effects, and concluded that C19ORF12 mutations cause a neurologic disease spectrum that may or may not include brain iron deposition. In vitro functional expression studies in COS-7 cells showed that the A63P mutant protein had a different intracellular localization compared to wildtype, with more generalized distribution throughout the cytoplasm rather than normal localization to the mitochondria or endoplasmic reticulum.


.0007   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, 3-BP DEL, NT197
SNP: rs398122409, gnomAD: rs398122409, ClinVar: RCV000074455, RCV001311507, RCV002265593, RCV004562242, RCV005016359

In 2 sibs with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Deschauer et al. (2012) identified compound heterozygous mutations in the C19ORF12 gene: a 3-bp in-frame deletion (c.197_199del), resulting in the deletion of a highly conserved residue (Gly33) in the predicted transmembrane domain, and a T11M substitution (614297.0002). The mother was heterozygous for the T11M mutation; DNA from the father was not available. The 3-bp deletion was not found in 1,000 control chromosomes and was absent from 80 HapMap individuals and the 1000 Genomes Project database. The patients were 27 and 17 years of age at the time of the report. Both had upper and lower motor neuron signs with pes cavus, winged scapula, and calf atrophy, and some difficulty walking. One had hyporeflexia with extensor plantar responses, whereas the other had hyperreflexia with clonus. Nerve studies showed reduced amplitudes with normal conduction times, consistent with axonal neuropathy. Both patients also had cognitive impairment with disinhibited and impulsive behavior; the younger sib had a history of global developmental delay since age 3 years. A third unrelated patient with a similar disorder was found to be compound heterozygous for the 3-bp deletion and an 11-bp deletion (614297.0001). Each unaffected parent was heterozygous for 1 of the mutations. This patient had onset of gait difficulties at age 9 years, distal muscle weakness, hyperreflexia, pes cavus, atrophy of the thenar muscles, learning difficulties, visual impairment due to optic atrophy, and emotional lability. Brain MRI of all 3 patients showed T2-weighted hypointensities in the global pallidus with some hypointensities also in the substantia nigra and cerebral peduncles, consistent with iron deposition. Deschauer et al. (2012) noted that the phenotype was reminiscent of juvenile-onset amyotrophic lateral sclerosis (ALS).

Landoure et al. (2013) identified a homozygous c.197_199del in a patient with NBIA4. He presented at age 4 years with speech difficulty followed by progressive spasticity and impaired walking. Other features included psychomotor slowness, weakness and atrophy of the distal extremities, and small, pale optic discs. EMG showed denervation consistent with a motor neuropathy, and brain MRI showed iron deposition in the globus pallidus. In vitro functional expression studies in COS-7 cells showed that the mutant protein had a different intracellular localization compared to wildtype, with more generalized distribution throughout the cytoplasm rather than normal localization to the mitochondria or endoplasmic reticulum.


.0008   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL RECESSIVE

C19ORF12, PRO83LEU ({dbSNP rs201987973})
SNP: rs201987973, gnomAD: rs201987973, ClinVar: RCV000211114

In 2 sisters, born of consanguineous Turkish parents, with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Kleffner et al. (2015) identified a homozygous c.248C-T transition (rs201987973) in the C19ORF12 gene, resulting in a pro83-to-leu (P83L) substitution at a highly conserved residue. The mutation segregated with the disorder in the family and was not found in the Exome Variant Server or 1000 Genomes Project databases, or in 96 control individuals. Functional studies of the variant and studies of patient cells were not performed, but Kleffner et al. (2015) noted that the same variant had previously been identified in 2 other families with the disorder by Hogarth et al. (2013). The phenotype in the sisters included progressive optic atrophy, spastic tetraparesis, cerebellar signs, and cognitive decline, reminiscent of Behr syndrome (210000).


.0009   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, 2-BP DEL, 265AT
SNP: rs1599534276, ClinVar: RCV000788048

In a girl with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), born of nonconsanguineous Italian parents, Monfrini et al. (2018) detected a heterozygous de novo 2-bp deletion (c.265_266delAT, NM_001031726) in exon 3 of the C19ORF12 gene that resulted in frameshift and premature termination of the protein (Met89GlyfsTer12). Sanger sequencing of other genes mutant in neurodegeneration with brain iron accumulation did not detect other pathogenic mutations or rearrangements. Quantitative RT-PCR in lymphocytes showed that mRNA quantity in the proband was not reduced compared to that of the parents and controls, suggesting absence of degradation through nonsense-mediated decay. Sequence analysis of the C19ORF12 transcripts revealed presence of the mutation in the proband and ruled out aberrant splicing. Several other tissues (hair, saliva, and urine) in addition to lymphocytes were examined and no evidence of mosaicism was seen. Monfrini et al. (2018) hypothesized that the heterozygous variant is pathogenic and suggested that the mutation may have a dominant-negative effect, although they also noted the possibility that the patient has a mutation in an unidentified causative gene.


.0010   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, 11-BP DEL, NT227
SNP: rs1599534394, ClinVar: RCV000788049

In a large 3-generation family (family 18) with 9 affected individuals with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298) transmitted in an autosomal dominant pattern, Gregory et al. (2019) identified an 11-basepair deletion (c.227_237del11, NM_001031726.3) in exon 3 of the C19ORF12 gene resulting in a methionine-to-threonine substitution followed by a frameshift and premature termination codon 3 amino acids later (Met76ThrfsTer3). The mutation occurred in the third (last) exon of the C19ORF12 gene. The mutation was present in 1 individual (18-205) who was healthy at 80 years of age. Individual 18-310, an obligate carrier with an affected mother and son, appeared to have no clinical features of the disorder.


.0011   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, TRP112TER
SNP: rs1555714808, ClinVar: RCV000504170, RCV004023363

In the proband (748-402) and her mother (748-301) from a 4-generation family (family 748) with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Gregory et al. (2019) detected a heterozygous c.336G-A transition (c.336G-A, NM_001031726.3) in exon 3 of the C19ORF12 gene that resulted in a trp112-to-ter (W112X) substitution.


.0012   NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 4, AUTOSOMAL DOMINANT

C19ORF12, GLN80TER
SNP: rs1064797235, ClinVar: RCV000488270, RCV000502393

In 2 adopted sibs (family 691) and an unrelated proband (family 698) with neurodegeneration with brain iron accumulation-4 (NBIA4; 614298), Gregory et al. (2019) identified a C-to-T transition at nucleotide 238 (c.238C-T, NM_001031726.3) in exon 3 of the C19ORF12 gene resulting in a premature termination codon replacing the glutamine at codon 80 of the C19ORF12 gene (Q80X). The mutation was shown to have occurred de novo in family 698; biological parents were not available for analysis in family 691. The sibs both presented at age 10 years and shared progressive spastic tetraparesis and optic disc pallor. They differed in dysphagia and cognitive decline. The unrelated proband experienced disease onset at age 5 years with gait disturbance, optic atrophy, and neuropsychiatric symptoms.


REFERENCES

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  6. Horvath, R., Holinski-Feder, E., Neeve, V. C. M., Pyle, A., Griffin, H., Ashok, D., Foley, C., Hudson, G., Rautensstrauss, B., Nurnberg, G., Nurnberg, P., Kortler, J., and 10 others. A new phenotype of brain iron accumulation with dystonia, optic atrophy, and peripheral neuropathy. Mov. Disord. 27: 789-793, 2012. [PubMed: 22508347] [Full Text: https://doi.org/10.1002/mds.24980]

  7. Kasapkara, C. S., Tumer, L., Gregory, A., Ezgu, F., Inci, A., Derinkuyu, B. E., Fox, R., Rogers, C., Hayflick, S. A new NBIA patient from Turkey with homozygous C19ORF12 mutation. Acta Neurol. Belg. 119: 623-625, 2019. [PubMed: 30298423] [Full Text: https://doi.org/10.1007/s13760-018-1026-5]

  8. Kleffner, I., Wessling, C., Gess, B., Korsukewitz, C., Allkemper, T., Schirmacher, A., Young, P., Senderek, J., Husstedt, I. W. Behr syndrome with homozygous C19ORF12 mutation. J. Neurol. Sci. 357: 115-118, 2015. [PubMed: 26187298] [Full Text: https://doi.org/10.1016/j.jns.2015.07.009]

  9. Landoure, G., Zhu, P.-P., Lourenco, C. M., Johnson, J. O., Toro, C., Bricceno, K. V., Rinaldi, C., Melleur, K. G., Sangare, M., Diallo, O., Pierson, T. M., Ishiura, H., and 19 others. Hereditary spastic paraplegia type 43 (SPG43) is caused by mutation in C19orf12. Hum. Mutat. 34: 1357-1360, 2013. [PubMed: 23857908] [Full Text: https://doi.org/10.1002/humu.22378]

  10. Meilleur, K. G., Traore, M., Sangare, M., Britton, A., Landoure, G., Coulibaly, S., Niare, B., Mochel, F., La Pean, A., Rafferty, I., Watts, C., Shriner, D., Littleton-Kearney, M. T., Blackstone, C., Singleton, A., Fischbeck, K. H. Hereditary spastic paraplegia and amyotrophy associated with a novel locus on chromosome 19. Neurogenetics 11: 313-318, 2010. [PubMed: 20039086] [Full Text: https://doi.org/10.1007/s10048-009-0230-0]

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Contributors:
Ada Hamosh - updated : 07/19/2019
Sonja A. Rasmussen - updated : 06/17/2019
Sonja A. Rasmussen - updated : 01/10/2019
Cassandra L. Kniffin - updated : 5/10/2016
Cassandra L. Kniffin - updated : 11/12/2013
Cassandra L. Kniffin - updated : 11/4/2013
Cassandra L. Kniffin - updated : 5/23/2013
Cassandra L. Kniffin - updated : 5/29/2012
Cassandra L. Kniffin - updated : 10/20/2011

Creation Date:
Patricia A. Hartz : 10/19/2011

Edit History:
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alopez : 07/19/2019
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joanna : 07/01/2016
carol : 5/11/2016
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terry : 7/5/2012
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carol : 10/21/2011
ckniffin : 10/20/2011
mgross : 10/19/2011