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Open Access Research article

Three novel germ-line VHL mutations in Hungarian von Hippel-Lindau patients, including a nonsense mutation in a fifteen-year-old boy with renal cell carcinoma

Gergely Losonczy1*, Ferenc Fazakas2, György Pfliegler3, István Komáromi2, Erzsébet Balázs1, Krisztina Pénzes2 and András Berta1

Author affiliations

1 Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, 98. Nagyerdei bld, 4012, Debrecen, Hungary

2 Haemostasis, Thrombosis and Vascular Biology Research Group of the Hungarian Academy of Sciences, Clinical Research Center, University of Debrecen, Debrecen, Hungary

3 Division of Rare Diseases, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary

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Citation and License

BMC Medical Genetics 2013, 14:3  doi:10.1186/1471-2350-14-3

Published: 8 January 2013

Abstract

Background

Von Hippel-Lindau disease is an autosomal dominantly inherited highly penetrant tumor syndrome predisposing to retinal and central nervous system hemangioblastomas, renal cell carcinoma and phaeochromocytoma among other less frequent complications.

Methods

Molecular genetic testing of the VHL gene was performed in five unrelated families affetced with type I VHL disease, including seven patients and their available family members.

Results

Molecular genetic investigations detected three novel (c.163 G > T, c.232A > T and c.555C > A causing p.Glu55X, p.Asn78Tyr and p.Tyr185X protein changes, respectively) and two previously described (c.340 + 1 G > A and c.583C > T, resulting in p.Gly114AspfsX6 and p.195GlnX protein changes, respectively) germline point mutations in the VHL gene. Molecular modeling of the VHL-ElonginC-HIF-1alpha complex predicted that the p.Asn78Tyr amino acid exchange remarkably alters the 77-83 loop structure of VHL protein and destabilizes the VHL-HIF-1alpha complex suggesting that the mutation causes type I phenotype and has high risk to associate to renal cell carcinoma. The novel p.55X nonsense mutation associated to bilateral RCC and retinal angioma in a 15-year-old male patient.

Conclusion

We describe the earliest onset renal cell carcinoma in VHL disease reported so far in a 15-year-old boy with a nonsense VHL mutation. Individual tailoring of screening schedule based on molecular genetic status should be considered in order to diagnose serious complications as early as possible. Our observations add to the understanding of genotype-phenotype correlation in VHL disease and can be useful for genetic counseling and follow-up of VHL patients.

Keywords:
Genotype-phenotype correlation; Germline mutation; Renal cell carcinoma; Von Hippel-Lindau disease