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American journal of medical genetics. Part ASep 2023 DOI:
10.1002/ajmg.a.63385

Microcystic lymphatic malformations in Turner syndrome are due to somatic mosaicism of PIK3CA

Nriagu, Bede N; Williams, Lydia S; Brewer, Niambi; Surrey, Lea F; Srinivasan, Abhay S; Li, Dong; Britt, Allison; Treat, James; Crowley, T Blaine; O'Connor, Nora; Ganguly, Arupa; Low, David; Queenan, Maria; Drivas, Theodore G; Zackai, Elaine H; Adams, Denise M; Hakonarson, Hakon; Snyder, Kristen M; Sheppard, Sarah E
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Abstract
Turner syndrome (45,X) is caused by a complete or partial absence of a single X chromosome. Vascular malformations occur due to abnormal development of blood and/or lymphatic vessels. They arise from either somatic or germline pathogenic variants in the genes regulating growth and apoptosis of vascular channels. Aortic abnormalities are a common, known vascular anomaly of Turner syndrome. However, previous studies have described other vascular malformations as a rare feature of Turner syndrome and suggested that vascular abnormalities in individuals with Turner syndrome may be more generalized. In this study, we describe two individuals with co-occurrence of Turner syndrome and vascular malformations with a lymphatic component. In these individuals, genetic testing of the lesional tissue revealed a somatic pathogenic variant in PIK3CA-a known and common cause of lymphatic malformations. Based on this finding, we conclude that the vascular malformations presented here and likely those previously in the literature are not a rare part of the clinical spectrum of Turner syndrome, but rather a separate clinical entity that may or may not co-occur in individuals with Turner syndrome.
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