Entry - #611376 - MUNGAN SYNDROME; MGS - OMIM
 
# 611376

MUNGAN SYNDROME; MGS


Alternative titles; symbols

VISCERAL NEUROMYOPATHY, FAMILIAL, WITH PSEUDOOBSTRUCTION, MEGADUODENUM, BARRETT ESOPHAGUS, AND CARDIAC ABNORMALITIES
PSEUDOOBSTRUCTION, CHRONIC IDIOPATHIC INTESTINAL, WITH BARRETT ESOPHAGUS AND CARDIAC ABNORMALITIES


Cytogenetic location: 8q23-q24     Genomic coordinates (GRCh38): 8:105,100,001-145,138,636


Gene-Phenotype Relationships
Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
8q23-q24 Mungan syndrome 611376 AR 2
Clinical Synopsis
 

INHERITANCE
- Autosomal recessive
HEAD & NECK
Eyes
- Ptosis, bilateral
CARDIOVASCULAR
Heart
- Ventricular septal defect, membranous
- Pulmonary valve regurgitation
- Tricuspid valve regurgitation
- Pulmonary valve stenosis, minimal
Vascular
- Supravalvular pulmonary stenosis, minimal
ABDOMEN
Gastrointestinal
- Visceral neuromyopathy
- Pseudoobstruction
- Megaduodenum
- Barrett esophagus, long-segment
- Aperistalsis
GENITOURINARY
Kidneys
- Renal hypoplasia
Ureters
- Vesicoureteral reflux
NEUROLOGIC
Peripheral Nervous System
- Visceral neuromyopathy
MISCELLANEOUS
- Based on report of 1 family (last curated August 2018)
MOLECULAR BASIS
- Caused by mutation in the homolog of S. pombe RAD21 (RAD21, 606462.0003)

TEXT

A number sign (#) is used with this entry because of evidence that Mungan syndrome (MGS) is caused by homozygous mutation in the RAD21 gene (606462) on chromosome 8q24. One such family has been reported.


Description

Mungan syndrome (MGS) is characterized by chronic intestinal pseudoobstruction (CIPO), megaduodenum, long-segment Barrett esophagus, and cardiac abnormalities of variable severity (summary by Bonora et al., 2015).


Clinical Features

Mungan et al. (2003) reported a large consanguineous Turkish family segregating autosomal recessive chronic idiopathic intestinal pseudoobstruction (CIIP) in which 3 sibs had megaduodenum, long-segment Barrett esophagus, and different cardiac abnormalities. Two brothers and a sister, ages 26, 28, and 30 years, respectively, who had recurrent abdominal pain and pseudoobstruction from childhood, underwent upper endoscopy that revealed long-segment Barrett esophagus, hypomotility, and delayed gastric emptying. A biopsy of striated muscle in 1 of the brothers was normal. Esophageal manometry revealed aperistalsis and undetectable lower esophageal pressures, and barium small-bowel enema showed megaduodenum and delayed emptying. Cardiac murmurs were noted in all 3 sibs and echocardiography revealed 'trivial' supravalvular pulmonary stenosis and 2(+) pulmonary and tricuspid valve regurgitation in the 26-year-old proband, membranous ventricular septal defect in his brother, and 'trivial' pulmonic valve stenosis in their sister. Other findings in the sibs included epilepsy, glaucoma, and otosclerosis in the proband and bilateral ptosis in his brother. A male and female cousin, also born of consanguineous parents, were reported to have gastrointestinal complaints and died at 19 and 15 years of age, respectively.

Deglincerti et al. (2007) investigated the Turkish family previously reported by Mungan et al. (2003) and found that the female cousin who died at age 15 did in fact have clinical and radiologic evidence of chronic idiopathic intestinal pseudoobstruction, as well as renal hypoplasia, vesicoureteral reflux, ascites, and unspecified granulomatous hepatitis. The authors examined full-thickness intestinal biopsies from the proband and his brother and observed abnormalities of both the neural and muscular components, suggesting an underlying neuromyopathy.


Inheritance

The transmission pattern of MGS in the family reported by Mungan et al. (2003) and Bonora et al. (2015) was consistent with autosomal recessive inheritance.


Mapping

Deglincerti et al. (2007) performed homozygosity mapping in the large consanguineous Turkish family originally reported by Mungan et al. (2003) with autosomal recessive visceral neuromyopathy and obtained a maximum 2-point lod score of 3.97 and maximum multipoint lod score of 5.01 for a novel microsatellite marker between D8S199 and D8S514. The critical interval spans about 13 Mb between D8S1830 and D8S1799 on chromosome 8q23-q24.


Molecular Genetics

In the large consanguineous Turkish family originally reported by Mungan et al. (2003), with intestinal pseudoobstruction mapping to chromosome 8q23-q24, Bonora et al. (2015) performed whole-exome sequencing and identified a homozygous missense mutation in the RAD21 gene (A622T; 606462.0003) that segregated fully with disease in the family and was not found in 500 Turkish controls or in public variant databases. Screening of RAD21 in 21 Italian and 12 Swedish patients with pseudoobstruction did not reveal any mutations.


REFERENCES

  1. Bonora, E., Bianco, F., Cordeddu, L., Bamshad, M., Francescatto, L., Dowless, D., Stanghellini, V. Cogliandro, R. F., Lindberg, G., Mungan, Z., Cefle, K., Ozcelik, T., and 14 others. Mutations in RAD21 disrupt regulation of APOB in patients with chronic intestinal pseudo-obstruction. Gastroenterology 148: 771-782, 2015. [PubMed: 25575569, images, related citations] [Full Text]

  2. Deglincerti, A., De Giorgio, R., Cefle, K., Devoto, M., Pippucci, T., Castegnaro, G., Panza, E., Barbara, G., Cogliandro, R. F., Mungan, Z., Palanduz, S., Corinaldesi, R., Romeo, G., Seri, M., Stanghellini, V. A novel locus for syndromic chronic idiopathic intestinal pseudo-obstruction maps to chromosome 8q23-q24. Europ. J. Hum. Genet. 15: 889-897, 2007. [PubMed: 17487221, related citations] [Full Text]

  3. Mungan, Z., Akyuz, F., Bugra, Z., Yonal, O., Ozturk, S., Acar, A., Cevikbas, U. Familial visceral myopathy with pseudo-obstruction, megaduodenum, Barrett's esophagus, and cardiac abnormalities. Am. J. Gastroent. 98: 2556-2560, 2003. [PubMed: 14638363, related citations] [Full Text]


Contributors:
Marla J. F. O'Neill - updated : 09/06/2018
Creation Date:
Marla J. F. O'Neill : 8/24/2007
alopez : 01/24/2024
carol : 09/06/2018
alopez : 03/28/2016
carol : 3/7/2008
joanna : 10/11/2007
wwang : 8/24/2007

# 611376

MUNGAN SYNDROME; MGS


Alternative titles; symbols

VISCERAL NEUROMYOPATHY, FAMILIAL, WITH PSEUDOOBSTRUCTION, MEGADUODENUM, BARRETT ESOPHAGUS, AND CARDIAC ABNORMALITIES
PSEUDOOBSTRUCTION, CHRONIC IDIOPATHIC INTESTINAL, WITH BARRETT ESOPHAGUS AND CARDIAC ABNORMALITIES


Cytogenetic location: 8q23-q24     Genomic coordinates (GRCh38): 8:105,100,001-145,138,636


Gene-Phenotype Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
8q23-q24 Mungan syndrome 611376 Autosomal recessive 2

TEXT

A number sign (#) is used with this entry because of evidence that Mungan syndrome (MGS) is caused by homozygous mutation in the RAD21 gene (606462) on chromosome 8q24. One such family has been reported.


Description

Mungan syndrome (MGS) is characterized by chronic intestinal pseudoobstruction (CIPO), megaduodenum, long-segment Barrett esophagus, and cardiac abnormalities of variable severity (summary by Bonora et al., 2015).


Clinical Features

Mungan et al. (2003) reported a large consanguineous Turkish family segregating autosomal recessive chronic idiopathic intestinal pseudoobstruction (CIIP) in which 3 sibs had megaduodenum, long-segment Barrett esophagus, and different cardiac abnormalities. Two brothers and a sister, ages 26, 28, and 30 years, respectively, who had recurrent abdominal pain and pseudoobstruction from childhood, underwent upper endoscopy that revealed long-segment Barrett esophagus, hypomotility, and delayed gastric emptying. A biopsy of striated muscle in 1 of the brothers was normal. Esophageal manometry revealed aperistalsis and undetectable lower esophageal pressures, and barium small-bowel enema showed megaduodenum and delayed emptying. Cardiac murmurs were noted in all 3 sibs and echocardiography revealed 'trivial' supravalvular pulmonary stenosis and 2(+) pulmonary and tricuspid valve regurgitation in the 26-year-old proband, membranous ventricular septal defect in his brother, and 'trivial' pulmonic valve stenosis in their sister. Other findings in the sibs included epilepsy, glaucoma, and otosclerosis in the proband and bilateral ptosis in his brother. A male and female cousin, also born of consanguineous parents, were reported to have gastrointestinal complaints and died at 19 and 15 years of age, respectively.

Deglincerti et al. (2007) investigated the Turkish family previously reported by Mungan et al. (2003) and found that the female cousin who died at age 15 did in fact have clinical and radiologic evidence of chronic idiopathic intestinal pseudoobstruction, as well as renal hypoplasia, vesicoureteral reflux, ascites, and unspecified granulomatous hepatitis. The authors examined full-thickness intestinal biopsies from the proband and his brother and observed abnormalities of both the neural and muscular components, suggesting an underlying neuromyopathy.


Inheritance

The transmission pattern of MGS in the family reported by Mungan et al. (2003) and Bonora et al. (2015) was consistent with autosomal recessive inheritance.


Mapping

Deglincerti et al. (2007) performed homozygosity mapping in the large consanguineous Turkish family originally reported by Mungan et al. (2003) with autosomal recessive visceral neuromyopathy and obtained a maximum 2-point lod score of 3.97 and maximum multipoint lod score of 5.01 for a novel microsatellite marker between D8S199 and D8S514. The critical interval spans about 13 Mb between D8S1830 and D8S1799 on chromosome 8q23-q24.


Molecular Genetics

In the large consanguineous Turkish family originally reported by Mungan et al. (2003), with intestinal pseudoobstruction mapping to chromosome 8q23-q24, Bonora et al. (2015) performed whole-exome sequencing and identified a homozygous missense mutation in the RAD21 gene (A622T; 606462.0003) that segregated fully with disease in the family and was not found in 500 Turkish controls or in public variant databases. Screening of RAD21 in 21 Italian and 12 Swedish patients with pseudoobstruction did not reveal any mutations.


REFERENCES

  1. Bonora, E., Bianco, F., Cordeddu, L., Bamshad, M., Francescatto, L., Dowless, D., Stanghellini, V. Cogliandro, R. F., Lindberg, G., Mungan, Z., Cefle, K., Ozcelik, T., and 14 others. Mutations in RAD21 disrupt regulation of APOB in patients with chronic intestinal pseudo-obstruction. Gastroenterology 148: 771-782, 2015. [PubMed: 25575569] [Full Text: https://doi.org/10.1053/j.gastro.2014.12.034]

  2. Deglincerti, A., De Giorgio, R., Cefle, K., Devoto, M., Pippucci, T., Castegnaro, G., Panza, E., Barbara, G., Cogliandro, R. F., Mungan, Z., Palanduz, S., Corinaldesi, R., Romeo, G., Seri, M., Stanghellini, V. A novel locus for syndromic chronic idiopathic intestinal pseudo-obstruction maps to chromosome 8q23-q24. Europ. J. Hum. Genet. 15: 889-897, 2007. [PubMed: 17487221] [Full Text: https://doi.org/10.1038/sj.ejhg.5201844]

  3. Mungan, Z., Akyuz, F., Bugra, Z., Yonal, O., Ozturk, S., Acar, A., Cevikbas, U. Familial visceral myopathy with pseudo-obstruction, megaduodenum, Barrett's esophagus, and cardiac abnormalities. Am. J. Gastroent. 98: 2556-2560, 2003. [PubMed: 14638363] [Full Text: https://doi.org/10.1111/j.1572-0241.2003.08707.x]


Contributors:
Marla J. F. O'Neill - updated : 09/06/2018

Creation Date:
Marla J. F. O'Neill : 8/24/2007

Edit History:
alopez : 01/24/2024
carol : 09/06/2018
alopez : 03/28/2016
carol : 3/7/2008
joanna : 10/11/2007
wwang : 8/24/2007