Case#: Female, 6 years old (age of onset), 8 years old (age at report). Developmentally normal at 6 years old but had a 1-year long history of painful and stiff joints. Her weight was in the 5th percentile, height in the 3rd percentile, and head circumference in the 10th percentile for her age group.
DiseaseAssertion: MPS1-S
FamilyInfo: The patient's parents are second cousins. She has two healthy brothers.
CasePresentingHPOs: Joint stiffness, recurrent otitis media, snoring, joint contractures, carpal tunnel syndrome (HP:0001387, HP:0000403, HP:0025267, HP:0100790, HP:0012185)
CaseHPOFreeText: Painful joints affecting the hands, wrists, knees, elbows, and shoulders. At 8 years old, she had second and third finger numbness. Flexion contractures in distal and proximal interphalangeal joints, wrists, and restricted joint mobility was observed. Echocardiogram showed thickening of the mitral and aortic valves, and brain magnetic resonance imaging demonstrated increased signal in the white matter surrounding dilated perivascular spaces.
CaseNotHPOs: Coarse facial features, cardiac murmurs, hernias (HP:0000256, HP:0030148, HP:0100790)
CaseNotHPOFreeText: Organomegaly
CaseEnzymeAssay: 1 nmol/h/mg (reference range, 14-41 nmol/h/mg)
CaseUrineGAGs: Excess heparan and dermatan sulfate
CaseERT: Enzyme replacement therapy was initiated. Improvements in hand mobility and joint size were noted, as well as less joint discomfort.
CaseBMT: N/A
Variant1: c.1039A>C (p.S347R)
Variant1ClinVarID: 1067172
Variant1CAID: CA355963126
Variant2: c.1039A>C (p.S347R)
Variant2ClinVarID: 1067172
Variant2CAID: CA355963126
AdditionalVariants: N/A
ParentalGenotype: N/A
PreviouslyPublished N/A