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Case report identifies PQBP1 variant in Chinese boy with Renpenning syndrome featuresWhat does a rare genetic change reveal about a boy's developmental challenges?

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Key Takeaway
Consider PQBP1 variants in males with severe developmental delay, microcephaly, and anal atresia.

A case report and systematic literature review describes the genetic and clinical characterization of a 4-year-7-month-old Chinese male proband with features consistent with Renpenning syndrome. The intervention was comprehensive clinical evaluation and whole exome sequencing. No comparator was reported. The main result was the identification of a hemizygous PQBP1 frameshift variant, NM_001032382.2:c.459_462delAGAG (p.Arg153fs), which was maternally inherited. The patient's clinical manifestations included severe global developmental delay, microcephaly, short stature, characteristic facial features, anal atresia, and autism spectrum disorder (ASD). Safety and tolerability data were not reported. Key limitations were not explicitly detailed in the provided abstract, but the authors note this is a single case report and the literature review component lacks detail. The practice relevance is restrained: this case expands recognition of the clinical spectrum associated with PQBP1 variants, which are known to cause Renpenning syndrome. However, findings from a single case cannot be generalized.

When a young boy faces multiple, complex health and developmental challenges, finding the 'why' can be a crucial first step for his family. A recent case report did just that for a 4-year-old boy in China. Through genetic testing, doctors identified a specific change in a gene called PQBP1, which he inherited from his mother. This genetic variant is known to cause Renpenning syndrome, a rare condition. The boy's symptoms—including severe global developmental delay, a very small head (microcephaly), short stature, distinctive facial features, autism spectrum disorder, and a birth defect called anal atresia—fit within the known spectrum of the disorder, while also highlighting how anal atresia can be part of the picture.

This work is a careful, in-depth study of one individual. The researchers combined a full clinical evaluation of the boy with a review of existing medical literature on similar cases. Their goal was to connect his specific genetic finding to his unique set of symptoms, adding to the collective medical understanding of what PQBP1-related disorders can look like.

It's important to remember that this is a single case report. The findings describe one child's journey and his particular genetic change. They cannot be applied broadly to predict what every person with a PQBP1 variant might experience. The report doesn't discuss any new treatments or interventions; its value is in sharpening the diagnostic picture for doctors who might encounter similar patients in the future.

What this means for you:
A single case helps map the complex symptoms of a rare genetic syndrome.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
BackgroundRenpenning syndrome (OMIM: 309500) is a rare X-linked intellectual disability caused by variations in the polyglutamine-binding protein 1 (PQBP1) gene, characterized by moderate to severe intellectual disability, microcephaly, short stature, lean body, small testes, and abnormal facial features.MethodsComprehensive clinical evaluation and whole exome sequencing were performed to identify the genetic basis of the clinical presentation in a 4-year-7-month-old male proband from a Chinese family. Detected variants underwent validation and familial segregation analysis by Sanger sequencing. Additionally, a literature review was conducted to analyze PQBP1-related genotype-phenotype correlations.ResultsThe proband exhibited typical manifestations of Renpenning syndrome, including severe global developmental delay, microcephaly, short stature, and characteristic facial features. Additionally, he presented with rare anal atresia and co-occurring autism spectrum disorder (ASD). Whole exome sequencing identified a hemizygous PQBP1 frameshift variant, NM_001032382.2:c.459_462delAGAG (p.Arg153fs) (VCV000010980.79), in the proband. Sanger sequencing confirmed this variant was maternally inherited.ConclusionThis report describes the first Chinese case of Renpenning syndrome caused by the PQBP1 c.459_462delAGAG variant, presenting with the core phenotype plus anal atresia and ASD. This case expands recognition of the clinical spectrum associated with PQBP1 variants.
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