Lipodystrophy - childhood onset

Gene: PSMB4

Amber List (moderate evidence)

PSMB4 (proteasome subunit beta 4)
EnsemblGeneIds (GRCh38): ENSG00000159377
EnsemblGeneIds (GRCh37): ENSG00000159377
OMIM: 602177, Gene2Phenotype
PSMB4 is in 4 panels

1 review

Achchuthan Shanmugasundram (Genomics England Curator)

Green List (high evidence)

The 'digenic' tag has been added as there are four additional cases with heterozygous PSMB4 variants and heterozygous variants in either PSMA3 and PSMB8.
Created: 8 Aug 2023, 11:33 a.m. | Last Modified: 8 Aug 2023, 11:33 a.m.
Panel Version: 4.40
Comment on list classification: There is sufficient evidence for the association of biallelic variants in PSMB4 with lipodystrophy (two unrelated cases and supporting functional evidence). Hence, this gene can be promoted to green rating in the next GMS review.
Created: 8 Aug 2023, 11:31 a.m. | Last Modified: 8 Aug 2023, 11:31 a.m.
Panel Version: 4.40
PMID:26524591 - One case with compound heterozygous variants in PSMB4 (monogenic), two cases with heterozygous variants in PSMB4 and PSMB8 (digenic) and two cases with heterozygous variants in PSMB4 and PSMB9 (digenic) were reported with proteasome-associated autoinflammatory syndrome (PRAAS) that includes lipodystrophy and lipid abnormalities. In addition, it was revealed from functional studies that these variants affect transcription, protein expression, protein folding, proteasome assembly, and, ultimately, proteasome activity.

PMID:34416217 - A boy with treatment-resistant cutaneous vasculitis was identified with novel heterozygous variants in PSMB4. This patient developed mild lipodystrophy after the successful second hematopoietic stem cell transplantation (HSCT).

This gene has been associated with PRAAS in OMIM and it includes lipodystrophy as one of the clinical manifestations.
Created: 8 Aug 2023, 11:28 a.m. | Last Modified: 8 Aug 2023, 11:36 a.m.
Panel Version: 4.40
This gene was added on recommendation of NHSE Genomic Medicine Service:
These autoinflammatory syndromes include a lipodystrophy (partial and generalised have both been reported) and are caused either by biallelic loss of function mutations (PMID: 26524591, 34416217) or by digenic heterozygous mutations in other proteasome encoding genes (PSMB8, PMSA3 PMID: 26524591). See panel app reviews for autoinflammatory syndromes.

PSMB9 has also been implicated in digenic cases but this is in a single familes and lipodystrophy is not reported in the autoinflammatory syndrome of carriers of biallelic loss of function mutations in PSMB9.
Created: 2 Aug 2023, 11:35 a.m. | Last Modified: 8 Aug 2023, 10:52 a.m.
Panel Version: 4.37

Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal

Phenotypes
Proteasome associated autoinflammatory syndrome-1, CANDLES (Chronic, atypical, neutrophillic dermatosis with lipodystrophy and elevated temperature syndrome), Joint contractures, muscle atrophy, microcytic anemia, and panniculitis-induced lipodystrophy (JMP syndrome)

Publications

Details

Mode of Inheritance
BIALLELIC, autosomal or pseudoautosomal
Sources
  • Expert Review Amber
  • NHS GMS
  • Expert list
Phenotypes
  • ?Proteasome-associated autoinflammatory syndrome 3 and digenic forms, OMIM:617591
Tags
digenic Q3_23_promote_green Q3_23_NHS_review
OMIM
602177
Clinvar variants
Variants in PSMB4
Penetrance
None
Publications
Panels with this gene

History Filter Activity

8 Aug 2023, Gel status: 2

Entity classified by Genomics England curator

Achchuthan Shanmugasundram (Genomics England Curator)

Gene: psmb4 has been classified as Amber List (Moderate Evidence).

8 Aug 2023, Gel status: 1

Added Tag, Added Tag, Added Tag

Achchuthan Shanmugasundram (Genomics England Curator)

Tag digenic tag was added to gene: PSMB4. Tag Q3_23_promote_green tag was added to gene: PSMB4. Tag Q3_23_NHS_review tag was added to gene: PSMB4.

8 Aug 2023, Gel status: 1

Set Phenotypes

Achchuthan Shanmugasundram (Genomics England Curator)

Phenotypes for gene: PSMB4 were changed from Proteasome associated autoinflammatory syndrome-1, CANDLES (Chronic, atypical, neutrophillic dermatosis with lipodystrophy and elevated temperature syndrome), Joint contractures, muscle atrophy, microcytic anemia, and panniculitis-induced lipodystrophy (JMP syndrome) to ?Proteasome-associated autoinflammatory syndrome 3 and digenic forms, OMIM:617591

8 Aug 2023, Gel status: 1

Set publications

Achchuthan Shanmugasundram (Genomics England Curator)

Publications for gene: PSMB4 were set to

2 Aug 2023, Gel status: 1

Created, Added New Source, Set mode of inheritance, Set Phenotypes

Achchuthan Shanmugasundram (Genomics England Curator)

gene: PSMB4 was added gene: PSMB4 was added to Lipodystrophy - childhood onset. Sources: Expert list,NHS GMS Mode of inheritance for gene: PSMB4 was set to BIALLELIC, autosomal or pseudoautosomal Phenotypes for gene: PSMB4 were set to Proteasome associated autoinflammatory syndrome-1, CANDLES (Chronic, atypical, neutrophillic dermatosis with lipodystrophy and elevated temperature syndrome), Joint contractures, muscle atrophy, microcytic anemia, and panniculitis-induced lipodystrophy (JMP syndrome)