Table 2.

Disorders to Consider in the Differential Diagnosis of RAB18 Deficiency

DisorderGene(s)MOIFeatures of the Differential Diagnosis Disorder
Overlapping w/RAB18 DeficiencyDistinguishing from RAB18 Deficiency
Prenatal TORCH infection (particularly rubella)NANACC, microphthalmiaPositive TORCH screen, frequently associated w/SNHL, cardiac defects, rash, hepatosplenomegaly
Monosomy 1p36 (OMIM 607872)NA De novo Microcephaly, DD/ID, genital abnormalities, rarely cataractsCharacteristic dysmorphic features, cardiac defects, hearing loss, skeletal & renal abnormalities often present
Monosomy 1q21 NA De novo Microcephaly, DD/ID, genital abnormalities, hypotonia, seizures, corpus callosum hypogenesis, cataractsID present in only ~30% of cases, usually mild-moderate. Cardiac defects, SNHL may be present.
Cerebrooculofacioskeletal syndrome (OMIM PS214150),
Cockayne syndrome
ERCC1
ERCC2
ERCC5
ERCC6
ERCC8
ARCC, microcornea, optic atrophy, microcephaly, ID, short stature, contractures, corpus callosum hypoplasia, cryptorchidismCutaneous photosensitivity; cultured cells from affected individuals are hypersensitive to UV radiation. Pigmentary retinopathy, brain calcifications, FTT, arthrogryposis, SNHL may be present.
Smith-Lemli-Opitz syndrome DHCR7 ARMicrocephaly, short stature, ID, hypotonia, genital abnormalities, CC↑ 7-dehydrocholesterol in serum. Characteristic dysmorphic features. Postaxial polydactyly or 2-3 toe syndactyly, cardiac defects, renal defects, & photosensitivity frequently present. Cataracts may appear acutely.
Cutis laxa, de Barsy syndrome (OMIM 219150 612940, 614438, 616603) ALDH18A1
PYCR1
AR/ADMicrocephaly, ID, corpus callosum hypogenesis, hypotonia, short stature, contractures, cataracts may be present.Lax, thin, sometimes wrinkled, skin. Progeria-like appearance. Cataracts may develop postnatally.
Peroxisome biogenesis disorder 14B (OMIM 614920) PEX11B ARCC, ID, microphthalmia, short stature, hypotonia & spasticityNormal MRI. Dry skin, SNHL may be present.
Epileptic encephalopathy, early infantile, 35 (OMIM 616647) ITPA ARCC, microcephaly, ID, short stature, hypotonia & spasticity, hypogonadismCharacteristic imaging findings, early-onset dilated cardiomyopathy
Marinesco-Sjögren syndrome SIL1 ARCC, hypotonia, ID, hypogonadismCerebellar ataxia; imaging shows cerebellar atrophy. ↑ serum creatine kinase, myopathy, skeletal abnormalities may be present; cataracts may appear postnatally.
Cataract, microcephaly, arthrogryposis, and kyphosis (CAMAK/CAMFAK) syndrome (OMIM 212540)NANACC, microcephaly, ID, contracturesKyphosis, arthrogryposis. Brain calcifications may be present. Cataracts may appear postnatally.

AD = autosomal dominant; AR = autosomal recessive; CC = congenital cataracts; DD = developmental delay; FTT = failure to thrive; ID = intellectual disability; MOI = mode of inheritance; NA = not applicable; SNHL = sensorineural hearing loss; XL = X-linked

From: RAB18 Deficiency

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