Heterogeneous clinical presentation in ICF syndrome: correlation with underlying gene defects

CMR Weemaes, MJD van Tol, Johnny Wang, MM ten Dam, MCJA van Eggermond, PE Thijssen, C Aytekin, N Brunetti-Pierri, Mirjam van der Burg, EG Davies, A Ferster, D Furthner, G Gimelli, A Gennery, B Kloeckener-Gruissem, S Meyn, C Powell, I Reisli, C Schuetz, A SchulzA Shugar, PJ van den Elsen, SM van der Maarel

Research output: Contribution to journalArticleAcademicpeer-review

105 Citations (Scopus)


Immunodeficiency with centromeric instability and facial anomalies (ICF) syndrome is a primary immunodeficiency, predominantly characterized by agammaglobulinemia or hypoimmunoglobulinemia, centromere instability and facial anomalies. Mutations in two genes have been discovered to cause ICF syndrome: DNMT3B and ZBTB24. To characterize the clinical features of this syndrome, as well as genotype-phenotype correlations, we compared clinical and genetic data of 44 ICF patients. Of them, 23 had mutations in DNMT3B (ICF1), 13 patients had mutations in ZBTB24 (ICF2), whereas for 8 patients, the gene defect has not yet been identified (ICFX). While at first sight these patients share the same immunological, morphological and epigenetic hallmarks of the disease, systematic evaluation of all reported informative cases shows that: (1) the humoral immunodeficiency is generally more pronounced in ICF1 patients, (2) B- and T-cell compartments are both involved in ICF1 and ICF2, (3) ICF2 patients have a significantly higher incidence of intellectual disability and (4) congenital malformations can be observed in some ICF1 and ICF2 cases. It is expected that these observations on prevalence and clinical presentation will facilitate mutation-screening strategies and help in diagnostic counseling.
Original languageUndefined/Unknown
Pages (from-to)1219-1225
Number of pages7
JournalEuropean Journal of Human Genetics
Issue number11
Publication statusPublished - 2013

Research programs

  • EMC MM-02-72-01

Cite this