CREBBP mutations in individuals without Rubinstein-Taybi syndrome phenotype

Leonie A. Menke, Martine J. van Belzen, Marielle Alders, Francesca Cristofoli, Nadja Ehmke, Patricia Fergelot, Alison Foster, Erica H. Gerkes, Mariette J. V. Hoffer, Denise Horn, Sarina G. Kant, Didier Lacombe, Eyby Leon, Saskia M. Maas, Daniela Melis, Valentina Muto, Soo-Mi Park, Hilde Peeters, Dorien J. M. Peters, Rolph PfundtConny M. A. van Ravenswaaij-Arts, Marco Tartaglia, Raoul C. M. Hennekam*, DDD Study

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

39 Citations (Scopus)
81 Downloads (Pure)


Mutations in CREBBP cause Rubinstein-Taybi syndrome. By using exome sequencing, and by using Sanger in one patient, CREBBP mutations were detected in 11 patients who did not, or only in a very limited manner, resemble Rubinstein-Taybi syndrome. The combined facial signs typical for Rubinstein-Taybi syndrome were absent, none had broad thumbs, and three had only somewhat broad halluces. All had apparent developmental delay (being the reason for molecular analysis); five had short stature and seven had microcephaly. The facial characteristics were variable; main characteristics were short palpebral fissures, telecanthi, depressed nasal ridge, short nose, anteverted nares, short columella, and long philtrum. Six patients had autistic behavior, and two had self-injurious behavior. Other symptoms were recurrent upper airway infections (n=5), feeding problems (n=7) and impaired hearing (n=7). Major malformations occurred infrequently. All patients had a de novo missense mutation in the last part of exon 30 or beginning of exon 31 of CREBBP, between base pairs 5,128 and 5,614 (codons 1,710 and 1,872). No missense or truncating mutations in this region have been described to be associated with the classical Rubinstein-Taybi syndrome phenotype. No functional studies have (yet) been performed, but we hypothesize that the mutations disturb protein-protein interactions by altering zinc finger function. We conclude that patients with missense mutations in this specific CREBBP region show a phenotype that differs substantially from that in patients with Rubinstein-Taybi syndrome, and may prove to constitute one (or more) separate entities. (c) 2016 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)2681-2693
Number of pages13
JournalAmerican Journal of Medical Genetics. Part A
Issue number10
Publication statusPublished - Oct-2016


  • exon 30
  • exon 31
  • whole exome sequencing
  • intellectual disability
  • Rubinstein-Taybi syndrome
  • RSTS
  • syndrome
  • mutation
  • clinical features
  • case series
  • genotype-phenotype correlation
  • CBP
  • ZZ

Cite this