Prenatal diagnosis of Fowler syndrome with two novel pathogenic variants of FLVCR2
- 1Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, 510280 Guangdong China
Abstract
Background: Proliferative vasculopathy and hydranencephaly-hydrocephaly (PVHH) syndrome, also known as Fowler syndrome, is a rare autosomal recessive disorder characterized by hydrocephaly and glomerular vasculopathy in the central nervous system. Fetal cases with Fowler syndrome usually leaded to severe fetal malformation and intrauterine death. Homozygous or compound heterozygous mutations in FLVCR2 cause Fowler syndrome. In the study, we described a prenatal case of Fowler syndrome from a Chinese family.
Methods: Trio clinical exome sequencing was performed to detect the suspected genetic variants, and cellular assays were used to investigate the deleterious effects caused by the two novel FLVCR2 variants identified in the proband.
Results: The trio clinical exome sequencing identified the proband had compound heterozygous variants in exon 1 of FLVCR2: c.320 C > T (p.Ser107Phe) and c.345del (p.Tyr116Thrfs*17), which were inherited from the father and the mother, respectively. We examined the cellular effects of the two novel variants. The novel missense variant c.320 C > T resulted in abnormal cellular localization with intracellular accumulation and partial endoplasmic reticulum retention of mutant protein. Together with the undetectable protein expression caused by c.345del variant, the two novel FLVCR2 variants contributed to the severe fetal malformation of the fetus. Furthermore, the study summarized the reported fetal cases with Fowler syndrome to compare various fetal phenotypes caused by different FLVCR2 pathogenic variants.
Conclusion: The study made definitive diagnosis for this prenatal case of Fowler syndrome through the integrated strategy of clinical observation, genotyping and functional analysis. Our study also broadened the variant spectrum of FLVCR2, and summarized prenatal clinical features to promote awareness of Fowler syndrome.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09800-z.
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BibTeX
@article{qiu2026prenatal,
title = {{Prenatal diagnosis of Fowler syndrome with two novel pathogenic variants of FLVCR2}},
author = {Liyan Qiu and Yuqing Yao and Chunling Li and Guiyun Zheng and Tuyin Yang and Fang Yang},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = aug,
doi = {10.1186/s12884-026-09800-z},
url = {https://doi.org/10.1186/s12884-026-09800-z},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Prenatal diagnosis of Fowler syndrome with two novel pathogenic variants of FLVCR2
AU - Liyan Qiu
AU - Yuqing Yao
AU - Chunling Li
AU - Guiyun Zheng
AU - Tuyin Yang
AU - Fang Yang
PY - 2026
DA - 2026/08/08
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09800-z
UR - https://doi.org/10.1186/s12884-026-09800-z
AB - Background: Proliferative vasculopathy and hydranencephaly-hydrocephaly (PVHH) syndrome, also known as Fowler syndrome, is a rare autosomal recessive disorder characterized by hydrocephaly and glomerular vasculopathy in the central nervous system. Fetal cases with Fowler syndrome usually leaded to severe fetal malformation and intrauterine death. Homozygous or compound heterozygous mutations in FLVCR2 cause Fowler syndrome. In the study, we described a prenatal case of Fowler syndrome from a Chinese family. Methods: Trio clinical exome sequencing was performed to detect the suspected genetic variants, and cellular assays were used to investigate the deleterious effects caused by the two novel FLVCR2 variants identified in the proband. Results: The trio clinical exome sequencing identified the proband had compound heterozygous variants in exon 1 of FLVCR2: c.320 C > T (p.Ser107Phe) and c.345del (p.Tyr116Thrfs*17), which were inherited from the father and the mother, respectively. We examined the cellular effects of the two novel variants. The novel missense variant c.320 C > T resulted in abnormal cellular localization with intracellular accumulation and partial endoplasmic reticulum retention of mutant protein. Together with the undetectable protein expression caused by c.345del variant, the two novel FLVCR2 variants contributed to the severe fetal malformation of the fetus. Furthermore, the study summarized the reported fetal cases with Fowler syndrome to compare various fetal phenotypes caused by different FLVCR2 pathogenic variants. Conclusion: The study made definitive diagnosis for this prenatal case of Fowler syndrome through the integrated strategy of clinical observation, genotyping and functional analysis. Our study also broadened the variant spectrum of FLVCR2, and summarized prenatal clinical features to promote awareness of Fowler syndrome. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09800-z.
SN - 1471-2393
ER -