A novel MGP mutation in a consanguineous family: review of the clinical and molecular characteristics of Keutel syndrome

Am J Med Genet A. 2005 May 15;135(1):36-40. doi: 10.1002/ajmg.a.30680.


Keutel syndrome (KS) [OMIM 245150] is a rare autosomal recessive condition, characterized by abnormal cartilage calcification. Mutations in the matrix Gla protein gene (MGP) have been previously reported in three unrelated KS families. MGP is an extracellular matrix protein that acts as a calcification inhibitor by repressing bone morphogenetic protein 2 (BMP2). Loss-of-function mutations of MGP result in abnormal calcification of the soft tissues, a cardinal feature of KS. We report the fourth MGP mutation (IVS2 + 1G > A) in a consanguineous Arab family, which results in the loss of the consensus donor splice site at the exon 2-intron 2 junction. In addition to the typical manifestations, we observed abnormalities in the white matter of the brain, optic nerve atrophy, and mid-dermal elastolysis in the affected individuals of this family. This report broadens the clinical phenotype observed in patients with KS. The effect of the IVS2 + 1G > A mutation is consistent with the previously reported loss-of-function mutations of MGP.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Abnormalities, Multiple / genetics*
  • Abnormalities, Multiple / pathology
  • Base Sequence
  • Calcinosis / pathology
  • Calcium-Binding Proteins / genetics*
  • Cartilage Diseases / pathology
  • Child
  • Child, Preschool
  • Consanguinity
  • DNA / chemistry
  • DNA / genetics
  • DNA Mutational Analysis
  • Ear / abnormalities
  • Extracellular Matrix Proteins / genetics*
  • Family Health
  • Female
  • Hand Deformities, Congenital / pathology
  • Humans
  • Male
  • Mutation*
  • Pulmonary Valve Stenosis / pathology
  • Syndrome


  • Calcium-Binding Proteins
  • Extracellular Matrix Proteins
  • matrix Gla protein
  • DNA