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CTC1 variants cause Coats plus syndrome and related telomere biology disorders, presenting with multisystem vascular, calcification, and bone marrow phenotypes under an autosomal-recessive loss-of-function model, while heterozygous variants may predispose to adult-onset bone marrow failure and interstitial lung disease.

Patient Information Key Findings Mutation PMID
Child with exudative retinopathy, cerebral calcifications, duodenal atresia, preaxial polydactyly, micropenis, microcephaly, and short stature New syndrome with normal telomere length; no CTC1 mutations detected Not reported PMID:23824919
Boy with Norrie disease and cerebroretinal microangiopathy with calcifications and cysts Compound heterozygous CTC1 variants c.775G>A (p.Val259Met); c.1213delG (p.Asp405MetfsTer?) PMID:23220793
Family with adult-onset leukoencephalopathy, cerebral calcifications, and cysts Distinct from CRMCC; no CTC1 mutations Not reported PMID:25034270
Eight-year-old Indian boy with Coats plus syndrome, dextrocardia, and situs inversus Homozygous CTC1 missense variant c.1451A>C (p.His484Pro) PMID:25928698
Adolescent with CRMCC features, seizures, osteopenia Heterozygous CTC1 mutation c.833G>T (p.Gly278Val) PMID:25843205
Chinese family with Coats plus syndrome Novel biallelic CTC1 missense variants c.1A>C (p.Met1Leu); c.775G>A (p.Val259Met); c.2066A>G (p.Tyr689Cys) PMID:29111009
23-year-old female with CRMCC and multisystem involvement CTC1 mutations confirmed (details not specified) Not reported PMID:28072696
Brazilian pedigree with progeroid features and recurrent bone fractures Compound heterozygous CTC1 pathogenic variants c.322C>T (p.Arg108Ter); c.2959C>T (p.Arg987Trp) PMID:30393977
Patient with both Coats plus syndrome and dyskeratosis congenita Compound heterozygous CTC1 variants Not reported PMID:32543263
6-year-old girl with Coats plus syndrome and severe gastrointestinal bleeding Diagnosis of Coats plus; CTC1 mutation not detailed Not reported PMID:35260125
15-year-old girl with Coats plus syndrome and drusenoid PEDs CTC1 splice, missense, and nonsense variants c.277C>T (p.Gln93Ter); c.2959C>T (p.Arg987Trp); c.3514+3A>G PMID:36177296
Two brothers with Coats plus syndrome and variable presentation CTC1 mutation confirmed; details not specified Not reported PMID:35416114
Adult with high-risk myelodysplastic syndrome and pulmonary fibrosis Heterozygous CTC1 frameshift variant c.1360del (p.Glu454SerfsTer9) PMID:37404458
59-year-old woman with diffuse hemangiomatosis and Kasabach-Merritt syndrome Two novel heterozygous CTC1 variants c.435+9A>C; c.3074C>T (p.Ala1025Val) PMID:36761951
Premature infant with retinopathy initially thought ROP Biallelic pathogenic CTC1 variants c.724_727del (p.Lys242LeufsTer?); c.2954_2956del (p.Cys985del) PMID:37008390
38-year-old woman with CPS presenting as capillary nonperfusion Pathogenic CTC1 mutation c.2954_2956del (p.Cys985del) PMID:37974921
Patient with classic dyskeratosis congenita Compound heterozygous CTC1 mutations p.Cys985del; c.724_727del (p.Lys242fs) PMID:22532422
Adults with acquired bone marrow failure syndromes (AA, PNH, MDS) Heterozygous deleterious CTC1 variants identified c.2996_2997del (p.Pro999fs); c.1213del (p.Asp405fs); c.724_727del (p.Lys242fs); c.3406G>A (p.Glu1136Lys); c.1360del (p.Glu454fs); c.3505G>A (p.Val1169Ile); c.1333C>T (p.Arg445Cys) PMID:30891747
Family with interstitial lung disease Novel heterozygous CTC1 variant causing short telomeres c.391G>C (p.Gly131Arg) PMID:37978541

Evidence Based Scoring (AI generated)

Allelic Consistency

Moderate

Multiple loss-of-function and missense CTC1 variants recur in similar domains (e.g., p.Val259Met, p.Cys985del) [PMID:23220793, PMID:29111009].

Phenotypic Consistency

Weak

CTC1 mutations produce diverse phenotypes across telomere biology disorders including Coats plus, DC, bone marrow failure, and ILD.

Penetrance

Moderate

Most cases are recessive, but unaffected heterozygous carriers observed (e.g., asymptomatic father in progeroid family) [PMID:30393977].

Ethnic Diversity

Strong

Cases reported in European, Indian, Chinese, Brazilian, Australian, and other populations.

Inheritance Consistency

Weak

Reports include autosomal recessive biallelic and heterozygous variants with adult-onset disease, indicating mixed inheritance patterns.

Mechanism of disease

Strong

Predominantly loss-of-function CTC1 variants align with telomere maintenance failure in autosomal-recessive Coats plus and related disorders.