MISSED BY OTHERS, DETECTED BY US
Genomic Unity® Case Study

Single exon RFX3 deletion explains a patient’s overall constellation of psychiatric symptoms

Clinical presentation

A 41-year-old male with a history of developmental delay and progressive, recurrent encephalopathy presented with the following additional symptoms:

  • Schizencephaly
  • Psychosis and catanoia
  • Gait dysfunction
  • Hypotonia and poor motor coordination
  • Auditory processing delay
  • Cerebellar cognitive affective syndrome
  • Psoriatic arthritis

Previous genetic testing

Multiple tests were performed with negative results including:

  • Karyotype
  • Whole genome sequencing
  • Mitochondrial genome sequencing

Genomic Unity® Testing

was ordered because it delivers the most comprehensive genomic insights, supporting the highest standard of patient care.

Results and interpretation

Variantyx Genomic Unity® testing identified a de novo, heterozygous, pathogenic 8.52 kb deletion in the RFX3 gene.

Encompassing exon 3, the deletion is expected to result in loss of protein function.

Diagnosis: Complex neurodevelopmental disorder

IGV view of RFX3 exon 3 deletion

Uniform data from both short-read WGS (top) and long-read WGS (bottom) clearly show the deletion, with long-read WGS providing precise sizing of 8,524 bp.

The Variantyx Difference

Why was this single exon deletion detected by Genomic Unity® testing, but missed by genome testing through another lab?

  • Most genetic tests – including standard genome sequencing – are unable to detect deletions smaller than 2 exons.
    Variantyx genome analysis has a detection range from 1 bp to whole chromosomal events, easily detecting this single exon deletion.

  • Both deletion breakpoints are intronic, adding to the complexity of detection.
    Variantyx genome analysis includes intronic regions, enabling breakpoint detection regardless of location.

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