Abstract
Floating-Harbor syndrome is a sporadic, autosomal dominantly-inherited, malformation syndrome characterized by typical craniofacial findings, proportional short stature, significantly delayed bone age, delayed expressive language, delayed speech, and normal head circumference. It is caused by heterozygous mutations in the SNF2-associated CBP activator protein gene (SRCAP) located on chromosome 16. Here, we report a 9.3 years old male patient who presented to the pediatric genetics outpatient clinic with retardation in early developmental stages, dysmorphic facial features, and short stature. A triangular face, short filtrum, posteriorly rotated ear, deep-set eyes, bulbous nose, prominent columella, and low hairline are unique facial features in the syndrome. He also has short stature, significant retardation in bone age, and retardation in expressive language, all suggesting Floating-Harbor syndrome. The diagnosis was confirmed through molecular testing which revealed a heterozygous c.7330C>T p.(Arg2444Ter) pathogenic variant in exon 34, of the SRCAP gene. Floating-Harbor syndrome should be remembered in the differential diagnosis of patients evaluated for short stature and learning disability with its unique facial features. By reporting a new case of Floating-Harbor syndrome our aim was to expand the clinical and molecular spectrum in this rare syndrome and increase diagnostic awareness for pediatric endocrinology practitioners.
Keywords: Floating-Harbor syndrome, SRCAP gene, short stature
Read the full text
4 sections · 1 figure · PDF
Create your free account to read the full text.
- Full text with figures and tables
- PDF and supplementary files
- Access on every Galenos journal
One Galenos account works on every Galenos journal site.
References
Pelletier G, Feingold M. Case report 1. In: Bergsma D, editor. Syndrome Identification. White Plains: National Foundation-March of Dimes; 1973. p. 8-9.
Leisti HDJ, Rimoin DL. Case report. In: Bergsma D, ed. Syndrome Identification. New York: National Foundation–March of Dimes; 1974. vol. 10, p. 305
White SM, Morgan A, Da Costa A, Lacombe D, Knight SJ, Houlston R, Whiteford ML, Newbury-Ecob RA, Hurst JA. The phenotype of Floating-Harbor syndrome in 10 patients. Am J Med Genet A. 2010;152:821-829.
Smith DW. Recognizable patterns of human malformation. Genetic, embryologic and clinical aspects. Major Probl Clin Pediatr. 1982;7:1-653.
Johnston H, Kneer J, Chackalaparampil I, Yaciuk P, Chrivia J. Identification of a novel SNF2/SWI2 protein family member, SRCAP, which interacts with CREB-binding protein. J Biol Chem. 1999;274:16370-16376.
Mohammadi P, Salehi Siavashani E, Mohammadi MF, Bahramy A, Almadani N, Garshasbi M. Whole-exome sequencing identified first homozygous frameshift variant in the COLEC10 gene in an Iranian patient causing 3MC syndrome type 3. Mol Genet Genomic Med. 2021;9:e1834. Epub 2021 Oct 12
Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, Grody WW, Hegde M, Lyon E, Spector E, Voelkerding K, Rehm HL; ACMG Laboratory Quality Assurance Committee. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015;17:405-424. Epub 2015 Mar 5
Alanis S, Blair MP, Kaufman LM, Bhat G, Shapiro MJ. Floating-Harbor syndrome with chorioretinal colobomas. Ophthalmic Genet. 2024;45:207-209. Epub 2023 Sep 18
Seifert W, Meinecke P, Krüger G, Rossier E, Heinritz W, Wüsthof A, Horn D. Expanded spectrum of exon 33 and 34 mutations in SRCAP and follow-up in patients with Floating-Harbor syndrome. BMC Med Genet. 2014;15:127.
Wong MM, Cox LK, Chrivia JC. The chromatin remodeling protein, SRCAP, is critical for deposition of the histone variant H2A.Z at promoters. J Biol Chem. 2007;282:26132-26139. Epub 2007 Jul 8
Nikkel SM, Dauber A, de Munnik S, Connolly M, Hood RL, Caluseriu O, Hurst J, Kini U, Nowaczyk MJ, Afenjar A, Albrecht B, Allanson JE, Balestri P, Ben-Omran T, Brancati F, Cordeiro I, da Cunha BS, Delaney LA, Destrée A, Fitzpatrick D, Forzano F, Ghali N, Gillies G, Harwood K, Hendriks YM, Héron D, Hoischen A, Honey EM, Hoefsloot LH, Ibrahim J, Jacob CM, Kant SG, Kim CA, Kirk EP, Knoers NV, Lacombe D, Lee C, Lo IF, Lucas LS, Mari F, Mericq V, Moilanen JS, Møller ST, Moortgat S, Pilz DT, Pope K, Price S, Renieri A, Sá J, Schoots J, Silveira EL, Simon ME, Slavotinek A, Temple IK, van der Burgt I, de Vries BB, Weisfeld-Adams JD, Whiteford ML, Wierczorek D, Wit JM, Yee CF, Beaulieu CL; FORGE Canada Consortium; White SM, Bulman DE, Bongers E, Brunner H, Feingold M, Boycott KM. The phenotype of Floating-Harbor syndrome: clinical characterization of 52 individuals with mutations in exon 34 of SRCAP. Orphanet J Rare Dis. 2013;8:63.
Hood RL, Lines MA, Nikkel SM, Schwartzentruber J, Beaulieu C, Nowaczyk MJ, Allanson J, Kim CA, Wieczorek D, Moilanen JS, Lacombe D, Gillessen- Kaesbach G, Whiteford ML, Quaio CR, Gomy I, Bertola DR, Albrecht B, Platzer K, McGillivray G, Zou R, McLeod DR, Chudley AE, Chodirker BN, Marcadier J; FORGE Canada Consortium; Majewski J, Bulman DE, White SM, Boycott KM. Mutations in SRCAP, encoding SNF2-related CREBBP activator protein, cause Floating-Harbor syndrome. Am J Hum Genet. 2012;90:308-313. Epub 2012 Jan 19
Robinson PL, Shohat M, Winter RM, Conte WJ, Gordon-Nesbitt D, Feingold M, Laron Z, Rimoin DL. A unique association of short stature, dysmorphic features, and speech impairment (Floating-Harbor syndrome). J Pediatr. 1988;113:703-706.
Nagasaki K, Asami T, Sato H, Ogawa Y, Kikuchi T, Saitoh A, Ogata T, Fukami M. Long-term follow-up study for a patient with Floating-Harbor syndrome due to a hotspot SRCAP mutation. Am J Med Genet A. 2014;164A:731-735. Epub 2013 Dec 20
Bo H, Jiang L, Zheng J, Sun J. Floating-Harbor syndrome treated with recombinant human growth hormone: a case report and literature review. Front Pediatr. 2021;9:747353.
Jeon J, Noh ES, Hwang IT. Floating-Harbor syndrome in a Korean patient with short stature and early puberty: a case report. J Clin Res Pediatr Endocrinol. 2026;18:176-180. Epub 2024 Jan 17
Turkunova ME, Barbitoff YA, Serebryakova EA, Polev DE, Berseneva OS, Bashnina EB, Baranov VS, Glotov OS, Glotov AS. Molecular genetics and pathogenesis of the floating harbor syndrome: case report of long-term growth hormone treatment and a literature review. Front Genet. 2022;13:846101.
Stagi S, Galluzzi F, Bindi G, Lapi E, Cecchi C, Salti R, Chiarelli F. Precocious puberty in a girl with floating-harbor syndrome. J Pediatr Endocrinol Metab. 2007;20:1333-7.


