Japanese siblings (a 7 years 3 months old male and a 2 years 1 month old female) were found to have WARBM-compatible phenotypes. Direct sequencing of RAB3GAP1 revealed novel compound heterozygous mutations in the siblings: a paternally inherited missense mutation (c.560G > C; p.Arg187Pro) in exon 7 and a maternally derived nonsense mutation (c.1009C > T; p.Arg337Ter) in exon 12.
The siblings had WARBM caused by novel mutations in RAB3GAP1. Since molecular diagnosis permits adequate genetic counseling and appropriate management for predicted complications such as adequate sex steroid supplementation therapy for hypogonadism, in addition to standard supportive therapies for developmental delay and visual dysfunction, we recommend molecular studies for this rare condition.