A novel HIST1HE pathogenic variant in a girl with macrocephaly and intellectual disability: a new case and review of literature

Pathogenic variants of HIST1H1E gene have recently been associated with a condition known as Rahman syndrome, characterized by overgrowth, intellectual disability and nonspecific dysmorphic features (high hairline, full cheeks, wide nasal bridge). Wide clinical variability is reported, especially regarding the level of neurodevelopment delay and intellectual disability. We report a 10-year-old girl with macrocephaly and global developmental delay, in whom a novel heterozygous variant in the HIST1H1E gene [c.392_395dup (p.Gly133fs)] was discovered, but involving the same C-terminal domain-protein domain reported previously. Comparing the clinical data of our patient with those previously described, a ‘core phenotype’ with macrocephaly, psychomotor delay/intellectual disability and mild facial dysmorphisms seems evident.