Alterations in SAMD9, AHSG, FRG2C, and FGFR4 Genes in a Case of Late-Onset Massive Tumoral Calcinosis

Background/Objective: Tumoral calcinosis (TC) is a rare, arcane, and debilitating disorder of phosphate metabolism manifesting as hard masses in soft tissues. Primary hyperphosphatemic TC has been shown to be caused by pathogenic variants in the genes encoding FGF23, GALNT3, and KLOTHO. We report a case of massive TC mechanistically associated with phosphatonin resistance associated with heterozygous alterations in the sterile alfa motif domain–containing protein-9 gene (SAMD9), alfa 2-Heremans-Schmid glycoprotein gene (AHSG), FSHD region gene 2-family member-C gene (FRG2C), and fibroblast growth factor receptor-4 gene (FGFR4). Case Report: A middle-aged Malay woman with systemic sclerosis presented with painful hard lumps of her axillae, lower limbs, and external genitalia. She was eucalcemic with mild hyperphosphatemia associated with reduced urinary phosphate excretion. Magnetic resonance imaging revealed calcified soft tissue masses. Paradoxically, the serum intact FGF23 level increased to 89.6 pg/mL, corroborated by Western blots, which also showed overexpression of sFRP4 and MEPE, consistent with phosphatonin resistance. Discussion: Whole genome sequencing identified 2 heterozygous alterations (p.A454T and p.T479M) in SAMD9, 2 heterozygous alterations (p.M248T and p.S256T) in AHSG, a frameshift alteration (p.Arg156fs) in FRG2C, and a heterozygous alteration (p.G388R) in FGFR4, all of which are associated with calcinosis. Nonsynonymous alterations of FRP4 and MEPE were also detected. Conclusion: This highlights that the simultaneous occurrence of alterations in several genes critical in phosphate homeostasis may trigger massive TC despite their heterozygosity. These findings should prompt functional studies in cell and animal models to reveal mechanistic insights in the pathogenesis of such crippling mineralization disorders

One-step epitaxy of high-mobility La-doped BaSnO3 films by high-pressure magnetron sputtering

As a unique perovskite transparent oxide semiconductor, high-mobility La-doped BaSnO3 films have been successfully synthesized by molecular beam epitaxy and pulsed laser deposition. However, it remains a big challenge for magnetron sputtering, a widely applied technique suitable for large-scale fabrication, to grow high-mobility La-doped BaSnO3 films. Here, we developed a method to synthesize high-mobility epitaxial La-doped BaSnO3 films (mobility up to 121 cm2V-1s-1 at the carrier density ~ 4.0 x 10^20 cm-3 at room temperature) directly on SrTiO3 single crystal substrates using high-pressure magnetron sputtering. The structural and electrical properties of the La-doped BaSnO3 films were characterized by combined high-resolution X-ray diffraction, X-ray photoemission spectroscopy, and temperature-dependent electrical transport measurements. The room temperature electron mobility of La-doped BaSnO3 films in this work is 2 to 4 times higher than the reported values of the films grown by magnetron sputtering. Moreover, in the high carrier density range (n > 3 x 10^20 cm-3), the electron mobility value of 121 cm2V-1s-1 in our work is among the highest values for all reported doped BaSnO3 films. It is revealed that high argon pressure during sputtering plays a vital role in stabilizing the fully relaxed films and inducing oxygen vacancies, which benefit the high mobility at room temperature. Our work provides an easy and economical way to massively synthesize high-mobility transparent conducting films for transparent electronics.Comment: 15 pages, 6 figure