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  • Open Access

Phenotypic variability of CCDC103 mutation in British Pakistani children with Primary Ciliary Dyskinesia (PCD)

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Cilia20154 (Suppl 1) :P61

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  • Nitric Oxide
  • Genetic Testing
  • Beat Frequency
  • Phenotypic Variability
  • Primary Ciliary Dyskinesia


PCD is an autosomal recessive condition that affects the structure and function of motile cilia in the respiratory tract, middle ear and reproductive organs. The estimated prevalence is 1:15,000, but as high as 1:2265 in the British Asian population.

Mutations in the CCDC103 gene have recently been identified as PCD disease-causing in Pakistani individuals. It is found to be an essential gene for dynein arm assembly and ciliary motility.


We present eleven British Pakistani children found to be homozygous for a missense mutation in CCDC103, resulting in the amino acid substitution His154Pro.


Nasal Nitric Oxide screening test results were normalised, mean 290ppb (range 22-857), compared to usual values in PCD (<100ppb). Ciliary beat frequency was also often in the normal range 10.6Hz (range 0- 16.3).

Seven had a defect of the ciliary inner and outer dynein arms demonstrated in ciliated nasal cells by electron microscopy. This defect was partial and distinct from the near complete absence of dynein arms seen in children with mutations in LRRC6 and ZMYND10.

A further four children (3 siblings) presented with a phenotype suggestive of PCD but electron microscopy studies were inconclusive on repeat testing. Genetic testing revealed the same CCDC103 homozygous mutations, making the diagnosis of PCD possible based on genetic analysis.


We report a high prevalence of the CCDC103 His154Pro mutation in the British Asian PCD community and the phenotypic variability of CCDC103 in order to raise awareness of the potential benefit of genetic testing as a diagnostic aid in non-typical PCD cases.

Authors’ Affiliations

Department of Respiratory Paediatrics, Leeds/ Bradford Primary Ciliary Dyskinesia Regional Unit, Leeds, UK
Leeds Institute for Molecular Medicine, Wellcome Trust Brenner Building, St James's Hospital, Leeds, UK
Centre for PCD Diagnosis and Research, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester Royal Infirmary, Leicester, UK
Genetics and Genomics Medicine, University College London Institute of Child Health, London, UK
Department of Respiratory Paediatrics, Primary Ciliary Dyskinesia Centre, Royal Brompton and Harefield Foundation Trust, London, UK


© Robson et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.