Disorders of immune dysregulation
Gene: RNU6ATAC
PMID 40975062 reports 1 individual from with biallelic RNU6ATAC variants causing childhood‑onset growth restriction, microcephaly, epilepsy, intellectual disability and ataxia. PMID 41808409 reports 3 unrelated families (3 individuals) with biallelic loss‑of‑function RNU6ATAC variants presenting with short stature, neurodevelopmental delay, epilepsy, immunodeficiency, skeletal dysplasia and other multisystem features; RNA‑seq shows marked excess of minor intron retention, confirming spliceosome dysfunction.
However, note overlap in authors between the two papers ?double-counting.
PMID 41864208 -- published version of the preprint referenced in previous reviews. 7 individuals from 4 families with early-onset diabetes (diagnosed aged <5 years) and immune dysregulatory features caused by bi-allelic variants in RNU6ATAC.
Genotype-phenotype correlation unclear at this stage but note that of the three individuals reported in 41808409, one did not have ID/neurological features but all had immunological involvement.Created: 27 Mar 2026, 2:11 p.m. | Last Modified: 27 Mar 2026, 2:11 p.m.
Panel Version: 1.4645
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Syndromic disease, MONDO:0002254
Publications
MedRxiv preprint Johnson et al., 2025 doi: https://doi.org/10.1101/2025.09.12.25335567
Identified 19 individuals with early-onset diabetes (diagnosed <5 years) and additional clinical features who had biallelic pathogenic variants in the novel disease gene RNU6ATAC (n=7) or in RNU4ATAC (n=12). 12/19 had additional immune features of immune dysregulation. Around 60% of patients also had microcephaly and developmental delay.
Among the 4 families with biallelic RNU6ATAC variants, the variants reported were: n.4T>C, n.6G>A, n.43G>A, n.68C>A, n.71C>T (homozygous or compound het).
RNU6ATAC has not yet been linked to any phenotypes in OMIM (accessed 5th Feb 2026).
Note gene is not protein coding.Created: 5 Feb 2026, 1:10 p.m. | Last Modified: 5 Feb 2026, 1:10 p.m.
Panel Version: 1.4241
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
neonatal diabetes; humoral immunue defect; microcephaly; developmental delay.
gene: RNU6ATAC was added gene: RNU6ATAC was added to Disorders of immune dysregulation. Sources: Expert Review Green,Literature non-coding gene tags were added to gene: RNU6ATAC. Mode of inheritance for gene: RNU6ATAC was set to BIALLELIC, autosomal or pseudoautosomal Publications for gene: RNU6ATAC were set to 41808409; 40975062; 41864208 Phenotypes for gene: RNU6ATAC were set to Syndromic disease, MONDO:0002254, RNU6ATAC-related