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Most cases present during the neonatal period with early lethality due to pulmonary hypoplasia and respiratory compromise while only few affected individuals have been reported to survive into adulthood. FAM20C is a ubiquitously expressed protein kinase that contains five functional domains including a catalytic domain, a binding pocket for FAM20A and three distinct <jats:italic>N<\/jats:italic>\u2010glycosylation sites. We report a newborn infant with a history of prenatal onset fractures, generalized osteosclerosis, and craniofacial dysmorphism and early lethality. The clinical presentation was highly suggestive of Raine syndrome. A homozygous, novel missense variant in exon 5 of <jats:italic>FAM20C<\/jats:italic> (c.1007T&gt;G; p.Met336Arg) was identified by targeted Sanger sequencing. Following in silico analysis and mapping of the variant on a three\u2010dimensional (3D) model of FAM20C it is predicted to be deleterious and to affect N\u2010glycosylation, protein folding, and subsequent secretion of FAM20C. In addition, we reviewed all published <jats:italic>FAM20C<\/jats:italic> mutations and observed that most pathogenic variants affect functional regions within the protein establishing evidence for an emerging genotype\u2013phenotype correlation.<\/jats:p>","DOI":"10.1002\/ajmg.a.61291","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T05:45:16Z","timestamp":1562910316000},"page":"1866-1871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A novel <i>FAM20C<\/i> mutation causes a rare form of neonatal lethal Raine syndrome"],"prefix":"10.1002","volume":"179","author":[{"given":"Christina Y.","family":"Hung","sequence":"first","affiliation":[{"name":"Division of Genetics and Genomics Boston Children's Hospital  Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Hussmann 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