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[齿状核红核苍白球路易体萎缩患者的临床和遗传特征]

[Clinical and genetic characteristics of patients with dentatorubro-pallidoluysian atrophy].

作者信息

Li Hua, Hu Xiangshu, Fei Lingxia, Zhang Peiqi, Chen Xinhao, Ouyang Mei, Zhang Wei, Liu Xingzhou

机构信息

Epilepsy Center, Guangdong 999 Brain Hospital, Guangzhou, Guangdong 510510, China. Email:

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2016 Oct;33(5):610-4. doi: 10.3760/cma.j.issn.1003-9406.2016.05.006.

Abstract

OBJECTIVE

To explore the clinical and genetic characteristics of patients with dentatorubro-pallidoluysian atrophy (DRPLA).

METHODS

DNA analysis for DRPLA gene was performed in two patients. Clinical features and genetic testing of Chinese DRPLA patients reported in the literature were reviewed in terms of initial symptoms, CAG repeat and age of onset.

RESULTS

Both families were confirmed by genetic analysis. In family 1, the number of CAG repeat in the proband, his brother and his mother was determined respectively as 8/65, 8/53 and 8/18. In family 2, the number of CAG repeat was respectively 13/63, 13/18, 18/52 and 13/13 in the proband, his brother, his father and his mother. The size of the expanded CAG repeats has inversely correlated with the age at onset (P<0.05, r=- 0.555). The age at onset of epilepsy was 10 and that for the onset of ataxia is forty years in initial symptom.

CONCLUSION

The clinical characteristics of DRPLA include epilepsy, ataxia and cognitive impairment. The initial symptoms are epilepsy in adolescence and ataxia in adults. The size of expanded CAG repeats inversely correlates with the age at onset. The initial symptoms are different with different age of onset. It is difficult to diagnose DRPLA at an early stage.

摘要

目的

探讨齿状核红核苍白球路易体萎缩(DRPLA)患者的临床及遗传特征。

方法

对2例患者进行DRPLA基因的DNA分析。从首发症状、CAG重复序列及发病年龄等方面对文献报道的中国DRPLA患者的临床特征及基因检测情况进行回顾。

结果

两个家系均经基因分析确诊。家系1中,先证者、其兄及母亲的CAG重复序列数分别确定为8/65、8/53和8/18。家系2中,先证者、其兄、其父亲及母亲的CAG重复序列数分别为13/63、13/18、18/52和13/13。CAG重复序列扩展的大小与发病年龄呈负相关(P<0.05,r=-0.555)。首发症状中癫痫发病年龄为10岁,共济失调发病年龄为40岁。

结论

DRPLA的临床特征包括癫痫、共济失调及认知障碍。首发症状在青少年期为癫痫,在成年期为共济失调。CAG重复序列扩展的大小与发病年龄呈负相关。不同发病年龄首发症状不同。DRPLA早期诊断困难。

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