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[一名患有智力残疾和癫痫等神经精神合并症儿童的KCNB1基因新突变及文献综述]

[A novel mutation in KCNB1 gene in a child with neuropsychiatric comorbidities with both intellectual disability and epilepsy and review of literature].

作者信息

Miao P, Peng J, Chen C, Gai N, Yin F

机构信息

Department of Pediatrics, Xiangya Hospital of Central South University/Hunan Intellectual and Developmental Disabilities Research Center, Changsha 410008, China.

出版信息

Zhonghua Er Ke Za Zhi. 2017 Feb 2;55(2):115-119. doi: 10.3760/cma.j.issn.0578-1310.2017.02.012.

DOI:10.3760/cma.j.issn.0578-1310.2017.02.012
PMID:28173649
Abstract

To explore the association between the phenotype and KCNB1 gene mutation. Clinical information including physical features, laboratory and genetic data of one patient of mental retardation with refractory epilepsy from Department of Pediatrics, Xiangya Hospital in January 2016 was analyzed. This patient was discovered to have KCNB1 gene mutations through whole exome sequencing. Relevant information about KCNB1 gene mutation was searched and collected from Pubmed, CNKI, Human Gene Mutation Database(HGMD) and Online Mendelian Inheritance in Man(OMIM). Searching was done using "KCNB1" as a keyword. A 3.5 years old boy who visited our hospital firstly at the age of 2 years because of development delay came for follow up as he developed seizures.The forms included tonic, clonic seizures and spasm. The condition became more severe 10 months later. Electroencephalogram(EEG) showed high frequency discharge (>85%). He had poor response to multiple anti-epileptic drugs, methylprednisolone and ketogenic diet. At the age of 3, he started to have mental regression. Whole exome-sequencing study (trios) identified a novel heterozygous mutation c. G1136T (p.G379V) in KCNB1, which is not available in the databases mentioned above. This is the first case report of KCNB1 gene mutation in China. Eight cases have been reported so far worldwide and all of them were diagnosed with refractory epilepsy. Those 8 reported cases of encephalopathy were all due to de novo mutation. The main clinical features of patients with KCNB1 mutations include severe to profound intellectual disability, intractable seizures, hypotonia and regression of cognition and motor activity which lead to poor prognosis.

摘要

探讨表型与KCNB1基因突变之间的关联。分析了2016年1月来自湘雅医院儿科的1例患有难治性癫痫的智力发育迟缓患者的临床信息,包括身体特征、实验室检查及基因数据。通过全外显子组测序发现该患者存在KCNB1基因突变。从PubMed、中国知网、人类基因突变数据库(HGMD)和《人类孟德尔遗传在线》(OMIM)中检索并收集有关KCNB1基因突变的相关信息。检索以“KCNB1”作为关键词。一名3.5岁男孩,2岁时因发育迟缓首次来我院就诊,出现癫痫发作后前来复诊。发作形式包括强直、阵挛发作和痉挛。10个月后病情加重。脑电图(EEG)显示高频放电(>85%)。他对多种抗癫痫药物、甲基强的松龙和生酮饮食反应不佳。3岁时开始出现智力衰退。全外显子组测序研究(三联体)在KCNB1基因中鉴定出一个新的杂合突变c.G1136T(p.G379V),上述数据库中均未收录。这是中国首例KCNB1基因突变的病例报告。目前全球已报道8例,均被诊断为难治性癫痫。报道的8例脑病病例均为新发突变。KCNB1基因突变患者的主要临床特征包括重度至极重度智力残疾、难治性癫痫、肌张力低下以及认知和运动功能衰退,预后较差。

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引用本文的文献

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Correlation Analyses of Clinical Manifestations and Variant Effects in -Related Neurodevelopmental Disorder.与相关神经发育障碍中临床表现与变异效应的相关性分析。
Front Pediatr. 2022 Jan 5;9:755344. doi: 10.3389/fped.2021.755344. eCollection 2021.
2
Epilepsy and neurobehavioral abnormalities in mice with a dominant-negative KCNB1 pathogenic variant.携带显性负性KCNB1致病变体的小鼠的癫痫和神经行为异常。
Neurobiol Dis. 2021 Jan;147:105141. doi: 10.1016/j.nbd.2020.105141. Epub 2020 Oct 22.
3
Genetic variations associated with pharmacoresistant epilepsy (Review).
与药物抵抗性癫痫相关的遗传变异(综述)。
Mol Med Rep. 2020 Apr;21(4):1685-1701. doi: 10.3892/mmr.2020.10999. Epub 2020 Feb 24.
4
Spectrum of K 2.1 Dysfunction in KCNB1-Associated Neurodevelopmental Disorders.KCNB1 相关神经发育障碍中 K 2.1 功能障碍谱。
Ann Neurol. 2019 Dec;86(6):899-912. doi: 10.1002/ana.25607. Epub 2019 Oct 24.
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Clinical features and outcome of 6 new patients carrying de novo gene mutations.6例携带新发基因突变的新患者的临床特征与转归
Neurol Genet. 2017 Dec 11;3(6):e206. doi: 10.1212/NXG.0000000000000206. eCollection 2017 Dec.