Chen Bin, Niu Songtao, Wang Xingao, Li Wei, Chen Na, Zhang Zaiqiang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing 100050, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing 100050, China.
J Clin Neurosci. 2018 Feb;48:133-137. doi: 10.1016/j.jocn.2017.10.069. Epub 2017 Nov 3.
Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant peripheral neuropathy caused by mutations in the peripheral myelin protein 22 (PMP22) gene. This study summarizes the clinical, electrophysiological, genetic, and imaging features of six unrelated Chinese Han patients with HNPP. Age of onset was within the second decade in five patients, and 46 years of age in one patient. Weakness or numbness in a unilateral lower extremity was the most common symptom in 5 patients, and bilateral sensorineural hearing loss was also detected in one patient. Electrophysiological presentations suggested demyelinating sensory-motor polyneuropathy in the group. Magnetic resonance imaging (MRI) of the cervical and lumbar spine revealed varying degrees of degeneration in five patients, and mild kyphosis of cervical vertebral bodies in 2 teen-aged patients. In addition, cranial MRI of one patient showed scattered demyelination in the frontal lobes. Targeted next-generation-sequencing (NGS) revealed a PMP22 deletion in five patients and a heterozygous c.199G>A mutation in exon 4 of PMP22 in one patient. The I92V variant of lipopolysaccharide-induced tumor necrosis factor (LITAF) gene was found in one patient. There was no relationship between the Ile92Val variant of LITAF and age of onset in this group, albeit the sample size was very small.
遗传性压力易感性周围神经病(HNPP)是一种常染色体显性周围神经病,由周围髓鞘蛋白22(PMP22)基因突变引起。本研究总结了6例无亲缘关系的中国汉族HNPP患者的临床、电生理、遗传和影像学特征。5例患者发病年龄在第二个十年内,1例患者为46岁。5例患者最常见的症状是单侧下肢无力或麻木,1例患者还检测出双侧感音神经性听力损失。电生理表现提示该组患者为脱髓鞘感觉运动性多发性神经病。颈椎和腰椎的磁共振成像(MRI)显示5例患者有不同程度的退变,2例青少年患者有颈椎椎体轻度后凸。此外,1例患者的头颅MRI显示额叶有散在脱髓鞘。靶向二代测序(NGS)显示5例患者存在PMP22缺失,1例患者在PMP22第4外显子有杂合的c.199G>A突变。1例患者发现脂多糖诱导的肿瘤坏死因子(LITAF)基因的I92V变异。尽管样本量非常小,但该组中LITAF基因的Ile92Val变异与发病年龄之间无相关性。