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一例报告:中国汉族患者CLCN1基因新的剪接突变(c.1401 + 1G > A)导致常染色体隐性先天性肌强直

A case report: autosomal recessive Myotonia congenita caused by a novel splice mutation (c.1401 + 1G > A) in CLCN1 gene of a Chinese Han patient.

作者信息

Miao Jing, Wei Xiao-Jing, Liu Xue-Mei, Kang Zhi-Xia, Gao Yan-Lu, Yu Xue-Fan

机构信息

Department of Neurology and Neuroscience Center, the First Affiliated Hospital of Jilin University, Changchun, 130021, Jilin, People's Republic of China.

出版信息

BMC Neurol. 2018 Sep 22;18(1):154. doi: 10.1186/s12883-018-1153-x.

Abstract

BACKGROUND

Autosomal recessive Myotonia congenita (Becker's disease) is caused by mutations in the CLCN1 gene. The condition is characterized by muscle stiffness during sustained muscle contraction and variable degree of muscle weakness that tends to improve with repeated contractions.

CASE PRESENTATION

A 21-year-old man presented with transient muscle stiffness since the last 10 years. He had difficulty in initiating movement and experienced muscle weakness after rest, which typically improved after repeated contraction (warm-up phenomenon). There was no significant family history. Medical examination showed generalized muscle hypertrophy. Serum creatine kinase level was 2-fold higher than the normal value. Electromyogram showed myotonic discharges. DNA sequence analysis identified a novel splice mutation (c.1401 + 1G > A) and a known mutation (c.1657A > T,p.Ile553Phe). He rapidly responded to treatment with mexiletine 100 mg three times a day for 6 months.

CONCLUSIONS

This case report of autosomal recessive Myotonia congenita caused by a novel compound heterozygous mutation expands the genotypic spectrum of CLCN1 gene.

摘要

背景

常染色体隐性先天性肌强直(贝克尔病)由CLCN1基因突变引起。该病的特征是持续肌肉收缩时出现肌肉僵硬,以及不同程度的肌无力,反复收缩后肌无力往往会改善。

病例报告

一名21岁男性自10年前起出现短暂性肌肉僵硬。他开始运动困难,休息后出现肌无力,反复收缩后(热身现象)通常会改善。无明显家族史。体格检查显示全身肌肉肥大。血清肌酸激酶水平比正常值高2倍。肌电图显示肌强直放电。DNA序列分析鉴定出一个新的剪接突变(c.1401+1G>A)和一个已知突变(c.1657A>T,p.Ile553Phe)。他对美西律100毫克每日三次治疗6个月反应迅速。

结论

本例由新型复合杂合突变引起的常染色体隐性先天性肌强直病例报告扩展了CLCN1基因的基因型谱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9b0/6151044/0fc98ff39e4c/12883_2018_1153_Fig1_HTML.jpg

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