Lee Byung Dae, Kong Ja Young, Kwon Chae Hwa, Park Je Min, Lee Young Min, Moon Eunsoo, Jeong Hee Jeong, Kim Soo Yeon, Lee Kang Yoon, Suh Hwagyu
Department of Psychiatry.
Biomedical Research Institute, Pusan National University Hospital, Busan.
Medicine (Baltimore). 2018 Oct;97(42):e12918. doi: 10.1097/MD.0000000000012918.
Idiopathic basal ganglia calcification (IBGC) is characterized by brain calcification and a wide variety of neurological and psychiatric symptoms. In families displaying an autosomal dominant inheritance pattern, three causative genes have been identified: SLC20A2, PDGFRB, and very recently, PDGFB. While in clinical practice sporadic presentation of IBGC is frequent, well-documented reports of true sporadic occurrences are rare. We report a case of a 61-year-old woman who presented with depressive and dystonic symptoms revealing IBGC. Her 41-year-old daughter was healthy. In the proband, we identified 4 mutations in PDGFB, and 1 exonic mutation in SLC20A2, all of which were absent in the daughter. These mutations may result in a loss-of-function of PDGF-B or SLC20A2, which has been shown to cause IBGC in humans and disrupts the blood-brain barrier in mice resulting in brain calcification. Herein, we present the occurrence of a sporadic patient of IBGC and its causative mutations.
特发性基底节钙化(IBGC)的特征是脑钙化以及各种各样的神经和精神症状。在呈现常染色体显性遗传模式的家族中,已确定了三个致病基因:SLC20A2、PDGFRB,以及最近发现的PDGFB。虽然在临床实践中,IBGC的散发性表现很常见,但有充分记录的真正散发性病例报告却很少。我们报告了一例61岁女性病例,该患者出现抑郁和肌张力障碍症状,经检查发现患有IBGC。她41岁的女儿身体健康。在该先证者中,我们在PDGFB中发现了4个突变,在SLC20A2中发现了1个外显子突变,而这些突变在其女儿体内均不存在。这些突变可能导致PDGF - B或SLC20A2功能丧失,已有研究表明这会在人类中引发IBGC,并破坏小鼠的血脑屏障,导致脑钙化。在此,我们介绍了一例IBGC散发性患者及其致病突变的情况。