Department of Neurology, APHP, Bicêtre University Hospital, Le Kremlin Bicêtre, France.
French National Reference Center for Rare Neuropathies (NNERF), Le Kremlin Bicêtre, France.
J Inherit Metab Dis. 2019 Sep;42(5):803-808. doi: 10.1002/jimd.12087. Epub 2019 Apr 8.
Phosphoglycerate kinase (PGK) deficiency is a rare X-linked metabolic disorder caused by mutations in the PGK1 gene. Patients usually develop various combinations of nonspherocytic hemolytic anemia (NSHA), myopathy, and central nervous system disorders. In this national multicenter observational retrospective study, we recorded all known French patients with PGK deficiency, and 3 unrelated patients were identified. Case 1 was a 32-year-old patient with severe chronic axonal sensorimotor polyneuropathy resembling Charcot-Marie-Tooth (CMT) disease, mental retardation, microcephaly, ophthalmoplegia, pes cavus, and the new c.323G > A PGK1 hemizygous mutation. Case 2 was a 71-year-old patient with recurrent exertional rhabdomyolysis, and a c.943G > A PGK1 hemizygous mutation. Case 3 was a 48-year-old patient with NSHA, retinitis pigmentosa, mental retardation, seizures, stroke, parkinsonism, and a c.491A > T PGK1 hemizygous mutation. This study confirms that PGK deficiency is an extremely rare disorder with a wide phenotypic spectrum, and demonstrates for the first time that PGK deficiency may affect the peripheral nervous system and present as a CMT-like disorder.
磷酸甘油酸激酶(PGK)缺乏症是一种罕见的 X 连锁代谢紊乱,由 PGK1 基因突变引起。患者通常会出现各种非球形红细胞溶血性贫血(NSHA)、肌肉病和中枢神经系统疾病的组合。在这项全国多中心观察性回顾性研究中,我们记录了所有已知的法国 PGK 缺乏症患者,还确定了 3 例无关患者。病例 1 是一名 32 岁的患者,患有严重的慢性轴索性感觉运动多发性神经病,类似于夏科-马里-图(CMT)病,智力低下,小头畸形,眼肌麻痹,高弓足畸形,存在新的 c.323G > A PGK1 半合突变。病例 2 是一名 71 岁的患者,反复发作的劳累性横纹肌溶解症,存在 c.943G > A PGK1 半合突变。病例 3 是一名 48 岁的患者,患有 NSHA、视网膜色素变性、智力低下、癫痫发作、中风、帕金森病,存在 c.491A > T PGK1 半合突变。本研究证实 PGK 缺乏症是一种极其罕见的疾病,具有广泛的表型谱,并首次表明 PGK 缺乏症可能影响周围神经系统,并表现为 CMT 样疾病。