Vázquez-Justes Daniel, Carreño-Gago Lidia, García-Arumi Elena, Traveset Alicia, Montoya Julio, Ruiz-Pesini Eduardo, López Ricard, Brieva Luis
Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
Departament de Patología Mitocondrial i Neuromuscular, Hospital Universitari Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
J Pediatr Genet. 2019 Dec;8(4):231-234. doi: 10.1055/s-0039-1691812. Epub 2019 May 28.
This article reports a Leber hereditary optic neuropathy (LHON) case associated for the first time with mitochondrial m.13513G>A mutation. We present a 16-year-old man who complained of subacute, painless, visual loss. Ocular examination showed optic nerve atrophy, papillary pseudoedema, and optic disc pallor. Extraocular manifestations included hypertrophic myocardiopathy and myopathy. Initial genetic analysis excluded the three most common LHON mutations. Sanger sequencing of the whole mitochondrial deoxyribonucleic acid showed no mutation. Next-generation sequencing (NGS) revealed m.13513G>A mutation in the NADH dehydrogenase (ND5) subunit gene ( ). The m.13513G>A mutation has never been associated with LHON phenotype without Leigh/mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes features. NGS techniques should be considered when this diagnosis is strongly suspected.
本文首次报道了一例与线粒体m.13513G>A突变相关的Leber遗传性视神经病变(LHON)病例。我们报告了一名16岁男性,他主诉亚急性、无痛性视力丧失。眼部检查显示视神经萎缩、视乳头假性水肿和视盘苍白。眼外表现包括肥厚性心肌病和肌病。初始基因分析排除了三种最常见的LHON突变。对整个线粒体脱氧核糖核酸进行的桑格测序未显示突变。下一代测序(NGS)揭示了烟酰胺腺嘌呤二核苷酸脱氢酶(ND5)亚基基因中的m.13513G>A突变( )。m.13513G>A突变从未与无Leigh/线粒体脑肌病、乳酸酸中毒和卒中样发作特征的LHON表型相关。当强烈怀疑该诊断时,应考虑使用NGS技术。