Han Ji Yoon, Lee Hyun Joo, Lee Young-Mock, Park Joonhong
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Departments of Pediatrics, Yonsei University College of Medicine, Seoul 06273, Korea.
Children (Basel). 2020 Sep 18;7(9):144. doi: 10.3390/children7090144.
Febrile seizure (FS) is related to a febrile illness (temperature > 38 °C) not caused by an infection of central nervous system, without neurologic deficits in children aged 6-60 months. The family study implied a polygenic model in the families of proband(s) with single FS, however in families with repeated FS, inheritance was matched to autosomal dominance with reduced disease penetrance. A 20 month-old girl showed recurrent FS and afebrile seizures without developmental delay or intellectual disability. The seizures disappeared after 60 months without anti-seizure medication. The 35 year-old proband's mother also experienced five episodes of simple FS and two episodes of unprovoked seizures before 5 years old. Targeted exome sequencing was conducted along with epilepsy/seizure-associated gene-filtering to identify the candidate causative mutation. As a result, a heterozygous c.2039A>G of the gene leading to a codon change of aspartic acid to glycine at the position 680 (rs547076322) was identified. This protein's glycine residue is highly conserved, and its allele frequency is 0.00002827 in the gnomAD population database. mutation may have an influential role in the occurrence of genetic epilepsies, especially those with febrile and afebrile seizures. Further investigation of mutations is needed to prove that it is a significant susceptible gene for febrile and/or afebrile seizures in early childhood.
热性惊厥(FS)与非中枢神经系统感染引起的发热性疾病(体温>38°C)相关,6至60个月大的儿童无神经功能缺损。家系研究表明,单发FS先证者家庭呈多基因模式,然而,在反复发生FS的家庭中,遗传方式符合常染色体显性遗传,但疾病外显率降低。一名20个月大的女孩反复出现FS和无热惊厥,无发育迟缓或智力障碍。未使用抗癫痫药物,惊厥在60个月后消失。35岁先证者的母亲在5岁前也经历过5次单纯性FS发作和2次无诱因惊厥发作。进行了靶向外显子组测序,并结合癫痫/惊厥相关基因筛选,以确定候选致病突变。结果,在该基因中鉴定出一个杂合的c.2039A>G突变,导致第680位密码子由天冬氨酸变为甘氨酸(rs547076322)。该蛋白的甘氨酸残基高度保守,其等位基因频率在gnomAD群体数据库中为0.00002827。该突变可能在遗传性癫痫的发生中起重要作用,尤其是那些伴有热性和无热惊厥的癫痫。需要对该突变进行进一步研究,以证明它是幼儿热性和/或无热惊厥的重要易感基因。