King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences , Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences , Jeddah, Saudi Arabia.
Neurol Res. 2021 Feb;43(2):141-147. doi: 10.1080/01616412.2020.1831331. Epub 2020 Oct 4.
Previously published studies demonstrated that mutations in cause early-onset autosomal recessive cerebellar ataxia 17. In this article, we report a novel homozygous missense variant in in two sisters who had late-onset cerebellar ataxia with epilepsy and describe their clinical and neuroradiological findings.
We included two female patients with typical symptoms of cerebellar ataxia supported by the MRI findings. Whole exome sequencing (WES) data analysis was performed to identify the underlying genetic defect in the proband. Sanger sequencing was used to confirm the variant in other family members.
WES revealed a homozygous missense variant in CWF19-like protein 1; gene c.395A>G; p.(Asp132Gly) (RefSeq NM_018294.4). This variant has not been described previously in the literature. Mutations in this gene are known to cause an autosomal recessive disorder, spinocerebellar ataxia, autosomal recessive 17 (OMIM #616127).
In conclusion, we report a novel variant in as a candidate causal variant in two sisters with autosomal recessive cerebellar ataxia. This is the first report coming from Arab countries. Additional reports in patients with a progressive course and adult-onset are needed, but this could be the first report of this disease diagnosed in adulthood since it is a disease of children and adolescents. In addition, our patients had epileptic seizures, which were not previously documented in patients with mutations. We postulate that mutations in this gene have widespread functional and structural changes in multiple levels of the neuraxis rather than being a pure cerebellar disorder.
先前的研究表明, 基因突变可导致早发性常染色体隐性小脑共济失调 17 型。本文报道了两例晚发性小脑共济失调伴癫痫的姐妹患者,她们均携带 基因的新型纯合错义变异,描述了其临床和神经影像学特征。
我们纳入了两例具有小脑共济失调典型症状的女性患者,其 MRI 结果支持该诊断。对先证者进行全外显子组测序(WES)数据分析,以确定潜在的遗传缺陷。对其他家族成员进行 Sanger 测序以验证该变异。
WES 发现 CWF19 样蛋白 1 基因的纯合错义变异; 基因 c.395A>G;p.(Asp132Gly)(RefSeq NM_018294.4)。该变异此前尚未在文献中描述过。该基因的突变已知可导致常染色体隐性遗传疾病,脊髓小脑共济失调,常染色体隐性 17 型(OMIM#616127)。
总之,我们报道了两例常染色体隐性小脑共济失调姐妹患者携带 基因的新型变异,这是来自阿拉伯国家的首例报道。需要更多具有进行性病程和成年起病的患者的报告,但这可能是首例成年起病的该疾病报告,因为该病好发于儿童和青少年。此外,我们的患者有癫痫发作,这在 基因突变患者中以前并未记录过。我们推测该基因的突变会导致中枢神经系统多个水平的广泛功能和结构改变,而不仅仅是单纯的小脑病变。