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携带杂合性PRRT2基因p.Arg217ProfsTer8突变时,可能以DSG2基因p.Val149Ile突变为遗传背景的致心律失常性右室心肌病(ARVC):一例报告

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) Probably Caused by DSG2 p.Val149Ile Mutation as Genetic Background When Carrying with Heterozygous PRRT2 p.Arg217ProfsTer8 Mutation: A Case Report.

作者信息

Huang Rui, Luo YinHua, Zhao Jingbo, Su Ke, Lei YuHua, Li Yuanhong

机构信息

Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi Prefecture, 445000, Hubei Province, People's Republic of China.

Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, 442000, Hubei Province, People's Republic of China.

出版信息

Int Med Case Rep J. 2021 May 12;14:307-313. doi: 10.2147/IMCRJ.S309668. eCollection 2021.

Abstract

BACKGROUND

ARVC is a rare genetic-related disease characterized by fibrous fat replacement in the ventricular myocardium, caused by mutations in genes encoding for the desmosomal proteins, such as the desmoglein-2 gene (DSG2). It is reported in the literature that other genetic factors may play a role in disease penetrance. Herein, we report a Chinese proband with ARVC, which was probably caused by DSG2 p.Val149Ile mutation as genetic background when carrying heterozygous PRRT2 p.Arg217ProfsTer8 mutation.

CASE PRESENTATION

A 17-year-old male with a history of paroxysmal kinesigenic dyskinesia (PKD) presented to the hospital for syncope induced by ventricular tachycardia. According to relevant clinical data and the diagnostic criteria of ARVC, a precise positive diagnosis of ARVC was finally made. Gene testing revealed that the patient carried a DSG2 heterozygous missense mutation (NM_001943: exon5: c.445G>A, p.Val149Ile) as well as frameshift mutation of PRRT2 (NM_001256442: exon2: p. Arg217Profs Ter8).

CONCLUSION

This is the first time to report a Chinese proband with ARVC and a history of PKD carrying both DSG2 p. val149ile mutation and PRRT2 p. Arg217ProfsTer8 mutation, which can provide a new direction for gene screening of patients with ARVC and further supplements for its diagnostic criteria.

摘要

背景

致心律失常性右室心肌病(ARVC)是一种罕见的遗传相关疾病,其特征为心室心肌纤维脂肪替代,由编码桥粒蛋白的基因突变引起,如桥粒芯糖蛋白-2基因(DSG2)。文献报道其他遗传因素可能在疾病的外显率中起作用。在此,我们报告一名患有ARVC的中国先证者,其在携带杂合PRRT2 p.Arg217ProfsTer8突变时,可能以DSG2 p.Val149Ile突变为遗传背景导致发病。

病例介绍

一名有阵发性运动诱发性运动障碍(PKD)病史的17岁男性因室性心动过速诱发晕厥入院。根据相关临床资料及ARVC诊断标准,最终确诊为ARVC。基因检测显示该患者携带DSG2杂合错义突变(NM_001943: exon5: c.445G>A, p.Val149Ile)以及PRRT2移码突变(NM_001256442: exon2: p.Arg217ProfsTer8)。

结论

这是首次报道一名患有ARVC且有PKD病史的中国先证者同时携带DSG2 p.val149ile突变和PRRT2 p.Arg217ProfsTer8突变,可为ARVC患者的基因筛查提供新方向,并对其诊断标准进行进一步补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c3c/8128131/654e6a77778e/IMCRJ-14-307-g0001.jpg

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