Medirex, a.s., Magnezitarska 2/C, 04013, Kosice, Slovakia.
Medirex Group Academy n.p.o., Novozamocka 67, Nitra, Slovakia.
J Med Case Rep. 2022 Feb 28;16(1):98. doi: 10.1186/s13256-022-03291-0.
ACAT-related enzyme 2 required for viability 1 (ARV1) encodes a transmembrane lipid transporter of the endoplasmic reticulum, which is presented in all eukaryotes and in plants. Deficiency of ARV1 is clinically presented as autosomal recessive developmental and epileptic encephalopathy 38 (DEE38) in humans and in mice. So far, three different homozygous and two compound heterozygous ARV1 mutations in humans have been reported in 15 children.
In this case report we present a novel homozygous in-frame ARV1-deletion (c.554_556delTAT, p.L185del) in a 21-year old Caucasian man with developmental delay, intellectual disability, seizures, walking and speech impairments, as well as with a dilated cardiomyopathy (DCM), which has not yet been firmly related to the ARV1-associated phenotype. Interestingly, this novel variant lies in the proximity of the p.G189R mutation, which was previously described in two brothers with DEE38 and dilated cardiomyopathy.
The finding of dilated cardiomyopathy in the presented as well as in three previously reported patients from two different families indicates that dilated cardiomyopathy is a part of the ARV1-induced DEE38 phenotype. However, more data are needed to make this conclusion definitive.
需要生存的 ACAT 相关酶 2(ARV1)编码内质网的跨膜脂质转运蛋白,它存在于所有真核生物和植物中。ARV1 的缺乏在临床上表现为常染色体隐性发育性和癫痫性脑病 38(DEE38),在人类和小鼠中均有发现。迄今为止,在 15 名儿童中已报道了三种不同的纯合子和两种复合杂合 ARV1 突变。
在本病例报告中,我们介绍了一名 21 岁的白种人男性,他患有发育迟缓、智力残疾、癫痫、行走和言语障碍以及扩张型心肌病(DCM),其 ARV1 基因发生了新的纯合框内缺失突变(c.554_556delTAT,p.L185del),这种新的变异位于 p.G189R 突变附近,该突变之前在两个患有 DEE38 和扩张型心肌病的兄弟中被描述过。
在本报告以及来自两个不同家庭的之前报道的另外三名患者中发现扩张型心肌病,表明扩张型心肌病是 ARV1 诱导的 DEE38 表型的一部分。然而,需要更多的数据来确定这一结论。