Prenatal Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, China.
Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, China.
Front Genet. 2022 Mar 10;13:821587. doi: 10.3389/fgene.2022.821587. eCollection 2022.
Recessive mutations in cause lethal neonatal rigidity and multifocal seizure syndrome (RMFSL), a phenotype characterized by neonatal microcephaly, hypertonia, and refractory epilepsy with premature death. Recently, attenuated disease variants have been described, suggesting that a wider clinical spectrum of -associated neurodegeneration exists than was previously thought. Here, we reported a 10-year-old girl with severe intellectual disability, rigidity, ataxia or dyspraxia, and cerebellar atrophy on brain MRI; two variants in the configuration [c.1014A > C (p.Pro338 = ); c.706delC (p.Leu236Cysfs*5)] were detected using whole-exome sequencing. RNA-seq confirmed significantly decreased transcript levels in the presence of the variant; further, it revealed an intron retention between exon 7 and exon 8 caused by the synonymous base substitute. Subsequent prenatal diagnosis for these two variants guided the parents to reproduce. We expand the phenotypic spectrum of -associated disorders by first reporting the pathogenic synonymous variant of the gene, resulting in clinical severity that is mild compared to the severe phenotype seen in RMFSL. Making an accurate diagnosis and prognostic evaluation of -associated neurodegeneration is important for reproductive consultation and disease management.
导致致命性新生儿僵硬和多灶性癫痫综合征(RMFSL)的隐性突变,其表型特征为新生儿小头畸形、高张力和难治性癫痫伴早逝。最近,已描述了减弱的疾病变异体,表明与相关的神经退行性疾病存在比以前认为更广泛的临床谱。在这里,我们报告了一名 10 岁女孩,其表现为严重智力残疾、僵硬、共济失调或运动障碍以及脑 MRI 上的小脑萎缩;使用全外显子组测序检测到 配置中的两个 变体[c.1014A > C(p.Pro338 = );c.706delC(p.Leu236Cysfs*5)]。RNA-seq 证实了在存在变异体的情况下显着降低的 转录本水平;此外,它还揭示了由于同义碱基取代而导致的 7 号外显子和 8 号外显子之间的内含子保留。随后对这两个变体进行的产前诊断指导父母进行了再生产。我们通过首次报告导致疾病严重程度比 RMFSL 中所见的严重表型轻的 基因的致病性同义变异体,扩展了与相关疾病的表型谱。对与相关的神经退行性疾病进行准确的诊断和预后评估对于生殖咨询和疾病管理很重要。