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GRIA4基因中的新型杂合错义变异与伴有或不伴有癫痫和步态异常的神经发育障碍相关。

Novel Heterozygous Missense Variant in GRIA4 Gene Associated With Neurodevelopmental Disorder With or Without Seizures and Gait Abnormalities.

作者信息

Wang Hua, Liu Jiatong, Li Fuwei, Teng Ziteng, Liu Mingyu, Gu Weiyue

机构信息

Department of Pediatric Neurology, Shengjing Hospital of China Medical University, Shenyang, China.

Chigene (Beijing) Translational Medical Research Center Co., Ltd., Beijing, China.

出版信息

Front Genet. 2022 Apr 20;13:859140. doi: 10.3389/fgene.2022.859140. eCollection 2022.

Abstract

Neurodevelopmental disorder with or without seizure and gait abnormalities (NEDSGA, MIM * 617864) is a newly described autosomal dominant inherited disease caused by a heterozygous variant in the GRIA4 gene. plays an essential role in excitatory synaptic transmission. In this study, we presented the clinical and genetic features of a female patient carrying a novel variant in and further reviewed the previously reported five different patients. Evaluation of the patient included a detailed history and clinical examination. Trio-whole exome sequencing (WES) was performed to identify pathogenic variants in NEDSGA. Sanger sequencing was further used to validate the variants. We described the clinical features of an infant diagnosed with NEDSGA caused by a variant, who presented with severe developmental delay, limb hypertonia, generalized seizure, retinal hypoplasia, and chorioretinal hyperpigmentation. The patient developed tricuspid regurgitation, and imaging examination revealed a patent foramen ovale. Trio-WES identified a novel heterozygous missense variant c.1918G>T, p.Ala640Ser in the GRIA4 gene. Multiple in silico tools predicted deleterious effects of p.Ala640Ser. A novel heterozygous missense variant in the GRIA4 gene (c.1918G>T) identified in the proband expanded the genotypic and phenotypic spectrum of disorders associated with variants. This is the first NEDSGA case reported in China. Our findings provide valuable information for the differential diagnosis of neonatal onset neurodevelopmental disorders.

摘要

伴有或不伴有癫痫发作及步态异常的神经发育障碍(NEDSGA,MIM * 617864)是一种新描述的常染色体显性遗传病,由GRIA4基因中的杂合变异引起。 其在兴奋性突触传递中起重要作用。在本研究中,我们介绍了一名携带GRIA4基因新变异的女性患者的临床和遗传特征,并进一步回顾了先前报道的五例不同患者。 对该患者的评估包括详细的病史和临床检查。进行了三联全外显子组测序(WES)以鉴定NEDSGA中的致病变异。进一步使用桑格测序来验证这些变异。 我们描述了一名因GRIA4基因变异被诊断为NEDSGA的婴儿的临床特征,该婴儿表现为严重发育迟缓、肢体张力亢进、全身性癫痫发作、视网膜发育不全和脉络膜视网膜色素沉着过度。该患者出现三尖瓣反流,影像学检查显示卵圆孔未闭。三联全外显子组测序在GRIA4基因中鉴定出一个新的杂合错义变异c.1918G>T,p.Ala640Ser。多种生物信息学工具预测p.Ala640Ser具有有害作用。 先证者中鉴定出的GRIA4基因中的一个新的杂合错义变异(c.1918G>T)扩展了与GRIA4基因变异相关疾病的基因型和表型谱。这是中国报道的首例NEDSGA病例。我们的发现为新生儿期起病的神经发育障碍的鉴别诊断提供了有价值的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/037f/9065404/4e5ea1e4b2e5/fgene-13-859140-g001.jpg

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