Zhang Jia, Li Yang, Luo Huan, Shen YaJun, Yuan Meng, Yang Zuozhen, Gan Jing
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2022 May 10;39(5):484-487.
To analyze the clinical characteristics and CSNK2B gene variant of 2 children with Poirier-Bienvenu neurodevelopmental syndrome, and to identify the possible pathogenic causes and provide evidence for clinical diagnosis.
Two children with Poirier-Bienvenu neurodevelopmental syndrome were selected from West China Second University Hospital, Sichuan University. The clinical manifestations, laboratory examination and CSNK2B gene variant were analyzed.
The main manifestations of 2 children were epilepsy, motor or intellectual retardation. Whole exon sequencing showed that CSNK2B gene c. 291+4A>T heterozygous splicing variant was found in case one, and CSNK2B copy number variation(CNV) was lost in case two. Case one received no special treatment, followed up for 8+ months, seizures and motor development were improved; case two had recurrent seizures for 9+ years, and received levetiracetam and clonazepam antiepileptic treatment. No seizures have occurred for 2 years now, and a large number of epileptic discharges can still be seen in video electroencephalogram (VEEG) with slightly backward intelligence and language development.
Our study further proves that the pathogenic variant of CSNK2B is related to epilepsy with developmental disorder, and enrich is the CSNK2B gene variant spectrum. The pathogenesis of CSNK2B has great clinical heterogeneity, with great difference in severity of nervous system injury and different prognosis, and agenesis of corpus callosum may be one of its clinical phenotypes.
分析2例波里耶-比温纽神经发育综合征患儿的临床特征及CSNK2B基因变异情况,明确可能的致病原因,为临床诊断提供依据。
选取四川大学华西第二医院的2例波里耶-比温纽神经发育综合征患儿,对其临床表现、实验室检查及CSNK2B基因变异进行分析。
2例患儿主要表现为癫痫、运动或智力发育迟缓。全外显子测序显示,病例一发现CSNK2B基因c.291+4A>T杂合剪接变异,病例二存在CSNK2B基因拷贝数变异(CNV)缺失。病例一未接受特殊治疗,随访8+个月,癫痫发作及运动发育有所改善;病例二反复癫痫发作9+年,接受左乙拉西坦和氯硝西泮抗癫痫治疗,目前已2年无癫痫发作,但视频脑电图(VEEG)仍可见大量癫痫样放电,智力及语言发育稍落后。
本研究进一步证明CSNK2B基因变异与伴有发育障碍的癫痫有关,丰富了CSNK2B基因变异谱。CSNK2B的发病机制具有很大的临床异质性,神经系统损伤严重程度及预后差异较大,胼胝体发育不全可能是其临床表型之一。