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一名患有早发性脊髓小脑共济失调的意大利患者携带V374A致病变异的第二例病例。

A Second Case With the V374A Pathogenic Variant in an Italian Patient With Early-Onset Spinocerebellar Ataxia.

作者信息

Palombo Flavia, La Morgia Chiara, Fiorini Claudio, Caporali Leonardo, Valentino Maria Lucia, Donadio Vincenzo, Liguori Rocco, Carelli Valerio

机构信息

IRCCS Istituto delle Scienze Neurologiche di Bologna (F.P., C.L.M., C.F., L.C., M.L.V., V.C.), Programma di Neurogenetica, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (C.L.M., V.D., R.L.), UOC Clinica Neurologica, Italy; and Department of Biomedical and NeuroMotor Sciences (DIBINEM) (M.L.V., R.L., V.C.), University of Bologna, Italy.

出版信息

Neurol Genet. 2022 Aug 8;8(5):e200004. doi: 10.1212/NXG.0000000000200004. eCollection 2022 Oct.

DOI:10.1212/NXG.0000000000200004
PMID:35949253
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9359624/
Abstract

BACKGROUND AND OBJECTIVES

To date, approximately 20 heterozygous mainly loss-of-function variants in have been associated with spinocerebellar ataxia (SCA) type 19 and 22, a clinically heterogeneous group of neurodegenerative disorders. We aimed at reporting the second patients with the V374A mutation from an independent family, confirming its pathogenic role.

METHODS

We describe the clinical history of a patient with SCA and conducted genetic investigations including mitochondrial DNA analysis and exome sequencing.

RESULTS

This male patient was reported to have unstable gait with tremors at the lower limbs and dysarthric speech since childhood. A neurologic examination also showed dysarthria, nystagmus, action tremor, dysmetria, and weak deep tendon reflexes. He had marked cerebellar atrophy at brain MRI, more evident at vermis. Molecular analysis, including exome sequencing and an in silico panel analysis of genes associated with SCA, revealed the c.1121T>C [p.V374A] mutation in .

DISCUSSION

This report consolidates the pathogenicity of the V374A mutation and suggests that the ataxic paroxysmal exacerbations are not a key phenotypic feature of this mutation.

摘要

背景与目的

迄今为止,约20种主要为功能缺失的杂合变异已与19型和22型脊髓小脑共济失调(SCA)相关,这是一组临床异质性神经退行性疾病。我们旨在报告来自独立家系的第二例携带V374A突变的患者,以证实其致病作用。

方法

我们描述了一名SCA患者的临床病史,并进行了包括线粒体DNA分析和外显子组测序在内的基因研究。

结果

该男性患者自童年起就有步态不稳伴下肢震颤和构音障碍。神经系统检查还显示构音障碍、眼球震颤、动作性震颤、辨距不良和腱反射减弱。脑部MRI显示他有明显的小脑萎缩,在蚓部更为明显。分子分析,包括外显子组测序和对与SCA相关基因的计算机模拟分析,在该基因中发现了c.1121T>C [p.V374A]突变。

讨论

本报告巩固了V374A突变的致病性,并表明共济失调性阵发性加重并非该突变的关键表型特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/9359624/59975071f317/NNG-2022-200005f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/9359624/59975071f317/NNG-2022-200005f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/9359624/59975071f317/NNG-2022-200005f1.jpg

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本文引用的文献

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Int J Mol Sci. 2021 Jul 31;22(15):8247. doi: 10.3390/ijms22158247.
2
V374A KCND3 Pathogenic Variant Associated With Paroxysmal Ataxia Exacerbations.与阵发性共济失调加重相关的V374A KCND3致病变体
Neurol Genet. 2021 Jan 6;7(1):e546. doi: 10.1212/NXG.0000000000000546. eCollection 2021 Feb.
3
Mutations in potassium channel kcnd3 cause spinocerebellar ataxia type 19.
KCnd3 钾通道基因突变导致 19 型脊髓小脑共济失调。
Ann Neurol. 2012 Dec;72(6):870-80. doi: 10.1002/ana.23700.
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Mutations in KCND3 cause spinocerebellar ataxia type 22.KCND3 基因突变导致脊髓小脑共济失调 22 型。
Ann Neurol. 2012 Dec;72(6):859-69. doi: 10.1002/ana.23701.