Yuan Jun-Hui, Higuchi Yujiro, Hashiguchi Akihiro, Ando Masahiro, Yoshimura Akiko, Nakamura Tomonori, Hiramatsu Yu, Sakiyama Yusuke, Takashima Hiroshi
Department of Neurology and Geriatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Front Neurol. 2023 Jan 26;14:1078195. doi: 10.3389/fneur.2023.1078195. eCollection 2023.
Genetic factors are recognized as the major reason for patients with periodic paralysis. The goal of this study was to determine the genetic causes of periodic paralysis in Japan.
We obtained a Japanese nationwide case series of 119 index patients (108 men and 11 women) clinically suspected of periodic paralysis, and a gene panel analysis, targeting , and genes, was conducted.
From 34 cases, 25 pathogenic/likely pathogenic/unknown significance variants were detected in (nine cases), (19 cases), or (six cases), generating a molecular diagnostic rate of 28.6%. In total, seven variants have yet been found linked to periodic paralysis previously. The diagnostic yield of patients with hypokalemic and hyperkalemic periodic paralyzes was 26.2 (17/65) and 32.7% (17/52), respectively. A considerably higher yield was procured from patients with than without positive family history (18/25 vs. 16/94), onset age ≤20 years (24/57 vs. 9/59), or recurrent paralytic attacks (31/94 vs. 3/25).
The low molecular diagnostic rate and specific genetic proportion of the present study highlight the etiological complexity of patients with periodic paralysis in Japan.
遗传因素被认为是周期性瘫痪患者的主要病因。本研究的目的是确定日本周期性瘫痪的遗传原因。
我们获得了一个日本全国范围内的病例系列,包括119例临床疑似周期性瘫痪的索引患者(108名男性和11名女性),并对相关基因进行了基因panel分析。
在34例患者中,在某些基因中检测到25个致病/可能致病/意义不明的变异,其中某基因9例,另一基因19例,还有一基因6例,分子诊断率为28.6%。总共发现7个变异此前尚未发现与周期性瘫痪有关。低钾性和高钾性周期性瘫痪患者的诊断率分别为26.2%(17/65)和32.7%(17/52)。有阳性家族史的患者比无阳性家族史的患者(18/25对16/94)、发病年龄≤20岁的患者(24/57对9/59)或有反复麻痹发作的患者(31/94对3/25)的诊断率要高得多。
本研究中较低的分子诊断率和特定的遗传比例凸显了日本周期性瘫痪患者病因的复杂性。