Wang Lin, Zhang Hongwei, Luo Junxia, Qi Fang, Liu Yong, Zhang Kaihui, Gao Zaifen
Epilepsy Center, the Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong 250022, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2023 Aug 10;40(8):1004-1008. doi: 10.3760/cma.j.cn511374-20220915-00622.
To explore the genetic etiology of a child with Hypomagnesemia, epilepsy and mental retardation syndrome (HSMR).
A child who was admitted to the Children's Hospital of Shandong University on July 9, 2021 due to repeated convulsions for 2 months was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and his pedigree members were collected for the extraction of genomic DNA. Whole exome sequencing was carried out, and candidate variant was verified by Sanger sequencing and bioinformatic analysis.
The child, a 1-year-and-7-month-old male, had presented with epilepsy and global developmental delay. Serological testing revealed that he has low serum magnesium. Genetic testing showed that the child has harbored a heterozygous c.1448delT (p.Val483GlyfsTer29) variant of the CNNM2 gene, which was de novo in origin. The variant has caused substitution of the Valine at position 483 by Glycine and formation of a termination codon after 29 amino acids at downstream. As predicted by Swiss-Model online software, the variant may alter the protein structure, resulting in a truncation. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.1448delT (p.Val483GlyfsTer29) was predicted as a pathogenic variant (PVS1+PS2+PM2_Supporting+PP4).
The heterozygous c.1448delT variant of the CNNM2 gene probably underlay the HSMR in this child. Above finding has enriched the phenotype-genotype spectrum of the CNNM2 gene.
探讨一名患有低镁血症、癫痫和智力发育迟缓综合征(HSMR)儿童的遗传病因。
选取一名于2021年7月9日因反复惊厥2个月入住山东大学齐鲁儿童医院的儿童作为研究对象。收集该儿童的临床资料。采集该儿童及其家系成员的外周血样本用于提取基因组DNA。进行全外显子组测序,并通过Sanger测序和生物信息学分析验证候选变异。
该儿童为1岁7个月男性,表现为癫痫和全面发育迟缓。血清学检测显示其血清镁水平低。基因检测表明该儿童携带CNNM2基因的杂合c.1448delT(p.Val483GlyfsTer29)变异,此变异为新发。该变异导致483位的缬氨酸被甘氨酸替代,并在下游29个氨基酸后形成终止密码子。经在线软件Swiss-Model预测,该变异可能改变蛋白质结构,导致截短。根据美国医学遗传学与基因组学学会(ACMG)的指南,c.1448delT(p.Val483GlyfsTer29)被预测为致病变异(PVS1+PS2+PM2_Supporting+PP4)。
CNNM2基因的杂合c.1448delT变异可能是该儿童HSMR的病因。上述发现丰富了CNNM2基因的表型-基因型谱。