Neurological Institute, University Hospitals Cleveland Medical Center, US.
Case Western Reserve University, US.
Tremor Other Hyperkinet Mov (N Y). 2023 Aug 22;13:24. doi: 10.5334/tohm.783. eCollection 2023.
Epsilon-sarcoglycan (SGCE) myoclonus-dystonia is autosomal dominant (AD) with reduced penetrance due to maternal imprinting 95% of the time. Patients may lack family history delaying diagnosis and treatment. Additionally, counseling patients on their risk of passing on the variant differs for females versus males.
A woman in her thirties with typical phenotype of myoclonus-dystonia but lacking an AD pedigree was found to have a pathogenic variant in the SGCE gene. She was counseled that her daughters each have a 2.5% chance of expressing the phenotype.
Understanding the genetics of SGCE-myoclonus-dystonia enables effective genetic counseling and arrival at a timely diagnosis and treatment.
In an era of advancing genetic analysis and precision medicine-based treatments, neurologists will be faced with increasing responsibility to properly counsel patients on the results of genetic testing. This case highlights a genetics pearl for counseling patients with epsilon-sarcoglycan myoclonus-dystonia, an autosomal dominant condition with penetrance differing by sex.
由于母系印迹的原因,epsilon-肌聚糖(SGCE)肌阵挛-肌张力障碍呈常染色体显性遗传(AD),外显率降低,这种情况 95%的时间都会发生。由于患者可能缺乏家族史,这会导致诊断和治疗延迟。此外,对于女性和男性,告知患者变体遗传风险的方式也不同。
一位三十多岁的女性,具有典型的肌阵挛-肌张力障碍表型,但缺乏 AD 家族史,被发现 SGCE 基因存在致病性变异。她被告知,她的女儿各有 2.5%的机会表现出该表型。
了解 SGCE-肌阵挛-肌张力障碍的遗传学,有助于进行有效的遗传咨询,并及时做出诊断和治疗。
在基因分析和基于精准医学的治疗不断发展的时代,神经科医生将面临越来越大的责任,需要正确地向接受基因检测的患者提供咨询。本病例突出了 epsilon-肌聚糖肌阵挛-肌张力障碍的遗传咨询要点,这是一种常染色体显性遗传疾病,其外显率因性别而异。