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早发性帕金森综合征、A型主动脉瘤和心肌致密化不全与MYH11基因新型变异c.2225C>T相关:一例报告

Early Onset Parkinson Syndrome, Type A Aortic Aneurysm and Noncompaction Associated With the Novel Variant c.2225C>T in MYH11: A Case Report.

作者信息

Finsterer Josef, Mehri Sounira

机构信息

Neurology, Neurology and Neurophysiology Center, Vienna, AUT.

Biochemistry Laboratory, LR12ES05, Nutrition-Functional Foods and Vascular Health, University of Monastir, Faculty of Medicine, Monastir, TUN.

出版信息

Cureus. 2023 Oct 10;15(10):e46793. doi: 10.7759/cureus.46793. eCollection 2023 Oct.

Abstract

Aortic aneurysm, left ventricular noncompaction, and early onset Parkinson syndrome have not been reported in association with variants. The patient is a 44-year-old male who developed a progressive ascending aortic aneurysm at age 30, requiring aortic repair at the age of 40. In addition, he developed Parkinson syndrome at the age of 37. He also suffered from myopia, hypothyroidism, arterial hypertension, hyperlipidemia, pre-diabetes, hyperbilirubinemia, obstructive sleep apnea syndrome (OSAS), and muscle cramps. Echocardiography and cardiac MRI showed left ventricular noncompaction. Genetic analysis revealed the novel heterozygous variant c.2225C>T (p.Ala742Val) in . Family history was positive for arterial hypertension (mother), carcinoma (brother), and diabetes (sister, father). There was consanguinity between the parents. With appropriate treatment, Parkinson syndrome and cardiac anomalies remained stable and there were no complications due to noncompaction or aortic repair. Considering that embryonic vascularisation may be involved in the pathophysiology of noncompaction and that is expressed in the myocardium, a causal relationship between the variant and noncompaction is conceivable. In conclusion, this is the first case showing an aortic aneurysm associated with noncompaction and Parkinson syndrome in a carrier of the novel, heterozygous variant c.2225C>T in . Carriers of variants should be prospectively and systematically screened for multisystem diseases as soon as the genetic defect is discovered in order not to delay any necessary treatment. First-degree relatives should be screened for the variant of a family member to track the trait of inheritance and confirm its pathogenicity.

摘要

主动脉瘤、左心室心肌致密化不全和早发性帕金森综合征尚未见与该变异相关的报道。患者为一名44岁男性,30岁时出现进行性升主动脉瘤,40岁时需要进行主动脉修复。此外,他在37岁时患上帕金森综合征。他还患有近视、甲状腺功能减退、动脉高血压、高脂血症、糖尿病前期、高胆红素血症、阻塞性睡眠呼吸暂停综合征(OSAS)和肌肉痉挛。超声心动图和心脏磁共振成像显示左心室心肌致密化不全。基因分析显示在[具体基因名称]中存在新的杂合变异c.2225C>T(p.Ala742Val)。家族史显示动脉高血压(母亲)、癌症(兄弟)和糖尿病(姐妹、父亲)呈阳性。父母之间存在近亲关系。经过适当治疗,帕金森综合征和心脏异常保持稳定,未因心肌致密化不全或主动脉修复出现并发症。考虑到胚胎血管生成可能参与心肌致密化不全的病理生理过程,且[具体基因名称]在心肌中表达,该变异与心肌致密化不全之间的因果关系是可以想象的。总之,这是首例报道携带新的杂合变异c.2225C>T的患者出现与心肌致密化不全和帕金森综合征相关的主动脉瘤。一旦发现基因缺陷,应前瞻性、系统性地对[具体基因名称]变异携带者进行多系统疾病筛查,以免延误任何必要治疗。应筛查一级亲属是否存在家庭成员的[具体基因名称]变异,以追踪遗传特征并确认其致病性。

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