Mitsutake Akihiko, Matsukawa Takashi, Naito Tatsuhiko, Ishiura Hiroyuki, Mitsui Jun, Harada Hiroaki, Fujio Keishi, Fujishiro Jun, Mori Harushi, Morishita Shinichi, Tsuji Shoji, Toda Tatsushi
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan.
Department of Neurology, International University of Health and Welfare Mita Hospital, Japan.
Intern Med. 2025 Mar 1;64(5):759-762. doi: 10.2169/internalmedicine.3999-24. Epub 2024 Aug 1.
We herein report a novel de novo KCNH5 variant in a patient with refractory epileptic encephalopathy. The patient exhibited seizures at 1 year and 7 months old, which gradually worsened, leading to a bedridden status. Brain magnetic resonance imaging (MRI) showed cerebral atrophy and cerebellar hypoplasia. A trio whole-exome sequence analysis identified a de novo heterozygous c.640A>C, p.Lys214Gln variant in KCNH5 that was predicted to be deleterious. Recent studies have linked KCNH5 to various epileptic encephalopathies, with many patients showing normal MRI findings. The present case expands the clinical spectrum of the disease, as it is characterized by severe neurological prognosis, cerebral atrophy, and cerebellar hypoplasia.
我们在此报告一名难治性癫痫性脑病患者中一种新的KCNH5基因新生变异。该患者在1岁7个月时出现癫痫发作,病情逐渐恶化,导致卧床不起。脑磁共振成像(MRI)显示脑萎缩和小脑发育不全。三联体全外显子测序分析在KCNH5基因中鉴定出一个新生的杂合c.640A>C、p.Lys214Gln变异,预测该变异有害。最近的研究已将KCNH5与各种癫痫性脑病联系起来,许多患者的MRI表现正常。本病例扩展了该疾病的临床谱,其特征为严重的神经预后、脑萎缩和小脑发育不全。