Marcelis Annelien, Van Reet Evelyne
AZ Sint-Maria Halle, Halle, Belgium.
Vrije Universiteit Brussel, Brussels, Belgium.
Case Rep Psychiatry. 2024 Sep 25;2024:5535830. doi: 10.1155/2024/5535830. eCollection 2024.
Kinesin family member 11 (KIF11)-associated disorder, a rare condition caused by autosomal dominant mutations in the KIF11 gene, presents with microcephaly, chorioretinal dysplasia, lymphoedema, and varying degrees of intellectual disability. While intellectual disability is often described in the literature on KIF11 mutations, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are only mentioned by a few authors but not thoroughly investigated. We present a case report of an 8-year-old boy with KIF11-associated disorder alongside ADHD and ASD but without intellectual disability. Genetic testing confirmed a KIF11 mutation. Cognitive, language, and motor assessments revealed delays in fine motor skills and attention deficits. The diagnosis of ADHD was confirmed by a child neurologist through multidisciplinary investigations, while the ASD diagnosis was established by a child psychiatrist. Despite the challenges of delayed psychiatric assessment, interventions including physiotherapy and medication management were initiated with positive results. We designed a parent support group survey that showed a higher prevalence of neurodevelopmental disorders in children with KIF11 mutations compared to the general population. Therefore, low-threshold referrals to a child psychiatrist have to be made when the potential presence of developmental problems is suspected. Collaboration between ophthalmologists, paediatricians, and child psychiatrists is crucial for early detection and intervention. Addressing developmental disorders promptly improves long-term outcomes and enhances quality of life. Moreover, gaining a deeper understanding of the higher prevalence of ASD and ADHD in individuals with KIF11 mutations could offer valuable insights into the genetic mechanisms underlying neurodevelopmental disorders.
驱动蛋白家族成员11(KIF11)相关疾病是一种由KIF11基因的常染色体显性突变引起的罕见病症,表现为小头畸形、脉络膜视网膜发育异常、淋巴水肿以及不同程度的智力残疾。虽然在关于KIF11突变的文献中经常描述智力残疾,但只有少数作者提及自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD),且未进行深入研究。我们报告一例8岁男孩患有KIF11相关疾病,同时伴有ADHD和ASD但无智力残疾。基因检测证实存在KIF11突变。认知、语言和运动评估显示精细运动技能延迟和注意力缺陷。儿童神经科医生通过多学科调查确诊为ADHD,而儿童精神科医生确诊为ASD。尽管精神科评估延迟存在挑战,但仍启动了包括物理治疗和药物管理在内的干预措施,并取得了积极效果。我们设计了一项家长支持小组调查,结果显示与普通人群相比,KIF11突变儿童中神经发育障碍的患病率更高。因此,当怀疑可能存在发育问题时,必须将儿童转介至儿童精神科医生处进行低门槛评估。眼科医生、儿科医生和儿童精神科医生之间的合作对于早期发现和干预至关重要。及时解决发育障碍可改善长期预后并提高生活质量。此外,深入了解KIF11突变个体中ASD和ADHD的较高患病率,可为神经发育障碍的遗传机制提供有价值的见解。