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Heshmatzad K, Naderi N, Masoumi T, Pouraliakbar H, Kalayinia S. Identification of a novel de novo pathogenic variant in GFAP in an Iranian family with Alexander disease by whole-exome sequencing. Eur J Med Res 2022; 27:174. [PMID: 36088400 PMCID: PMC9464415 DOI: 10.1186/s40001-022-00799-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Alexander disease (AxD) is a rare leukodystrophy with an autosomal dominant inheritance mode. Variants in GFAP lead to this disorder and it is classified into three distinguishable subgroups: infantile, juvenile, and adult-onset types. Objective The aim of this study is to report a novel variant causing AxD and collect all the associated variants with juvenile and adult-onset as well. Methods We report a 2-year-old female with infantile AxD. All relevant clinical and genetic data were evaluated. Search strategy for all AxD types was performed on PubMed. The extracted data include total recruited patients, number of patients carrying a GFAP variant, nucleotide and protein change, zygosity and all the clinical symptoms. Results A novel de novo variant c.217A > G: p. Met73Val was found in our case by whole-exome sequencing. In silico analysis categorized this variant as pathogenic. Totally 377 patients clinically diagnosed with juvenile or adult-onset forms were recruited in these articles, among them 212 patients were affected with juvenile or adult-onset form carrier of an alteration in GFAP. A total of 98 variants were collected. Among these variants c.262C > T 11/212 (5.18%), c.1246C > T 9/212 (4.24%), c.827G > T 8/212 (3.77%), c.232G > A 6/212 (2.83%) account for the majority of reported variants. Conclusion This study highlighted the role of genetic in AxD diagnosing. It also helps to provide more information in order to expand the genetic spectrum of Iranian patients with AxD. Our literature review is beneficial in defining a better genotype–phenotype correlation of AxD disorder.
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Oshima Y, Takahashi-Iwata I, Sato S, Harada T, Yoshida T, Yabe I. Pearls & Oy-sters: Adult-Onset Alexander Disease With Transient Swelling of the Medulla Oblongata. Neurology 2021; 97:602-605. [PMID: 34039724 DOI: 10.1212/wnl.0000000000012268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yuki Oshima
- From the Department of Neurology (Y.O., I.T.-I., S.S., I.Y.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University; Department of Diagnostic Imaging (T.H.), Hokkaido University Graduate School of Medicine; and Department of Neurology (T.Y.), Kyoto Prefectural University of Medicine
| | - Ikuko Takahashi-Iwata
- From the Department of Neurology (Y.O., I.T.-I., S.S., I.Y.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University; Department of Diagnostic Imaging (T.H.), Hokkaido University Graduate School of Medicine; and Department of Neurology (T.Y.), Kyoto Prefectural University of Medicine
| | - Shoki Sato
- From the Department of Neurology (Y.O., I.T.-I., S.S., I.Y.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University; Department of Diagnostic Imaging (T.H.), Hokkaido University Graduate School of Medicine; and Department of Neurology (T.Y.), Kyoto Prefectural University of Medicine
| | - Taisuke Harada
- From the Department of Neurology (Y.O., I.T.-I., S.S., I.Y.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University; Department of Diagnostic Imaging (T.H.), Hokkaido University Graduate School of Medicine; and Department of Neurology (T.Y.), Kyoto Prefectural University of Medicine
| | - Tomokatsu Yoshida
- From the Department of Neurology (Y.O., I.T.-I., S.S., I.Y.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University; Department of Diagnostic Imaging (T.H.), Hokkaido University Graduate School of Medicine; and Department of Neurology (T.Y.), Kyoto Prefectural University of Medicine
| | - Ichiro Yabe
- From the Department of Neurology (Y.O., I.T.-I., S.S., I.Y.), Faculty of Medicine and Graduate School of Medicine, Hokkaido University; Department of Diagnostic Imaging (T.H.), Hokkaido University Graduate School of Medicine; and Department of Neurology (T.Y.), Kyoto Prefectural University of Medicine.
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Keller SR, Mallack EJ, Rubin JP, Accardo JA, Brault JA, Corre CS, Elizondo C, Garafola J, Jackson-Garcia AC, Rhee J, Seeger E, Shullanberger KC, Tourjee A, Trovato MK, Waldman AT, Wallace JL, Wallace MR, Werner K, White A, Ess KC, Becker C, Eichler FS. Practical Approaches and Knowledge Gaps in the Care for Children With Leukodystrophies. J Child Neurol 2021; 36:65-78. [PMID: 32875938 PMCID: PMC7736398 DOI: 10.1177/0883073820946154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Leukodystrophies are a group of neurodegenerative genetic disorders that affect approximately 1 in 7500 individuals. Despite therapeutic progress in individual leukodystrophies, guidelines in neurologic care are sparse and consensus among physicians and caregivers remains a challenge. At patient advocacy meetings hosted by Hunter's Hope from 2016-2018, multidisciplinary experts and caregivers met to conduct a literature review, identify knowledge gaps and summarize best practices regarding neurologic care. Stages of severity in leukodystrophies guided recommendations to address different levels of need based on a newly defined system of disease severity. Four core neurologic domains prioritized by families were identified and became the focus of this guideline: sleep, pain, seizures/epilepsy, and language/cognition. Based on clinical severity, the following categories were used: presymptomatic, early symptomatic, intermediate symptomatic, and advanced symptomatic. Across the leukodystrophies, neurologic care should be tailored to stages of severity while accounting for unique aspects of every disease and multiple knowledge gaps present. Standardized tools and surveys can help guide treatment but should not overburden families.
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Affiliation(s)
- Stephanie R. Keller
- Department of Pediatrics, Division of Pediatric Neurology, Emory University/Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Eric J. Mallack
- Department of Pediatrics, Division of Child Neurology, Weill Cornell
Medical College/New York-Presbyterian Hospital, New York, NY, USA
| | - Jennifer P. Rubin
- Department of Pediatric Neurology, Northwestern Feinberg School of
Medicine, Chicago, IL, USA
| | - Jennifer A. Accardo
- Department of Neurology, Children’s Hospital of Richmond at VCU,
Richmond, VA, USA
| | - Jennifer A. Brault
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | - Camille S. Corre
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Camila Elizondo
- East Boston Neighborhood Health Canter, East Boston, MA, USA
| | - Jennifer Garafola
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Jullie Rhee
- Children’s National Health Systems, Washington, DC, USA
| | | | | | - Amanda Tourjee
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa K. Trovato
- Department of Physical Medicine and Rehabilitation, Kennedy Krieger Institute and Johns Hopkins University, Baltimore, MD, USA
| | - Amy T. Waldman
- Division of Neurology, The Children’s Hospital of Philadelphia,
University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Klaus Werner
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Angela White
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kevin C. Ess
- Department of Pediatrics, Division of Pediatric Neurology Vanderbilt University Medical Center, Nashville, TN, USA
| | - Catherine Becker
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Florian S. Eichler
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA,Florian S. Eichler, MD, Department of
Neurology, Massachusetts General Hospital, 175 Cambridge Street, Suite 340,
Boston, MA 02114, USA.
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Fu MH, Chang YY, Lin NH, Yang AW, Chang CC, Liu JS, Peng CH, Wu KLH, Perng MD, Lan MY. Recessively-Inherited Adult-Onset Alexander Disease Caused by a Homozygous Mutation in the GFAP Gene. Mov Disord 2020; 35:1662-1667. [PMID: 32374915 DOI: 10.1002/mds.28099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/01/2020] [Accepted: 04/09/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Alexander disease (AxD) is an autosomal-dominant leukodystrophy caused by heterozygous mutations in the glial fibrillary acidic protein (GFAP) gene. OBJECTIVES The objective of this report is to characterize the clinical phenotype and identify the genetic mutation associated with adult-onset AxD. METHODS A man presented with progressive unsteadiness since age 16. Magnetic resonance imaging findings revealed characteristic features of AxD. The GFAP gene was screened, and a candidate variant was functionally tested to evaluate causality. RESULTS A homozygous c.197G > A (p.Arg66Gln) mutation was found in the proband, and his asymptomatic parents were heterozygous for the same mutation. This mutation affected GFAP solubility and promoted filament aggregation. The presence of the wild-type protein rescued mutational effects, consistent with the recessive nature of this mutation. CONCLUSIONS This study is the first report of AxD caused by a homozygous mutation in GFAP. The clinical implication is while examining patients with characteristic features on suspicion of AxD, GFAP screening is recommended even without a supportive family history. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mu-Hui Fu
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Yee Chang
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Center for Parkinson's Disease, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ni-Hsuan Lin
- Institute of Molecular Medicine, College of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Ai-Wen Yang
- Institute of Molecular Medicine, College of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan.,Department of Medical Science, College of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jia-Shou Liu
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Huei Peng
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kay L H Wu
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Senior Citizen Services, National Tainan Institute of Nursing, Tainan, Taiwan
| | - Ming-Der Perng
- Institute of Molecular Medicine, College of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan.,Department of Medical Science, College of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Min-Yu Lan
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Center for Parkinson's Disease, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Hsu AK, Rosow DE, Wallerstein RJ, April MM. Familial congenital bilateral vocal fold paralysis: a novel gene translocation. Int J Pediatr Otorhinolaryngol 2015; 79:323-7. [PMID: 25617187 DOI: 10.1016/j.ijporl.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES True vocal fold (TVF) paralysis is a common cause of neonatal stridor and airway obstruction, though bilateral TVF paralysis is seen less frequently. Rare cases of familial congenital TVF paralysis have been described with implied genetic origin, but few genetic abnormalities have been discovered to date. The purpose of this study is to describe a novel chromosomal translocation responsible for congenital bilateral TVF immobility. METHODS The charts of three patients were retrospectively reviewed: a 35 year-old woman and her two children. The mother had bilateral TVF paralysis at birth requiring tracheotomy. Her oldest child had a similar presentation at birth and also required tracheotomy, while the younger child had laryngomalacia without TVF paralysis. Standard karyotype analysis was done using samples from all three patients and the parents of the mother, to assess whether a chromosomal abnormality was responsible. RESULTS Karyotype analysis revealed the same balanced translocation between chromosomes 5 and 14, t(5;14) (p15.3, q11.2) in the mother and her two daughters. No other genetic abnormalities were identified. Neither maternal grandparent had the translocation, which appeared to be a spontaneous mutation in the mother with autosomal dominant inheritance and variable penetrance. CONCLUSIONS A novel chromosomal translocation was identified that appears to be responsible for familial congenital bilateral TVF paralysis. While there are other reports of genetic abnormalities responsible for this condition, we believe this is the first describing this particular translocation.
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Affiliation(s)
- Amy K Hsu
- Department of Otolaryngology/Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - David E Rosow
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, United States.
| | - Robert J Wallerstein
- Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA, United States
| | - Max M April
- Department of Otolaryngology/Head and Neck Surgery, New York University School of Medicine, New York, NY, United States
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Adult onset Alexander disease presenting with progressive spastic paraplegia. Parkinsonism Relat Disord 2014; 20:241-2. [DOI: 10.1016/j.parkreldis.2013.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/06/2013] [Accepted: 10/13/2013] [Indexed: 11/21/2022]
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