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Ying Y, Yu S, Zhang J, He J, Xu X, Hong X, Zhu F. A case of McLeod syndrome caused by a nonsense variation c.942G>A in the XK gene: A case report. Front Genet 2023; 14:1073139. [PMID: 36816020 PMCID: PMC9929429 DOI: 10.3389/fgene.2023.1073139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
McLeod syndrome is a rare XK gene-related progressive, debilitating disease involving multiple systems. The blood group phenotypes in McLeod syndrome patients usually display the Kx antigen loss and a decrease in the Kell blood group system antigen expression. This paper describes a 41-year-old male Chinese patient with McLeod syndrome. He first attended a hospital in 2015 and developed progressively worsening symptoms 4 years ago. As the disease progressed, the patient exhibited memory loss, unresponsiveness, and chorea and displayed elevated creatine kinase levels. However, McLeod syndrome could not be diagnosed by these signs and laboratory results. The patient was readmitted to the hospital in 2020 and was suspected of having McLeod syndrome. Serological analysis of the Kell blood group system and genotyping for the XK blood group system were performed, revealing the weak expression of the K antigen and the negative K antigen. Sequencing of the coding region of the XK gene showed a hemizygous c.942G>A variation in the XK gene, which resulted in a premature stop codon at position 314 (p.Trp314Ter). Therefore, the patient was diagnosed with McLeod syndrome. In conclusion, this paper presents a case of McLeod syndrome caused by a nonsense variation c.942G>A in the XK gene. The analysis of the XK gene and blood group antigen is helpful for the diagnosis of McLeod syndrome and for distinguishing it from many other diseases.
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Affiliation(s)
- Yanling Ying
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Shifang Yu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingjing Zhang
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ji He
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xianguo Xu
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaozhen Hong
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China,*Correspondence: Xiaozhen Hong, ; Faming Zhu,
| | - Faming Zhu
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China,*Correspondence: Xiaozhen Hong, ; Faming Zhu,
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Tian PC, Wang Y, Chen Z, Shi DD, Wang HL, Luo Q. The first case report of McLeod syndrome in an infant with a novel mutation (c.89C>A, p. Ser30X) in XK. Clin Neurol Neurosurg 2019; 184:105421. [PMID: 31319236 DOI: 10.1016/j.clineuro.2019.105421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/01/2019] [Accepted: 07/07/2019] [Indexed: 11/16/2022]
Abstract
McLeod syndrome (MLS) is a rare multisystem disorder and X-linked recessive inheritance disorder caused by mutations of the X-linked Kx blood group (XK) gene. The manifestations progress slowly and mainly appear in middle age, which make it difficult to distinguish MLS from other neuromuscular disorders. Here, we present a case of a 10-month-old Chinese boy who was taken to hospital for herpes of the extremities and oral cavity along with febrile seizures in June 2017. The laboratory test revealed persistent elevated levels of serum creatine phosphokinase and abnormal liver function. The results of the electrocardiogram showed sinus tachycardia, and magnetic resonance imaging of the brain showed enlarged bilateral ventricles and third ventricle. Genetic analysis by next-generation sequencing revealed a novel nonsense mutation c.89C > A (p. Ser30X) in exon 1 of XK. To the best of our knowledge, this is the first case report of infants with MLS confirmed by genetic analysis.
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Affiliation(s)
- Pei-Chao Tian
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yue Wang
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zheng Chen
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dan-Dan Shi
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huai-Li Wang
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiang Luo
- Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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McLeod syndrome: Five new pedigrees with novel mutations. Parkinsonism Relat Disord 2019; 64:293-299. [PMID: 31103486 DOI: 10.1016/j.parkreldis.2019.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/20/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To present five new McLeod Syndrome (MLS) pedigrees with novel XK gene mutations, review the literature of this disorder, and discuss the typical and atypical clinical features noted with these new mutations. METHODS This is a multi-center retrospective review of five MLS cases with novel gene mutations. Genotypic and phenotypic information has been obtained from each center. RESULTS Five novel mutations are reported in this Case series. New clinical findings include prolonged asymptomatic elevated creatine kinase (CK) levels, vocal tics, presence of obstructive sleep apnea (OSA), and one patient of Vietnamese ethnicity. CONCLUSIONS We expand on the clinical and genetic spectrum of MLS demonstrating the clinical variability of MLS.
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Liu J, Bader B, Danek A. Neuroacanthocytosis in china: a review of published reports. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2014; 4:248. [PMID: 25374764 PMCID: PMC4219110 DOI: 10.7916/d8q23xdx] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/21/2014] [Indexed: 12/03/2022]
Abstract
Background Neuroacanthocytosis (NA) syndromes are a group of rare diseases characterized by the presence of acanthocytes and neuronal multisystem pathology, including chorea-acanthocytosis (ChAc), McLeod syndrome (MLS), Huntington's disease-like 2 (HDL-2), and pantothenate kinase-associated neurodegeneration (PKAN). China has the largest population in the world, which makes it a good location for investigating rare diseases like NA. Methods We searched Medline, ISI Proceedings, China National Knowledge Infrastructure, and Wanfang Data for literature published through December 31, 2013 for all the published Chinese NA case reports and extracted the clinical and laboratory findings. Results A total of 42 studies describing 66 cases were found to be eligible for inclusion. Age of symptom onset ranged from 5 to 74 years. The most common findings included hyperkinetic movements (88%), orofacial dyskinesia (80%), dystonia (67%), and dysarthria (68%), as well as caudate atrophy or enlarged lateral ventricles on neuroimaging (64%), and elevated creatine kinase (52%). Most cases were not confirmed by any specific molecular tests. Only two cases were genetically studied and diagnosed as ChAc or MLS. Discussion In view of the prevalence of NA syndromes in other countries, the number of patients in China appears to be underestimated. Chinese NA patients may benefit from the establishment of networks that offer specific diagnoses and care for rare diseases.
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Affiliation(s)
- Jia Liu
- Neurologische Klinik, Klinikum der Universität München, 81377 München, Germany
| | - Benedikt Bader
- Neurologische Klinik, Klinikum der Universität München, 81377 München, Germany
| | - Adrian Danek
- Neurologische Klinik, Klinikum der Universität München, 81377 München, Germany
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Man BL, Yuen YP, Fu YP. The first report of a Chinese family with McLeod syndrome. BMJ Case Rep 2014; 2014:bcr-2013-202785. [PMID: 24895410 DOI: 10.1136/bcr-2013-202785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report the first case of a Chinese family with McLeod syndrome (MLS). The two affected brothers show significant phenotypic heterogeneity. The index case has peripheral acanthocytosis, choreoathetosis of his feet, a slowly progressive neuropathy and myopathy, and an elevated serum creatine kinase (CK) level. His elder brother has more prominent chorea of the shoulders, epilepsy, a rapidly progressive neuropathy and normal serum CK. The diagnosis of MLS was confirmed by a genetic test which showed a hemizygous frameshift mutation in the XK gene.
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Affiliation(s)
- Bik Ling Man
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, Hong Kong
| | - Yuet Ping Yuen
- Department of Chemical Pathology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yat Pang Fu
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, Hong Kong
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A novel XK gene mutation in a Taiwanese family with McLeod syndrome. J Neurol Sci 2014; 340:221-4. [DOI: 10.1016/j.jns.2014.02.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/19/2014] [Accepted: 02/24/2014] [Indexed: 11/16/2022]
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Wiethoff S, Xiromerisiou G, Bettencourt C, Kioumi A, Tsiptsios I, Tychalas A, Evaggelia M, George K, Makris V, Hardy J, Houlden H. Novel single base-pair deletion in exon 1 of XK gene leading to McLeod syndrome with chorea, muscle wasting, peripheral neuropathy, acanthocytosis and haemolysis. J Neurol Sci 2014; 339:220-2. [PMID: 24529944 PMCID: PMC3988988 DOI: 10.1016/j.jns.2014.01.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 01/22/2014] [Accepted: 01/27/2014] [Indexed: 11/16/2022]
Abstract
We present a 70-year-old male patient of Greek origin with choreatic movements of the tongue and face, lower limb muscle weakness, peripheral neuropathy, elevated creatinephosphokinase (CPK), acanthocytosis and haemolysis in the absence of Kell RBC antigens with an additional Factor IX-deficiency. Genetic testing for mutations in the three exons of the XK gene revealed a previously unreported hemizygous single base-pair frameshift deletion at exon 1 (c.229delC, p.Leu80fs). In conclusion, we hereby describe a rare phenotype of a patient with McLeod syndrome which was discovered coincidentally during routine blood group testing and consecutively genetically confirmed.
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Affiliation(s)
- Sarah Wiethoff
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | | | - Conceição Bettencourt
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.
| | - Anna Kioumi
- Department of Haematology, Papageorgiou Hospital, Thessaloniki, Greece
| | - Iakovos Tsiptsios
- Department of Neurology, Papageorgiou Hospital, Thessaloniki, Greece
| | | | | | - Kaltsounis George
- Department of Haematology, Papageorgiou Hospital, Thessaloniki, Greece
| | - Vasileios Makris
- Orthopedic Department, Papageorgiou Hospital, Thessaloniki, Greece
| | - John Hardy
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK; MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
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