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Kamdar P, Geetha TS, Palocaren T, Kandagaddala M, Chinniah PK, Murugan S, Vedam R, Danda S. Diagnostic exome identifies a novel PRKG2 mutation in a proband with skeletal dysplasia. Clin Genet 2024; 105:453-454. [PMID: 38072398 DOI: 10.1111/cge.14465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/29/2023] [Accepted: 11/22/2023] [Indexed: 03/07/2024]
Abstract
This graphic abstract combines pedigree, dysmorphology features, radiographs, and the PRKG2 protein domain, specifically the CNB-A regulatory domain, which harbors a mutation resulting in premature protein termination.
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Affiliation(s)
- Payal Kamdar
- Clinical Genetics, Christian Medical College, Vellore, India
| | | | - Thomas Palocaren
- Paediatric Orthopaedics, Christian Medical College, Vellore, India
| | | | | | | | | | - Sumita Danda
- Clinical Genetics, Christian Medical College, Vellore, India
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Kumar M, Aaron R, Varkki SD, Danda S, Ranganathan S, Paul GR. A rare variant c.1802T>C (p. Ile601Thr) associated with severe phenotype among people with cystic fibrosis from south India, and potential genetic admixture in Réunion, France. Pediatr Pulmonol 2024. [PMID: 38501349 DOI: 10.1002/ppul.26965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Madhan Kumar
- Department of Pediatrics, Christian Medical College, Vellore, India
| | - Rekha Aaron
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sneha D Varkki
- Department of Pediatrics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, University of Melbourne, Australia
| | - Grace R Paul
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
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Yoganathan S, Whitney R, Thomas M, Danda S, Chettali AM, Prasad AN, Farhan SMK, AlSowat D, Abukhaled M, Aldhalaan H, Gowda VK, Kinhal UV, Bylappa AY, Konanki R, Lingappa L, Parchuri BM, Appendino JP, Scantlebury MH, Cunningham J, Hadjinicolaou A, El Achkar CM, Kamate M, Menon RN, Jose M, Riordan G, Kannan L, Jain V, Manokaran RK, Chau V, Donner EJ, Costain G, Minassian BA, Jain P. KCTD7-related progressive myoclonic epilepsy: Report of 42 cases and review of literature. Epilepsia 2024; 65:709-724. [PMID: 38231304 DOI: 10.1111/epi.17880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVE KCTD7-related progressive myoclonic epilepsy (PME) is a rare autosomal-recessive disorder. This study aimed to describe the clinical details and genetic variants in a large international cohort. METHODS Families with molecularly confirmed diagnoses of KCTD7-related PME were identified through international collaboration. Furthermore, a systematic review was done to identify previously reported cases. Salient demographic, epilepsy, treatment, genetic testing, electroencephalographic (EEG), and imaging-related variables were collected and summarized. RESULTS Forty-two patients (36 families) were included. The median age at first seizure was 14 months (interquartile range = 11.75-22.5). Myoclonic seizures were frequently the first seizure type noted (n = 18, 43.9%). EEG and brain magnetic resonance imaging findings were variable. Many patients exhibited delayed development with subsequent progressive regression (n = 16, 38.1%). Twenty-one cases with genetic testing available (55%) had previously reported variants in KCTD7, and 17 cases (45%) had novel variants in KCTD7 gene. Six patients died in the cohort (age range = 1.5-21 years). The systematic review identified 23 eligible studies and further identified 59 previously reported cases of KCTD7-related disorders from the literature. The phenotype for the majority of the reported cases was consistent with a PME (n = 52, 88%). Other reported phenotypes in the literature included opsoclonus myoclonus ataxia syndrome (n = 2), myoclonus dystonia (n = 2), and neuronal ceroid lipofuscinosis (n = 3). Eight published cases died over time (14%, age range = 3-18 years). SIGNIFICANCE This study cohort and systematic review consolidated the phenotypic spectrum and natural history of KCTD7-related disorders. Early onset drug-resistant epilepsy, relentless neuroregression, and severe neurological sequalae were common. Better understanding of the natural history may help future clinical trials.
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Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Robyn Whitney
- Comprehensive Pediatric Epilepsy Program, Division of Neurology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Asuri N Prasad
- Division of Pediatric Neurology and Clinical Neurosciences, Department of Pediatrics, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
| | - Sali M K Farhan
- Department of Neurology and Neurosurgery, and Department of Human Genetics, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Daad AlSowat
- Division of Pediatric Neurology, Neurosciences Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Musaad Abukhaled
- Division of Pediatric Neurology, Neurosciences Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hesham Aldhalaan
- Division of Pediatric Neurology, Neurosciences Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Vykuntaraju K Gowda
- Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
| | - Uddhava V Kinhal
- Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
| | - Arun Y Bylappa
- Department of Pediatric Neurology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
| | - Ramesh Konanki
- Department of Pediatric Neurology, Rainbow Children's Hospital, Hyderabad, Telangana, India
| | - Lokesh Lingappa
- Department of Pediatric Neurology, Rainbow Children's Hospital, Hyderabad, Telangana, India
| | | | - Juan P Appendino
- Pediatric Neurology Service, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Morris H Scantlebury
- Departments of Pediatrics and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jessie Cunningham
- Hospital Library and Archives, Learning Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Aristides Hadjinicolaou
- Division of Neurology, Department of Pediatrics, CHU (Centre Hospitalier Universitaire) Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada
| | - Christelle Moufawad El Achkar
- Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mahesh Kamate
- Department of Pediatric Neurology, Jawaharlal Nehru Medical College, KLE (Karnataka Lingayat Education) Academy of Higher Education and Research, KLE's Dr Prabhakar Kore (PK) Hospital, Belagavi, Karnataka, India
| | - Ramshekhar N Menon
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, Kerala, India
| | - Manna Jose
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, Kerala, India
| | - Gillian Riordan
- Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | | | - Vivek Jain
- Department of Pediatric Neurology, Neoclinic Children's Hospital, Jaipur, Rajasthan, India
| | - Ranjith Kumar Manokaran
- Division of Pediatric neurology, Department of Neurology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Vann Chau
- Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth J Donner
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gregory Costain
- Division of Clinical and Metabolic Genetics, Hospital for Sick Children, and Program in Genetics & Genome Biology, SickKids Research Institute, Toronto, Ontario, Canada
| | - Berge A Minassian
- Division of Neurology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Puneet Jain
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Shajil C, Sathishkumar D, Kumar S, Danda S. Homozygous CARD14 variant presenting as infantile erythroderma. BMJ Case Rep 2024; 17:e254090. [PMID: 38233005 PMCID: PMC10806972 DOI: 10.1136/bcr-2022-254090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
A wide range of inherited and acquired conditions can manifest as infantile erythroderma, among which CARD14-associated papulosquamous eruption (CAPE) is a rare cause. An infant boy presented with a psoriasiform rash that progressed to erythroderma and was unresponsive to topical steroids and cyclosporine. The early onset of the disease, its severity and resistance to conventional treatment were suggestive of a genetic cause. Genetic evaluation revealed a homozygous CARD14 variant of uncertain significance establishing the diagnosis of CAPE, and his parents were heterozygous carriers. There was only minimal improvement in the condition with supportive management and treatment with acitretin. Unfortunately, the child succumbed to sepsis and metabolic complications following a sudden worsening of skin disease. This case highlights the significance of genetic studies in diagnosing treatment-refractory cases of infantile erythroderma and emphasises the importance of early recognition of this rare condition.
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Affiliation(s)
- Chandana Shajil
- Department of Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Dharshini Sathishkumar
- Department of Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Sathish Kumar
- Pediatric Rheumatology Unit, Department of Pediatrics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Danda D, Goel R, Kabeerdoss J, Sun C, Danda S, Lincy Franklin A, Joseph G, Nath SK. Angiogenesis related genes in Takayasu Arteritis (TAK): robust association with Tag SNPs of IL-18 and FGF-2 in a South Asian Cohort. J Hum Genet 2024; 69:13-18. [PMID: 37848720 DOI: 10.1038/s10038-023-01198-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
We performed genetic association study for genes encoding angiogenic and angiostatic proteins in patients with Takayasu arteritis (TAK). A total of 96 SNPs involving 60 genes were studied. Genotyping was performed in Fluidigm 96.96 Dynamic Array chip. All statistical analysis for SNP evaluation was performed using PLINK software. Initial analyses revealed five SNPs from three genes [IL-18 (encodes Interleukin-18), FGF2 (encodes Fibroblast Growth Factor-2), and ANGPT1 (encodes Angiopoietin-1)] as significantly different between controls and cases (uncorrected p < 0.05). After permutation-based analysis, two tag SNPs on the promoter region of IL-18 (rs187238 and rs1946518) and one 3'UTR tag SNP (rs1476217) of FGF2 were significantly associated with susceptibility to TAK, with p and OR (95% CI) of 0.0006 and 1.64 (1.25-2.17), 0.03 and 1.28 (1.02-1.64) & 0.016 and 1.33 (1.05-1.67), respectively; while, the two tag SNPs of ANGPT1 gene (rs6469101 and rs16875900) showed a trend (p = 0.055 & p = 0.051, respectively after permutation based correction). There is robust linkage disequilibrium between the two tag SNPs of IL-18 gene as validated by 1000 genome data of South Asian population; the eQTL effects of these tag SNPs of IL-18 and FGF2 genes on adjacent genes further suggest that these tag SNPs act as genetic risks for development of TAK in South Asians, with possible functional implications towards future biomarker development. Genotype phenotype study by genetic model-based analysis also revealed associations between genotype subsets and clinical features like fever, visual loss, left subclavian and coronary artery involvement in our TAK patients.
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Affiliation(s)
- Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India.
| | - Ruchika Goel
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jayakanthan Kabeerdoss
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
- Department of Paediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Celi Sun
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anisea Lincy Franklin
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - George Joseph
- Department of Cardiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Swapan K Nath
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
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Nagarajan B, Gowda VK, Yoganathan S, Sharawat IK, Srivastava K, Vora N, Badheka R, Danda S, Kalane U, Kaur A, Madaan P, Mehta S, Negi S, Panda PK, Rajadhyaksha S, Saini AG, Saini L, Shah S, Srinivasan VM, Suthar R, Thomas M, Vyas S, Sankhyan N, Sahu JK. Landscape of genetic infantile epileptic spasms syndrome-A multicenter cohort of 124 children from India. Epilepsia Open 2023; 8:1383-1404. [PMID: 37583270 PMCID: PMC10690684 DOI: 10.1002/epi4.12811] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Abstract
OBJECTIVE Literature on the genotypic spectrum of Infantile Epileptic Spasms Syndrome (IESS) in children is scarce in developing countries. This multicentre collaboration evaluated the genotypic and phenotypic landscape of genetic IESS in Indian children. METHODS Between January 2021 and June 2022, this cross-sectional study was conducted at six centers in India. Children with genetically confirmed IESS, without definite structural-genetic and structural-metabolic etiology, were recruited and underwent detailed in-person assessment for phenotypic characterization. The multicentric data on the genotypic and phenotypic characteristics of genetic IESS were collated and analyzed. RESULTS Of 124 probands (60% boys, history of consanguinity in 15%) with genetic IESS, 105 had single gene disorders (104 nuclear and one mitochondrial), including one with concurrent triple repeat disorder (fragile X syndrome), and 19 had chromosomal disorders. Of 105 single gene disorders, 51 individual genes (92 variants including 25 novel) were identified. Nearly 85% of children with monogenic nuclear disorders had autosomal inheritance (dominant-55.2%, recessive-14.2%), while the rest had X-linked inheritance. Underlying chromosomal disorders included trisomy 21 (n = 14), Xq28 duplication (n = 2), and others (n = 3). Trisomy 21 (n = 14), ALDH7A1 (n = 10), SCN2A (n = 7), CDKL5 (n = 6), ALG13 (n = 5), KCNQ2 (n = 4), STXBP1 (n = 4), SCN1A (n = 4), NTRK2 (n = 4), and WWOX (n = 4) were the dominant single gene causes of genetic IESS. The median age at the onset of epileptic spasms (ES) and establishment of genetic diagnosis was 5 and 12 months, respectively. Pre-existing developmental delay (94.3%), early age at onset of ES (<6 months; 86.2%), central hypotonia (81.4%), facial dysmorphism (70.1%), microcephaly (77.4%), movement disorders (45.9%) and autistic features (42.7%) were remarkable clinical findings. Seizures other than epileptic spasms were observed in 83 children (66.9%). Pre-existing epilepsy syndrome was identified in 21 (16.9%). Nearly 60% had an initial response to hormonal therapy. SIGNIFICANCE Our study highlights a heterogenous genetic landscape and phenotypic pleiotropy in children with genetic IESS.
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Affiliation(s)
- Balamurugan Nagarajan
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Vykuntaraju K. Gowda
- Department of Pediatric NeurologyIndira Gandhi Institute of Child HealthBengaluruIndia
| | - Sangeetha Yoganathan
- Pediatric Neurology Unit, Department of Neurological SciencesChristian Medical CollegeVelloreIndia
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of PediatricsAll India Institute of Medical SciencesRishikeshIndia
| | - Kavita Srivastava
- Pediatric Neurology Unit, Department of PediatricsBharati Vidyapeeth Deemed University Medical CollegePuneIndia
| | - Nitish Vora
- Royal Institute of Child NeurosciencesAhmedabadIndia
| | - Rahul Badheka
- Royal Institute of Child NeurosciencesAhmedabadIndia
| | - Sumita Danda
- Department of Medical GeneticsChristian Medical CollegeVelloreIndia
| | - Umesh Kalane
- Pediatric Neurology Division, Department of PediatricsAll India Institute of Medical SciencesRishikeshIndia
| | - Anupriya Kaur
- Genetics and Metabolic Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Priyanka Madaan
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
- Department of Pediatric NeurologyAmrita Institute of Medical SciencesFaridabadIndia
| | - Sanjiv Mehta
- Royal Institute of Child NeurosciencesAhmedabadIndia
| | - Sandeep Negi
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Prateek Kumar Panda
- Pediatric Neurology Division, Department of PediatricsAll India Institute of Medical SciencesRishikeshIndia
| | - Surekha Rajadhyaksha
- Pediatric Neurology Unit, Department of PediatricsBharati Vidyapeeth Deemed University Medical CollegePuneIndia
| | - Arushi Gahlot Saini
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
- Department of PediatricsAll India Institute of Medical SciencesJodhpurIndia
| | | | | | - Renu Suthar
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Maya Thomas
- Pediatric Neurology Unit, Department of Neurological SciencesChristian Medical CollegeVelloreIndia
| | - Sameer Vyas
- Division of Neuroimaging and Interventional Neuroradiology, Department of Radiodiagnosis and ImagingPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Naveen Sankhyan
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Jitendra Kumar Sahu
- Pediatric Neurology Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarhIndia
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Muthusamy K, Sivadasan A, Dixon L, Sudhakar S, Thomas M, Danda S, Wszolek ZK, Wierenga K, Dhamija R, Gavrilova R. Adult-onset leukodystrophies: a practical guide, recent treatment updates, and future directions. Front Neurol 2023; 14:1219324. [PMID: 37564735 PMCID: PMC10410460 DOI: 10.3389/fneur.2023.1219324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/19/2023] [Indexed: 08/12/2023] Open
Abstract
Adult-onset leukodystrophies though individually rare are not uncommon. This group includes several disorders with isolated adult presentations, as well as several childhood leukodystrophies with attenuated phenotypes that present at a later age. Misdiagnoses often occur due to the clinical and radiological overlap with common acquired disorders such as infectious, immune, inflammatory, vascular, metabolic, and toxic etiologies. Increased prevalence of non-specific white matter changes in adult population poses challenges during diagnostic considerations. Clinico-radiological spectrum and molecular landscape of adult-onset leukodystrophies have not been completely elucidated at this time. Diagnostic approach is less well-standardized when compared to the childhood counterpart. Absence of family history and reduced penetrance in certain disorders frequently create a dilemma. Comprehensive evaluation and molecular confirmation when available helps in prognostication, early initiation of treatment in certain disorders, enrollment in clinical trials, and provides valuable information for the family for reproductive counseling. In this review article, we aimed to formulate an approach to adult-onset leukodystrophies that will be useful in routine practice, discuss common adult-onset leukodystrophies with usual and unusual presentations, neuroimaging findings, recent advances in treatment, acquired mimics, and provide an algorithm for comprehensive clinical, radiological, and genetic evaluation that will facilitate early diagnosis and consider active treatment options when available. A high index of suspicion, awareness of the clinico-radiological presentations, and comprehensive genetic evaluation are paramount because treatment options are available for several disorders when diagnosed early in the disease course.
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Affiliation(s)
- Karthik Muthusamy
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, United States
| | - Ajith Sivadasan
- Department of Neurological Sciences, Christian Medical College, Tamil Nadu, Vellore, India
| | - Luke Dixon
- Department of Radiology, Imperial College, NHS Trust, London, United Kingdom
| | - Sniya Sudhakar
- Department of Radiology, Great Ormond Street Hospital, London, United Kingdom
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Tamil Nadu, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Klaas Wierenga
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, United States
| | - Radhika Dhamija
- Department of Clinical Genomics and Neurology, Mayo Clinic, Phoenix, AZ, United States
| | - Ralitza Gavrilova
- Department of Clinical Genomics and Neurology, Mayo Clinic, Rochester, MN, United States
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Yoganathan S, Bhasin H, Garg D, Malik P, Saini AG, Chandran M, Korula S, Arunachal G, Danda S, Thomas M, Oommen SP, Sharma S. Childhood Neurological Disorders With Hyperhomocystinemia: A Case-Based Review. Pediatr Neurol 2023; 146:26-30. [PMID: 37413720 DOI: 10.1016/j.pediatrneurol.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/17/2023] [Accepted: 06/07/2023] [Indexed: 07/08/2023]
Abstract
Hyperhomocysteinemia is a rare neurometabolic syndrome with diverse manifestations in the pediatric age group, thereby posing a diagnostic challenge. Biochemical testing is imperative to guide plan of evaluation, which may include appropriate genetic testing, in inherited disorders. Through this case-based approach, we demonstrate the heterogeneity of clinical presentation, biochemical and genetic evaluation, and treatment strategies that may reverse this condition among children.
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Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Himani Bhasin
- Department of Pediatrics, University College of Medical Sciences, New Delhi, India
| | - Divyani Garg
- Department of Neurosciences, Neo Hospital, Noida, India
| | - Prateek Malik
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Arushi Gahlot Saini
- Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Mahalakshmi Chandran
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sophy Korula
- Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gautham Arunachal
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Samuel Philip Oommen
- Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suvasini Sharma
- Department of Pediatrics (Neurology Division), Lady Hardinge Medical College, New Delhi, India.
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Selina A, Kandagaddala M, Kumar V, Abraham SSC, Danda S, Madhuri V. SERPINF1 gene variants causing late-onset progressive deforming osteogenesis imperfecta - A study of 18 patients from India. Bone Rep 2023; 18:101690. [PMID: 37425194 PMCID: PMC10323215 DOI: 10.1016/j.bonr.2023.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/09/2023] [Accepted: 05/24/2023] [Indexed: 07/11/2023] Open
Abstract
SERPINF1 gene variants lead to a severe type of osteogenesis imperfecta (OI) attributed to defects in the matrix mineralization. We present 18 patients with SERPINF1 gene variants leading to severe progressive deforming OI, the largest series in the world to date. These patients were normal at birth and had the first fracture between 2 months to 9 years; progression of deformities was seen in 12 adolescents who became nonambulatory. Radiologically, compression fractures with kyphoscoliosis, protrusio acetabuli, and lytic lesions in the metaphysis and pelvis were seen in older children with classical popcorn appearance in the distal femoral metaphysis in three. By exome sequencing and targeted sequencing, we identified ten variants. One was unreported and novel; three other novel variants in this series were reported earlier. The recurrent deletion inframe mutation p.phe277del was found in 5 patients from three families. Alkaline phosphatase was elevated in all children on the first visit. Bone mineral density was low in all patients and showed improvement at two years in seven children on regular pamidronate therapy. For others, the 2 year BMD data were not available. The Z scores for four of the seven children showed worsening at the 2-year follow-up.
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Joshi SP, Thomas M, Yoganathan S, Danda S, Chandran M, Jasper A. Clinico-Etiological Spectrum and Functional Outcomes of Children with Pre-Status Dystonicus and Status Dystonicus (SD): A Descriptive Study. Ann Indian Acad Neurol 2023; 26:268-274. [PMID: 37538432 PMCID: PMC10394458 DOI: 10.4103/aian.aian_660_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 08/05/2023] Open
Abstract
Background Status dystonicus (SD) is a life-threatening movement disorder emergency characterized by increasingly frequent and severe episodes of generalized dystonia, requiring urgent hospital admission. The diverse clinico-etiological spectrum, high risk of recurrence, and residual disabilities complicate functional outcomes. Aim We aim to describe the clinico-etiological spectrum, radiology, therapeutic options, and follow-up of patients with pre-status dystonicus (pre-SD) and SD. Methodology A cross-sectional retrospective study was carried out in a tertiary care referral center. The clinical, laboratory, and radiology data of all patients aged less than 18 years with pre-SD and SD from January 2010 to December 2020 were collected. The Dystonia Severity Assessment Plan (DSAP) scale for grading severity and the modified Rankin Scale (mRS) for assessing outcome were used at the last follow-up visit. Results Twenty-eight patients (male:female: 2.1:1) experiencing 33 episodes of acute dystonia exacerbation were identified. The median age at the onset of dystonia and SD presentation was 8.71 (range: 0.25-15.75) and 9.12 (range: 1-16.75) years, respectively. Four patients experienced more than one episode of SD. The etiological spectrum of SD includes metabolic (Wilson's disease-13, L-aromatic amino acid decarboxylase deficiency-one, and Gaucher's disease-one), genetic (neurodegeneration with brain iron accumulation-three and KMT2B and THAP 1 gene-related-one each), structural-three, post-encephalitic sequelae (PES)-four, and immune-mediated (anti-NMDA receptor encephalitis-one). Five patients had pre-SD (DSAP grade 3), and 23 patients had established SD (DSAP grade 4-17 and DSAP grade 5-six). The Rapid escalation of chelation therapy precipitated SD in 11 patients with Wilson's disease. Febrile illness or pneumonia precipitated SD in nine patients. Twenty-three episodes of SD required midazolam infusion in addition to anti-dystonic medications. The median duration of hospital stay was 10 days (range: 3-29). Twenty-three patients had resolution of SD but residual dystonia persisted, while two patients had no residual dystonia at follow-up. Three patients succumbed owing to refractory SD and its complications. Conclusion Early identification of triggers, etiology, and appropriate management are essential to calm the dystonic storm.
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Affiliation(s)
- Shridhar P. Joshi
- Paediatric Neurology Unit, Departments of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Paediatric Neurology Unit, Departments of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sangeetha Yoganathan
- Paediatric Neurology Unit, Departments of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mahalakshmi Chandran
- Neurochemistry Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anitha Jasper
- Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
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Das S, Thomas M, Yoganathan S, Muthusamy K, Barney AM, A SSC, Dutta AK, A R, Mohan S, Danda S. Exploration of clinical and genetic findings in Ataxia-Telangiectasia (AT) patients from the Indian subcontinent. Eur J Med Genet 2023; 66:104766. [PMID: 37075885 DOI: 10.1016/j.ejmg.2023.104766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/12/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Ataxia-Telangiectasia (AT) is a rare autosomal recessive neurodegenerative disorder. It is caused by mutations in the Ataxia-Telangiectasia mutated (ATM) gene, which codes for protein ATM serine/threonine kinase. OBJECTIVE We aim to describe the clinical and radiological findings in children and adolescents of 20 molecularly confirmed cases of AT. We aim to correlate these findings with the genotype identified among them. METHODS This retrospective study included 20 patients diagnosed clinically and genetically with AT over 10 years. The clinical, radiological and laboratory data were extracted from the hospital's electronic medical records. Molecular testing was done using next generation sequencing and Sanger sequencing. In silico predictions were performed for the variants identified by applying Cryp-Skip, Splice site prediction by Neural Network, Mutation Taster and Hope prediction tool. RESULTS Consanguinity was documented in nearly half of the patients. Telangiectasia was absent in 10%. Microcephaly was seen in 40% cases. The incidence of malignancy in our study population was low. Molecular testing done in the 18 families (20 patients) identified 23 variants of which ten were novel. Biallelic homozygous variants were noted in 13 families and compound heterozygous in 5 families. Out of the 13 families who were homozygous, 8 families (61.5%) (9 patients) have history of consanguinity. In silico prediction of novel missense variants, NM_000051.4 (ATM_v201): c.2702T > C showed disruption of the α-helix of ATM protein and NM_000051.4 (ATM_v201): c.6679C > G is expected to disturb the rigidity of protein structure in the FAT domain. The four novel splice site variants and two intronic variants result in exon skipping as predicted by Cryp-Skip. CONCLUSIONS AT should be confirmed by molecular testing in young-onset cerebellar ataxia, even without telangiectasia. Awareness of this rare disease will facilitate study of larger cohorts from Indian population to characterize variants and determine its prevalence in this population.
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Affiliation(s)
- Sweta Das
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India; Department of Biochemistry and Medical Genetics, Xavier University School of Medicine, Aruba, the Netherlands.
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India
| | - Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India
| | - Karthik Muthusamy
- Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India; Department of Clinical Genomics at Mayo Clinic, Jacksonville, FL, USA
| | - Anitha M Barney
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | | | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Rekha A
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Sony Mohan
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
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Pranav Chand R, Vinit W, Vaidya V, Iyer AS, Shelke M, Aggarwal S, Magar S, Danda S, Moirangthem A, Phadke SR, Goyal M, Ranganath P, Mistri M, Shah P, Shah N, Kotecha UH. Proband only exome sequencing in 403 Indian children with neurodevelopmental disorders: Diagnostic yield, utility and challenges in a resource-limited setting. Eur J Med Genet 2023; 66:104730. [PMID: 36801247 DOI: 10.1016/j.ejmg.2023.104730] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
Whole exome sequencing is recommended as the first tier test for neurodevelopmental disorders (NDDs) with trio being an ideal option for the detection of de novo variants. Cost constraints have led to adoption of sequential testing i.e. proband-only whole exome followed by targeted testing of parents. The reported diagnostic yield for proband exome approach ranges between 31 and 53%. Typically, these study designs have aptly incorporated targeted parental segregation before concluding a genetic diagnosis to be confirmed. The reported estimates however do not accurately reflect the yield of proband only standalone whole -exome, a question commonly posed to the referring clinician in self pay medical systems like India. To assess the utility of standalone proband exome (without follow up targeted parental testing), we retrospectively evaluated 403 cases of neurodevelopmental disorders referred for proband-only whole exome sequencing at Neuberg Centre for Genomic Medicine (NCGM), Ahmedabad during the period of January 2019 and December 2021. A diagnosis was considered confirmed only upon the detection of Pathogenic/Likely Pathogenic variants in concordance with patient's phenotype as well as established inheritance pattern. Targeted parental/familial segregation analysis was recommended as a follow up test where applicable. The diagnostic yield of the proband-only standalone whole exome was 31.5%. Only 20 families submitted samples for follow up targeted testing, and a genetic diagnosis was confirmed in twelve cases increasing the yield to 34.5%. To understand factors leading to poor uptake of sequential parental testing, we focused on cases where an ultra-rare variant was detected in hitherto described de novo dominant neurodevelopmental disorder. A total of 40 novel variants in genes associated with de novo autosomal dominant disorders could not be reclassified as parental segregation was denied. Semi-structured telephonic interviews were conducted upon informed consent to comprehend reasons for denial. Major factors influencing decision making included lack of definitive cure in the detected disorders; especially when couples not planning further conception and financial constraints to fund further targeted testing. Our study thus depicts the utility and challenges of proband-only exome approach and highlights the need for larger studies to understand factors influencing decision making in sequential testing.
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Affiliation(s)
| | - Wankhede Vinit
- Kids Neuro Clinic and Child Rehabilitation Center, Nagpur, Maharashtra, India
| | - Varsha Vaidya
- Kpond Children Super Specialty Hospital, Aurangabad, Maharashtra, India
| | | | - Madhavi Shelke
- Integrated Centre for Child Neurodevelopment, Aurangabad, Maharashtra, India
| | | | - Suvarna Magar
- MGM Medical College and Hospitals, Aurangabad, India
| | - Sumita Danda
- Christian Medical College and Hospital, Vellore, India
| | - Amita Moirangthem
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | - Mehul Mistri
- Neuberg Centre for Genomic Medicine, Ahmedabad, 380059, Gujarat, India
| | - Parth Shah
- Neuberg Centre for Genomic Medicine, Ahmedabad, 380059, Gujarat, India
| | - Nidhi Shah
- Neuberg Centre for Genomic Medicine, Ahmedabad, 380059, Gujarat, India
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Shajan AM, Kumar M, Navaneethan P, Danda S, Beck MM. An Unusual Case of BSND Gene–Related (Type IV) Bartter Syndrome Presenting as Antenatal Bartter Syndrome: A Case Report and Review of Literature. Maternal Fetal Med 2023. [DOI: 10.1097/fm9.0000000000000182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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14
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Kotambail A, Selvam P, Muthusamy K, Thomas M, Sudhakar SV, Ghati C, Danda S, Arunachal G. Clustering of Juvenile Canavan disease in an Indian community due to population bottleneck and isolation: genomic signatures of a founder event. Eur J Hum Genet 2023; 31:73-80. [PMID: 36202930 PMCID: PMC9823096 DOI: 10.1038/s41431-022-01198-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/10/2022] [Accepted: 09/15/2022] [Indexed: 02/08/2023] Open
Abstract
Mild/juvenile Canavan disease (M/JCD) is less frequently reported in the literature and little is known about its pathogenetic mechanisms. We report a comprehensive investigation into the pathogenetic mechanism of a novel NM_000049.4(ASPA):c.526G>A variant in two families. The families belong to Telugu Devanga Chettiar community (TDC) from southern India. TDC has a complex history of migration from their historical origin centuries ago with high endogamy. TDC probably has the highest clustering M/JCD recorded historically (around 24 cases). The pathogenic variant was shown to cause non-classical splicing defect resulting in two different transcripts. The splicing aberration, a loss of function mechanism coupled with a milder missense effect can explain the milder phenotype compared to the infantile-onset CD. The high clustering of an extremely rare form of neurodegenerative disorder with reduced fitness, led us to speculate the possibility of a founder event. Genotyping array of TDC and multiple distinct populations of Indian origin for several population genetic parameters was performed. It yielded robust signatures of a founder event in TDC, such as a high fixation index, increased runs of homozygosity and identity-by-descent in the absence of consanguinity; a large haplotype with high linkage disequilibrium among markers comprising the pathogenic variant; a robust population structure; mutation dating, estimating the age of the potential founder of TDC at around 375 years; possibly a high carrier rate in TDC. This study has not only focused its attention on natural history and pathogenetics but also paves way for carrier screening programs in TDC and future therapeutic studies.
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Affiliation(s)
- Ananthapadmanabha Kotambail
- Department of Human Genetics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pavalan Selvam
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Karthik Muthusamy
- Paediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Paediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Sniya Valsa Sudhakar
- Department of Radiodiagnosis, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Chetan Ghati
- Department of Human Genetics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Gautham Arunachal
- Department of Human Genetics, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India.
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Aaron R, Beck MM, Arunachal G, Aleyamma TK, Sebastian A, Chandy RG, Thomas A, Danda S. NLRP7 Mutation in Recurrent Non-familial Molar Pregnancies: A Case Series. Indian J Gynecol Oncolog 2022. [DOI: 10.1007/s40944-022-00661-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Malik P, Yoganathan S, Danda S, Thomas M. Unusual Magnetic Resonance Imaging Findings in 3-Hydroxy-3-Methylglutaryl-Coenzyme A Lyase Deficiency. Neuropediatrics 2022; 53:445-447. [PMID: 35193149 DOI: 10.1055/a-1779-4234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Prateek Malik
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sangeetha Yoganathan
- Department of Pediatric Neurology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Neurology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Department of Pediatric Neurology, Christian Medical College, Vellore, Tamil Nadu, India
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17
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Beck MM, Thomas S, Sowmya S, Goel A, Danda S. Successful Outcome of Pregnancy in Niemann-Pick Disease Type B: A Case Report and Review of Literature. J Obstet Gynaecol India 2022; 72:399-402. [PMID: 36457455 PMCID: PMC9701292 DOI: 10.1007/s13224-022-01686-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
Niemann-Pick (NPD) is a rare autosomal recessive disease, caused by deficiency of acid sphingomyelinase enzyme leading to accumulation of lipids mainly in the reticuloendothelial system and lungs. We describe the case of a 29-year-old primigravida, recently diagnosed with NPD type B. At initial evaluation, her platelets were normal, liver enzymes slightly elevated and splenomegaly on scan. Pregnancy care was by a multidisciplinary team which routinely monitored her liver and pulmonary functions along with platelets. Labor was induced at 37 + 1 weeks of gestation because of fetal growth restriction. She underwent an cesarean section for failed induction and delivered a healthy male baby. Conclusion: Successful outcomes in such pregnancies depend upon close monitoring by a multidisciplinary team.
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Affiliation(s)
- Manisha Madhai Beck
- Department of Obstetrics and Gynaecology, Unit IV, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Susanna Thomas
- Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - S. Sowmya
- Department of Obstetric Medicine, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Ashish Goel
- Department of Hepatology and Gastroenterology, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu 632004 India
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18
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Barney AM, Danda S, Cherian AG, Aronraj J, Jayaprakash L, Abraham VJ, Christudass CS, Marcus TA. Association of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms with vitamin B12 deficiency and adverse perinatal outcomes among pregnant women of rural South India - a cross sectional longitudinal study. J Perinat Med 2022; 50:1230-1238. [PMID: 35822733 DOI: 10.1515/jpm-2022-0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/11/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine the occurrence of MTHFR gene polymorphisms and to study their association with vitamin B12 deficiency and adverse perinatal outcomes among a cohort of pregnant women from Kaniyambadi block, Tamil Nadu. METHODS 120 consecutive pregnant women who were ≤20 weeks of gestational age from the 82 villages of Kaniyambadi block were recruited. Genomic DNA was isolated from the peripheral blood. PCR amplification was done followed by Sangers sequencing. Maternal and neonatal outcomes were extracted. Data was entered and analysed. RESULTS Our study found the occurrence of c.1298A>C variant in homozygous state in 14.2% and c.677C>T heterozygous state in 15%. Sanger sequencing of exon 7 identified another pathogenic variant c.1262G>T in heterozygous state in two of them. Both the mothers who harboured that variant had preterm delivery and one of them gave birth to a low-birth-weight neonate. In the entire cohort, 5% of the mothers had abortion, 4.2% of them had preterm delivery and 8.8% of the neonates had low birth weight. Presence of c.1298A>C or c.677C>T variants were associated with vitamin B12 deficiency [Pearson Chi squared value (χ2)=7.9 and 7.6 respectively; p=0.02]. Heterozygous pathogenic variant c.1262G>T was associated with both adverse maternal [χ2=11.5; p=0.001] and neonatal [χ2=18.3; p=0.009] outcomes. CONCLUSIONS MTHFR gene polymorphisms could be associated with several adverse perinatal outcomes and vitamin B12 deficiency. Further larger studies are needed to prove the pathogenicity of c.1262G>T variant on pregnancy.
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Affiliation(s)
- Anitha M Barney
- Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anne G Cherian
- Department of Obstetrics' and Gynaecology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jency Aronraj
- Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lavanya Jayaprakash
- Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinod J Abraham
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Tobey A Marcus
- Department of Obstetrics' and Gynaecology, Christian Medical College, Vellore, Tamil Nadu, India
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Bharathi NK, Thomas MM, Yoganathan S, Chandran M, Aaron R, Danda S. Phenotypic Pleiotropy in Arginase Deficiency: A Single Center Cohort. Ann Indian Acad Neurol 2022; 25:1104-1108. [PMID: 36911443 PMCID: PMC9996474 DOI: 10.4103/aian.aian_612_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 11/21/2022] Open
Abstract
Background Arginase deficiency is considered a masquerader of diplegic cerebral palsy. The rarity of hyperammonemic crisis and the slowly progressive course has made it a unique entity among the urea cycle defects. Objectives The aim of our study is to describe the varied phenotypic spectrum of children with arginase deficiency. Methodology This retrospective study included children and adolescents aged <18 years with a biochemical or genetic diagnosis of arginase deficiency from May 2011 to May 2022. Data were collected from the hospital's electronic database. The clinical presentation, laboratory parameters at baseline and during metabolic decompensation, neuroimaging, electroencephalography findings, and molecular studies were analyzed. Results About 11 children from nine families with biochemically or genetically proven arginase deficiency were analyzed. The male: female ratio was 2.7:1. Consanguineous parentage was observed in all children. The median age at presentation was 36 months (Range: 5 months-18 years). All children with onset of symptoms in early childhood had a predominant delay in motor milestones of varying severity. Metabolic decompensation with encephalopathy occurred in all except two children (n = 9, 81.8%). Pyramidal signs were present in all patients and additional extrapyramidal signs in two children. Positive family history was present in four probands. Seizures occurred in all children. Epilepsy with electrical status in slow wave sleep and West syndrome was noted in three children. All children had elevated ammonia and arginine at the time of metabolic crisis. The spectrum of neuroimaging findings includes periventricular, subcortical, and deep white matter signal changes and diffusion restriction. The mean duration of follow-up was 38.6 ± 34.08 months. All patients were managed with an arginine-restricted diet and sodium benzoate with or without ornithine supplementation. Conclusion Spastic diparesis, recurrent encephalopathy, presence of family history, and elevated serum arginine levels must alert the clinician to suspect arginase deficiency. Atypical presentations in our cohort include frequent metabolic crises and epileptic encephalopathy. Early identification and management will ensure a better neurodevelopmental outcome.
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Affiliation(s)
- Narmadham K. Bharathi
- Paediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Mary Thomas
- Paediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sangeetha Yoganathan
- Paediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mahalakshmi Chandran
- Neurochemistry Laboratory, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rekha Aaron
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
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Kumar M, Yoganathan S, Todari S, Suresh P, Chandran M, Danda S, Mathew LG, Koshy B, Thomas M. Hereditary Folate Malabsorption: A Rare Treatable Disorder with Hematological and Neurological Manifestations. Ann Indian Acad Neurol 2022; 25:1238-1241. [PMID: 36911455 PMCID: PMC9996535 DOI: 10.4103/aian.aian_1118_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 03/14/2023] Open
Affiliation(s)
- Madhan Kumar
- Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sangeetha Yoganathan
- Pediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Siddarth Todari
- Pediatric Hematology Oncology Unit, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Parvathy Suresh
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mahalakshmi Chandran
- Pediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Leni Grace Mathew
- Pediatric Hematology Oncology Unit, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Beena Koshy
- Developmental Pediatrics Unit, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Pediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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A R, Chandran S, Ghatak AR, Thomas N, Danda S. Novel Mutations in CRLF1: Case Reports with Crisponi Syndrome. Indian J Pediatr 2022; 89:1148-1150. [PMID: 35984556 DOI: 10.1007/s12098-022-04263-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/24/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Abstract
Crisponi syndrome (CS) is a rare autosomal recessive syndrome, characterized by episodic facial muscle contraction with trismus, abundant salivation along with intermittent hyperthermia, feeding difficulties, characteristic facial dysmorphism, and camptodactyly. Here the authors report two South Indian neonates with confirmed diagnosis of Crisponi syndrome, caused by novel pathogenic variants in cytokine receptor-like factor 1 (CRLF1) gene. The classical clinical findings observed in the present cases were feeding difficulty, facial dysmorphism, tachypnea, contractures, camptodactyly, opisthotonus, hyperthermia, poor growth, and facial muscle contraction resembling probable tetanus. The patients with variants identified in the signal peptide domain had typical spasms from day one of life as compared to the variants in other domains who had later onset at neonatal period. The authors provide a review of the cases described, so far, from India highlighting that no common variants attribute to this rare syndrome. Recognizing this syndrome is crucial to differentiate it from infective conditions and for effective genetic counseling. Though tetanus is almost eradicated in developing countries, genetic causes should be suspected in new cases.
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Affiliation(s)
- Rekha A
- Department of Clinical Genetics, Christian Medical College, 632002, Vellore, Tamil Nadu, India
| | - Shanu Chandran
- Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Arpita Roy Ghatak
- Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Niranjan Thomas
- Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, 632002, Vellore, Tamil Nadu, India.
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Garg D, Yoganathan S, Shamim U, Mankad K, Gulati P, Bonifati V, Botre A, Kalane U, Saini AG, Sankhyan N, Srivastava K, Gowda VK, Juneja M, Kamate M, Padmanabha H, Panigrahi D, Pachapure S, Udani V, Kumar A, Pandey S, Thomas M, Danda S, Iqbalahmed SA, Subramanian A, Pemde H, Singh V, Faruq M, Sharma S. Clinical Profile and Treatment Outcomes of Hypermanganesemia with Dystonia 1 and 2 among 27 Indian Children. Mov Disord Clin Pract 2022; 9:886-899. [PMID: 36247901 PMCID: PMC9547147 DOI: 10.1002/mdc3.13516] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 05/23/2022] [Accepted: 06/06/2022] [Indexed: 11/12/2022] Open
Abstract
Background Hypermanganesemia with dystonia 1 and 2 (HMNDYT1 and 2) are rare, inherited disorders of manganese transport. Objectives We aimed to describe clinical, laboratory features, and outcomes among children with HMNDYT. Methods We conducted a retrospective multicenter study involving tertiary centers across India. We enrolled children between 1 month to 18 years of age with genetically confirmed/clinically probable HMNDYT. Clinical, laboratory profile, genetic testing, treatment details, and outcomes scored by treating physicians on a Likert scale were recorded. Results We enrolled 27 children (19 girls). Fourteen harbored SLC30A10 mutations; nine had SLC39A14 mutations. The SLC39A14 cohort had lower median age at onset (1.3 [interquartile range (IQR), 0.7-5.5] years) versus SLC30A10 cohort (2.0 [IQR, 1.5-5.1] years). The most frequent neurological features were dystonia (100%; n = 27), gait abnormality (77.7%; n = 21), falls (66.7%; n = 18), and parkinsonism (59.3%; n = 16). Median serum manganese (Mn) levels among SLC39A14 (44.9 [IQR, 27.3-147.7] mcg/L) cohort were higher than SLC30A10 (29.4 [17.1-42.0] mcg/L); median hemoglobin was higher in SLC30A10 (16.3 [IQR, 15.2-17.5] g/dL) versus SLC39A14 cohort (12.5 [8.8-13.2] g/dL). Hepatic involvement and polycythaemia were observed exclusively in SLC30A10 variants. A total of 26/27 children underwent chelation with disodium calcium edetate. Nine demonstrated some improvement, three stabilized, two had marked improvement, and one had normalization. Children with SLC39A14 mutations had poorer response. Two children died and nine were lost to follow-up. Conclusions We found female predominance. Children with SLC39A14 mutations presented at younger age and responded less favorably to chelation compared to SLC30A10 mutations. There is emerging need to better define management strategies, especially in low resource settings.
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Affiliation(s)
- Divyani Garg
- Department of NeurologyLady Hardinge Medical College and Associated HospitalsNew DelhiIndia
| | | | - Uzma Shamim
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative BiologyNew DelhiIndia
| | - Kshitij Mankad
- Department of RadiologyGreat Ormond Street Hospital NHS Foundation TrustLondonUnited Kingdom
| | - Parveen Gulati
- Department of RadiodiagnosisDoctor Gulati Imaging InstituteNew DelhiIndia
| | - Vincenzo Bonifati
- Department of Clinical Genetics, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | | | - Umesh Kalane
- Department of PediatricsDeenanath Mangeshkar HospitalPuneIndia
| | - Arushi Gahlot Saini
- Department of Pediatrics, Advanced Pediatric CenterPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Naveen Sankhyan
- Department of Pediatrics, Advanced Pediatric CenterPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Kavita Srivastava
- Department of PediatricsBharati Vidyapeeth Deemed University Medical CollegePuneIndia
| | - Vykuntaraju K. Gowda
- Division of Pediatric NeurologyIndira Gandhi Institute of Child HealthBangaloreIndia
| | - Monica Juneja
- Department of Pediatrics, Lok Nayak Hospital, Maulana Azad Medical CollegeUniversity of DelhiNew DelhiIndia
| | - Mahesh Kamate
- Child Development and Pediatric Neurology Division, Department of PediatricsKAHER's J N Medical CollegeBelgaumIndia
| | - Hansashree Padmanabha
- Department of NeurologyNational Institute of Mental Health and NeurosciencesBangaloreIndia
| | | | - Shaila Pachapure
- Department of Pediatrics, KAHER's J N Medical CollegeBelgaumIndia
| | - Vrajesh Udani
- Department of Child NeurologyPD Hinduja Hospital and Medical Research CentreMumbaiIndia
| | - Atin Kumar
- Department of RadiodiagnosisAll India Institute of Medical SciencesNew DelhiIndia
| | - Sanjay Pandey
- Department of NeurologyGovind Ballabh Pant Institute of Postgraduate medical education and researchNew DelhiIndia
| | - Maya Thomas
- Department of Neurological SciencesChristian Medical CollegeVelloreIndia
| | - Sumita Danda
- Department of Clinical GeneticsChristian Medical CollegeVelloreIndia
| | | | | | - Harish Pemde
- Department of Pediatrics (Neurology division)Lady Hardinge Medical College and Associated HospitalsNew DelhiIndia
| | - Varinder Singh
- Department of Pediatrics (Neurology division)Lady Hardinge Medical College and Associated HospitalsNew DelhiIndia
| | - Mohammed Faruq
- Genomics and Molecular MedicineCSIR‐Institute of Genomics and Integrative BiologyNew DelhiIndia
| | - Suvasini Sharma
- Department of Pediatrics (Neurology division)Lady Hardinge Medical College and Associated HospitalsNew DelhiIndia
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Joy P, Madhuri V, Palocaren T, Das S, Susan Cleave Abraham S, Korula S, Koshy B, Jose J, Chandran M, Danda S. Case report of a rare purine synthesis disorder due to 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase (AICAR) deficiency. Brain Dev 2022; 44:645-649. [PMID: 35637059 DOI: 10.1016/j.braindev.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/03/2022] [Accepted: 05/12/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AICA (5-aminoimidazole-4-carboxamide) ribosiduria is an inborn error in purine biosynthesis caused due to biallelic pathogenic variants in the 5-aminoimidazole-4-carboxamide ribonucleotide-formyltransferase/imp cyclohydrolase (ATIC) gene located on chromosome 2q35. ATIC codes for a bifunctional enzyme, AICAR transformylase and inosine monophosphate (IMP) cyclohydrolase, which catalyse the last two steps of de novo purine synthesis. This disorder has been previously reported in only 4 cases worldwide, and herein, we report the first from India. CASE REPORT The proband presented with global developmental delay, developmental hip dysplasia (DDH), acyanotic heart disease and nystagmoid eye movements. Whole exome sequencing (WES) identified compound heterozygous pathogenic variants in the ATIC. A novel splice site variant; c.1321-2A > G and a previously reported missense variant; c.1277A > G (p.Lys426Arg) were identified. Segregation analysis of parents showed the father to be a heterozygous carrier for the splice site variant and the mother, a heterozygous carrier for the missense variant. CONCLUSION This case of a rare genetic disorder of purine biosynthesis of ATIC deficiency is the first case reported from India. Early diagnosis lead to early interventional therapy and genetic counselling.
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Affiliation(s)
- Praisy Joy
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | - Vrisha Madhuri
- Department of Paediatric Orthopaedics, Christian Medical College, Vellore, India
| | - Thomas Palocaren
- Department of Paediatric Orthopaedics, Christian Medical College, Vellore, India
| | - Sweta Das
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | | | - Sophy Korula
- Department of Paediatric Endocrinology, Christian Medical College, Vellore, India
| | - Beena Koshy
- Department of Developmental Paediatrics, Christian Medical College, Vellore, India
| | - John Jose
- Department of Cardiology, Christian Medical College, Vellore, India
| | | | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, India.
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Yoganathan S, Kumar M, Malhotra M, Joy P, Danda S, Thomas M, David KS, Jasper A, Selvin SST. Eye signs in a child with ROBO3 gene mutation. Indian J Ophthalmol 2022; 70:2643-2644. [PMID: 35791185 PMCID: PMC9426051 DOI: 10.4103/ijo.ijo_2065_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sangeetha Yoganathan
- Pediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Madhan Kumar
- Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mukul Malhotra
- Pediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Praisy Joy
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Pediatric Neurology Unit, Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Kenny S David
- Department of Orthopedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anitha Jasper
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
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25
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Kabeerdoss J, Danda D, Goel R, Mohan H, Danda S, Scofield RH. Genome-Wide DNA Methylation Profiling in CD8 T-Cells and Gamma Delta T-Cells of Asian Indian Patients With Takayasu Arteritis. Front Cell Dev Biol 2022; 10:843413. [PMID: 35813204 PMCID: PMC9259853 DOI: 10.3389/fcell.2022.843413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Takayasu’s Arteritis (TA) is a chronic inflammatory disease that affects aorta and its main branches at their origin. Genetic, pathological and functional studies have shown that CD8 and Gamma delta (γ/δ) T-lymphocytes are involved in inflammatory processes in affected regions of arteries causing vascular damage. The molecular function of these lymphocytes remains unclear and currently no epigenetic studies are available in TA. We primarily performed genome wide methylation analysis in CD8 T cells and γδ T cells of patients with TA and compared with healthy controls. Methods: We recruited 12 subjects in each group namely TA patient and healthy controls. Blood samples were collected after obtaining informed written consent. CD8 T cells and γδ T cells were separated from whole blood. DNA extracted from these cells and were subjected to bisulfite treatment. Finally, bisulfite treated DNA was loaded in Infinium Methylation EPIC array. Bioinformatics analysis was used to identify differential methylation regions which were then mapped to genes. Results: Interleukin (IL)-32 and Lymphotoxin-A were genes significantly hypomethylated in CD8 T-cells. Anti-inflammatory cytokine genes, IL-10, IL-1RN and IL-27 were hypomethylated in γδ T cells of TA patients as compared to healthy controls. Gene enrichment analysis using Gene Ontology (GO) database and Kyoto Encyclopaedia of Genes and Genomes (KEGG) identified that genes involved in T-cell receptor signalling pathways were hypomethylated in CD8 T-cells and hypermethylated in γδ T cells of TA patients. Conclusion: CD8 T-cells might play a major role in immunopathogenesis of inflammation in TA, whereas γδ T cells may play a regulatory role.
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Affiliation(s)
- Jayakanthan Kabeerdoss
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- *Correspondence: Debashish Danda, ; Jayakanthan Kabeerdoss,
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
- *Correspondence: Debashish Danda, ; Jayakanthan Kabeerdoss,
| | - Ruchika Goel
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Hindhumathi Mohan
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - R. Hal Scofield
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
- Department of Veterans Affairs, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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26
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Danda S, Datar C, Kher A, Deshpande T, Thomas MM, Oommen SP. First reported cases with Xia-Gibbs syndrome from India harboring novel variants in AHDC1. Am J Med Genet A 2022; 188:2501-2504. [PMID: 35596688 DOI: 10.1002/ajmg.a.62844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/03/2022] [Accepted: 04/16/2022] [Indexed: 11/10/2022]
Abstract
We report here two girls from different Indian families identified with novel variants in the AT Hook DNA Binding Motif Containing 1 gene (AHDC1) causing Xia-Gibbs syndrome. The diagnosis was made by clinical exome in both cases. Inconsistent dysmorphic features such as dolichocephaly in the first patient and brachycephaly in the second were observed. Prominent jaw and gelastic seizures were other features of patient 1. Thus, this syndrome, with developmental delay, poor expressive language and overlapping clinical phenotype requires the utility of next generation sequencing for diagnostic confirmation.
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Affiliation(s)
- Sumita Danda
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Chaitanya Datar
- Department of Paediatrics, Genetics Unit, Bharati Vidyapeeth Medical College and Hospital, Pune, India
| | - Archana Kher
- Department of Paediatrics, Genetics Unit, Bharati Vidyapeeth Medical College and Hospital, Pune, India
| | - Tanmay Deshpande
- Department of Paediatrics, Genetics Unit, Bharati Vidyapeeth Medical College and Hospital, Pune, India
| | - Maya Mary Thomas
- Department of Paediatric Neurology, Christian Medical College and Hospital, Vellore, India
| | - Samuel P Oommen
- Department of Developmental Paediatrics, Christian Medical College and Hospital, Vellore, India
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27
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Chiramel MJ, Mathew L, Athirayath R, Chapla A, Sathishkumar D, Mani T, Danda S, George R. Genotype of autosomal recessive congenital ichthyosis from a tertiary care center in India. Pediatr Dermatol 2022; 39:420-424. [PMID: 35412663 DOI: 10.1111/pde.14944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Autosomal recessive congenital ichthyosis (ARCI) refers to non-syndromic ichthyosis caused by mutations in one of the 13 identified genes. There are limited data on the genotype of ARCI and its phenotypic correlation from India. OBJECTIVES The aim of this study was to characterize the genotype of ARCI among patients from the Indian subcontinent. METHODS Twenty-eight patients clinically diagnosed as ARCI were recruited prospectively from September 2017 to June 2019 (21 months). DNA was extracted from peripheral blood and analyzed for the 13 described ARCI genes-TGM1, ABCA12, ALOX12B, ALOXE3, CERS3, CYP4F22, LIPN, NIPAL4, PNPLA1, SDR9C7, SLC27A4, SULT2B1, and CASP14 by next-generation sequencing using an in-house panel. The variants identified were confirmed by Sanger sequencing and compared with known pathogenic variants to establish pathogenicity. We also attempted to correlate the phenotype with the genotype. RESULTS Among the 28 patients recruited (M = 17, F = 11), we identified phenotypes of congenital ichthyosiform erythroderma in 12 (42.9%), 8 with lamellar ichthyosis (28.6%), 5 with intermediate phenotype (17.9%), and 3 with bathing suit ichthyosis (10.7%). Pathogenic and likely pathogenic variants were identified in 22 (78.6%) patients, involving 7 out of the 13 known ARCI genes while 6 (21.4%) did not have pathogenic variants. These included TGM1 mutation in 6 (21.4%), ALOX12B and ALOXE3 in 4 (14.3%) each, NIPAL4 and PNPLA1 in 3 (10.7%) each, and ABCA12 and CERS3 in 1 (3.6%) patient each. Previously unknown pathogenic variants were found in 59.1 % of patients. CONCLUSIONS Our patients with ARCI were found to have genotypes as previously described in other populations.
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Affiliation(s)
- Minu Jose Chiramel
- Department of Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Lydia Mathew
- Department of Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Rekha Athirayath
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Aaron Chapla
- Department of Endocrinology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Dharshini Sathishkumar
- Department of Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Thenmozhi Mani
- Department of Biostatistics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Renu George
- Department of Dermatology (Retired), Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Cherian AG, Kamath V, Srivastava V, Danda S, Sebastian T, Beck MM. Spectrum of Chromosomal Abnormalities Detected by Conventional Cytogenetic Analysis Following Invasive Prenatal Testing of Fetuses with Abnormal Ultrasound Scans. J Obstet Gynaecol India 2022; 72:209-216. [PMID: 35928088 PMCID: PMC9343546 DOI: 10.1007/s13224-022-01626-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/17/2022] [Indexed: 10/18/2022] Open
Abstract
Objectives The frequent association between malformations and chromosomal abnormalities is now well-established. This study looks at the incidence and type of chromosomal abnormalities detected by conventional cytogenetic analysis in women undergoing invasive tests following detection of fetal anomalies on antenatal scans as well as incidence of other genetic abnormalities detected by DNA analysis of fetuses with congenital anomalies that had a normal karyotype. Materials and Methods A retrospective, observational study of pregnant women undergoing invasive testing following identification of fetal anomalies by ultrasonography was carried out in a tertiary care facility, Vellore, India, between 2011 and 2018. Results 169 women underwent an invasive diagnostic procedure following detection of fetal anomalies. The most common indication for doing fetal karyotype was the presence of major fetal structural anomalies (142/169, 84%) with over a third (48/142, 34%) having multisystem involvement. Fetal hydrops was the next most common indication, detected in 18/169 (10%) fetuses. Aneuploidy was seen 19 of 25 fetuses (76%) with an abnormal karyotype with autosomal aneuploidy accounting for 13 (68%) and sex chromosome aneuploidy for seven (37%) of the fetuses. One fetus had double aneuploidy. In fetuses with normal karyotype, no additional information was obtained from further genetic testing. Conclusions The overall detection rate of chromosomal abnormalities in our study using conventional cytogenetic analysis was 14.8%, the majority (72%) being associated with structural malformations, 20% with non-immune hydrops and 4% with soft markers. Abnormal karyotypes were seen in 12.7% of fetuses with structural malformations.
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29
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Aaron R, Chapla A, Danda S, Zachariah U, Eapen CE, Goel A. Multiplex PCR-based Sequencing of ATP7B Gene in Wilson's Disease - A Preliminary Study. J Clin Exp Hepatol 2022; 12:711-713. [PMID: 35535059 PMCID: PMC9077194 DOI: 10.1016/j.jceh.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/01/2021] [Indexed: 12/12/2022] Open
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30
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Yoganathan S, Kumar M, John D, Danda S, Oommen S, Umakant S, Thomas M. Oculodigital sign: A clinical clue for diagnosis. Ann Indian Acad Neurol 2022; 25:560-561. [PMID: 35936593 PMCID: PMC9350766 DOI: 10.4103/aian.aian_755_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/19/2021] [Accepted: 01/09/2022] [Indexed: 11/04/2022] Open
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31
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Korula S, Yoganathan S, Peter J, Chandran M, Christudass CS, Danda S. Late Onset Multiple Acyl-CoA Dehydrogenase Deficiency: A Rare Treatable Neurometabolic Disorder. Ann Indian Acad Neurol 2022; 25:983-985. [PMID: 36561017 PMCID: PMC9764879 DOI: 10.4103/aian.aian_370_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sophy Korula
- Paediatric Endocrinology and Metabolism Division, Paediatric Unit-1, Christian Medical College, Vellore, Tamil Nadu, India,Address for correspondence: Dr. Sophy Korula, Paediatric Endocrinology and Metabolism Division, Paediatric Unit-1, Christian Medical College, Vellore - 632004, Tamil Nadu, India. E-mail:
| | - Sangeetha Yoganathan
- Department of Neurological Sciences, Paediatric Neurology Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jeyanthi Peter
- Department of Paediatrics, Christian Fellowship Hospital, Oddanchatram, Tamil Nadu, India
| | - Mahalakshmi Chandran
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Sumita Danda
- Department of Medical Genetics, Clinical Genetics Unit, Christian Medical College, Vellore, Tamil Nadu, India
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32
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Yoganathan S, Srinivasaraghavan R, Kumar M, Kratz L, Mular S, Sudhakar SV, Malik P, Chandran M, Thomas M, Danda S. Fumaric Aciduria: A Rare Cause of Refractory Epilepsy. Ann Indian Acad Neurol 2022; 25:738-740. [PMID: 36211164 PMCID: PMC9540961 DOI: 10.4103/aian.aian_47_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Madhan Kumar
- Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lisa Kratz
- Biochemical Genetics Laboratory, Kennedy Krieger Institute, Baltimore, United States
| | - Shraddha Mular
- Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sniya V. Sudhakar
- Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prateek Malik
- Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mahalakshmi Chandran
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India,Address for correspondence: Dr. Sumita Danda, Department of Medical Genetics, Christian Medical College, Vellore - 632 004, Tamil Nadu, India. E-mail:
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Yoganathan S, Kumar M, Sushma L, Danda S, Thomas M. An Inherited Cause of Stroke Mimic in a Toddler. Indian J Pediatr 2022; 89:98. [PMID: 34468936 DOI: 10.1007/s12098-021-03904-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore-632004, Tamil Nadu, India
| | - Madhan Kumar
- Department of Pediatrics, Christian Medical College, Vellore- 632004, Tamil Nadu, India
| | - Lenka Sushma
- Department of Neurological Sciences, Christian Medical College, Vellore-632004, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore- 632004, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore-632004, Tamil Nadu, India.
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Yoganathan S, Kumar M, Sharma S, Patel S, Danda S, Thomas M. SGCE Myoclonus-Dystonia: An Inherited Movement Disorder. Neurology 2021; 98:289. [PMID: 34906973 DOI: 10.1212/wnl.0000000000013209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Madhan Kumar
- Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suvasini Sharma
- Neurology Division, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi- 110 001, India
| | - Smruti Patel
- Neurology Division, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi- 110 001, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore- 632004, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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Chaudhary AK, Gholse A, Nagarajaram HA, Dalal AB, Gupta N, Dutta AK, Danda S, Gupta R, Sankar HV, Bhavani GS, Girisha KM, Phadke SR, Ranganath P, Bashyam MD. Ectodysplasin pathogenic variants affecting the furin-cleavage site and unusual clinical features define X-linked hypohidrotic ectodermal dysplasia in India. Am J Med Genet A 2021; 188:788-805. [PMID: 34863015 DOI: 10.1002/ajmg.a.62579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/20/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022]
Abstract
Hypohidrotic ectodermal dysplasia (HED) is a rare genetic disorder caused by mutational inactivation of a developmental pathway responsible for generation of tissues of ectodermal origin. The X-linked form accounts for the majority of HED cases and is caused by Ectodysplasin (EDA) pathogenic variants. We performed a combined analysis of 29 X-linked hypohidrotic ectodermal dysplasia (XLHED) families (including 12 from our previous studies). In addition to the classical triad of symptoms including loss (or reduction) of ectodermal structures, such as hair, teeth, and sweat glands, we detected additional HED-related clinical features including facial dysmorphism and hyperpigmentation in several patients. Interestingly, global developmental delay was identified as an unusual clinical symptom in many patients. More importantly, we identified 22 causal pathogenic variants that included 15 missense, four small in-dels, and one nonsense, splice site, and large deletion each. Interestingly, we detected 12 unique (India-specific) pathogenic variants. Of the 29 XLHED families analyzed, 11 (38%) harbored pathogenic variant localized to the furin cleavage site. A comparison with HGMD revealed significant differences in the frequency of missense pathogenic variants; involvement of specific exons and/or protein domains and transition/transversion ratios. A significantly higher proportion of missense pathogenic variants (33%) localized to the EDA furin cleavage when compared to HGMD (7%), of which p.R155C, p.R156C, and p.R156H were detected in three families each. Therefore, the first comprehensive analysis of XLHED from India has revealed several unique features including unusual clinical symptoms and high frequency of furin cleavage site pathogenic variants.
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Affiliation(s)
- Ajay Kumar Chaudhary
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
| | - Aishwarya Gholse
- Laboratory of Computational Biology, Department of Systems and Computational Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Hampapathalu Adimurthy Nagarajaram
- Laboratory of Computational Biology, Department of Systems and Computational Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Ashwin Bhikaji Dalal
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Atanu Kumar Dutta
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Rekha Gupta
- Department of Medical Genetics, Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Hariharan V Sankar
- Department of Pediatrics, SAT Hospital, Medical College, Trivandrum, India
| | - Gandham SriLakshmi Bhavani
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Shubha Rao Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Prajnya Ranganath
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India.,Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Murali Dharan Bashyam
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
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Kumar M, Danda S, Reddy H, S J, Paul G, Varkki S. 158: Late diagnosis of cystic fibrosis after first decade of life: Clinical observations of a milder phenotype in India. J Cyst Fibros 2021. [PMCID: PMC8518449 DOI: 10.1016/s1569-1993(21)01583-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Aaron R, Chapla A, Kumar M, Paul G, Danda S, Varkki S. 657: Importance of screening for splice site and deep intronic variants—Insights from cystic fibrosis genetic testing on patients from the Indian subcontinent. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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38
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Tamhankar PM, Vasudevan L, Kondurkar P, Niazi S, Christopher R, Solanki D, Dholakia P, Muranjan M, Kamate M, Kalane U, Sheth J, Tamhankar V, Gulati R, Vasikarla M, Danda S, Naushad SM, Girisha KM, Patil S. Clinical Characteristics, Molecular Profile, and Outcomes in Indian Patients with Glutaric Aciduria Type 1. J Pediatr Genet 2021; 10:213-221. [PMID: 34504725 DOI: 10.1055/s-0040-1715528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/27/2020] [Indexed: 10/23/2022]
Abstract
Glutaric acidemia type 1 (GA-1, OMIM 231670) is an autosomal recessive inborn error of metabolism caused by the deficiency of glutaryl-coenzyme A (CoA) dehydrogenase with most children presenting in infancy with encephalopathy, dystonia, and macrocephaly. In this article, we presented the clinical characteristics, molecular profile, and outcomes in 29 unrelated families with affected children (30 cases total). The mean age at onset of illness was 10 months (±14.58), whereas the mean age at referral for molecular diagnosis was 29.44 months (±28.11). Patients were residents of nine different states of India. Clinical presentation varied from acute encephalitis followed by neuroregression and chronic/insidious developmental delay. Neurological sequelae varied from asymptomatic (no sequelae, 2 patients) to moderate (5 patients) and severe (23 patients) sequelae. All patients underwent blood tandem mass spectrometry (TMS on dried blood spots) and/or urine gas chromatography mass spectrometry (GCMS). Neuroimaging demonstrated batwing appearance in 95% cases. Sanger's sequencing of GCDH , covering all exons and exon-intron boundaries, was performed for all patients. Variants identified include 15 novel coding variants: p.Met100Thr, p.Gly107Ser, p.Leu179Val, p.Pro217Ser, p. Phe236Leufs*107, p.Ser255Pro, p.Met266Leufs*2, p.Gln330Ter, p.Thr344Ile, p.Leu345Pro, p.Lys377Arg, p.Leu424Pro, p.Asn373Lys, p.Lys377Arg, p.Asn392Metfs*9, and nine known genetic variants such as p.Arg128Gln, p.Leu179Arg, p.Trp225Ter, p.Met339Val, p.Gly354Ser, p.Arg402Gln, p.Arg402Trp, p.His403Tyr, and p.Ala433Val (Ensembl transcript ID: ENST00000222214). Using in silico analysis, genetic variants were shown to be affecting the residues responsible for homotetramer formation of the glutaryl-CoA dehydrogenase protein. Treatment included oral carnitine, riboflavin, protein-restricted diet, lysine-deficient special formulae, and management of acute crises with intravenous glucose and hydration. However, the mortality (9/30, 27.58%) and morbidity was high in our cohort with only two patients affording the diet. Our study is the largest multicentric, genetic variant-proven series of glutaric aciduria type 1 from India till date.
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Affiliation(s)
- Parag M Tamhankar
- Genetic Research Center, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India.,Centre for Medical Genetics, Mumbai, Maharashtra, India.,Sandor Life Sciences Pvt. Ltd., Hyderabad, Andhra Pradesh, India
| | - Lakshmi Vasudevan
- Genetic Research Center, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Pratima Kondurkar
- Genetic Research Center, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Sarfaraj Niazi
- Biomedical Informatics Center of Indian Council of Medical Research, National Institute for Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Dhaval Solanki
- Mantra Child and Neurology and Epilepsy Clinic, Bhavnagar, Gujarat, India
| | | | - Mamta Muranjan
- Department of Pediatrics, Seth Gordhandas Sunderdas Medical College and King Edward Memorial hospital, Mumbai, Maharashtra, India
| | - Mahesh Kamate
- Department of Pediatric Neurology, Jawaharlal Nehru Medical College, Karnataka Lingayat Education University, Belgaum, Karnataka, India
| | - Umesh Kalane
- Pediatric Neurology Centre, Swargate, Pune, Maharashtra, India
| | - Jayesh Sheth
- Foundation for Research in Genetics and Endocrinology Institute of Human Genetics, Foundation for Research in Genetics and Endocrinology House, Satellite, Ahmedabad, Gujarat, India
| | | | - Reena Gulati
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
| | | | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Shaik M Naushad
- Sandor Life Sciences Pvt. Ltd., Hyderabad, Andhra Pradesh, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Mistry PK, Lukina E, Ben Turkia H, Shankar SP, Feldman H, Ghosn M, Mehta A, Packman S, Lau H, Petakov M, Assouline S, Balwani M, Danda S, Hadjiev E, Ortega A, Foster MC, Gaemers SJM, Peterschmitt MJ. Clinical outcomes after 4.5 years of eliglustat therapy for Gaucher disease type 1: Phase 3 ENGAGE trial final results. Am J Hematol 2021; 96:1156-1165. [PMID: 34161616 PMCID: PMC8457136 DOI: 10.1002/ajh.26276] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/06/2021] [Accepted: 06/12/2021] [Indexed: 01/31/2023]
Abstract
Eliglustat, an oral substrate reduction therapy, is approved for eligible adults with Gaucher disease type 1. In the Phase 3 ENGAGE trial of previously untreated adults with Gaucher disease type 1, eliglustat‐treated patients had statistically significant improvements in organ volumes and hematologic parameters compared with placebo in the 9‐month primary analysis. We report final outcomes by time on eliglustat among all patients who participated in the ENGAGE trial and extension. No patient deteriorated clinically or withdrew due to adverse events; 39/40 patients entered the open‐label extension period and 34/40 (85%) remained in the trial until completion or switching to commercial eliglustat after its approval (2.3–6 years). Clinically meaningful improvements in Gaucher disease manifestations were seen in all patients concomitant with reductions in pathological lipid substrate levels (glucosylceramide and glucosylsphingosine). Among patients with 4.5 years of eliglustat exposure, mean spleen volume decreased by 66% (from 17.1 to 5.8 multiples of normal [MN], n = 13), mean liver volume decreased by 23% (from 1.5 to 1.1 MN, n = 13), mean hemoglobin increased 1.4 g/dl (from 11.9 to 13.4 g/dl, n = 12), mean platelet count increased by 87% (from 67.6 to 122.6 × 109/L, n = 12), median chitotriosidase decreased by 82% (from 13 394 to 2312 nmol/h/ml, n = 11), median glucosylceramide decreased by 79% (from 11.5 to 2.4 μg/ml, n = 11), median glucosylsphingosine decreased by 84% (from 518.5 to 72.1 ng/ml, n = 10), and mean spine T‐score increased from −1.07 (osteopenia) to −0.53 (normal) (n = 9). The magnitude of improvement in Gaucher disease manifestations and biomarkers over time was similar among the full trial cohort. Eliglustat was well‐tolerated and led to clinically significant improvements in previously untreated patients with Gaucher disease type 1 during 4.5 years of treatment.
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Affiliation(s)
| | - Elena Lukina
- National Research Center for Hematology Moscow Russia
| | | | | | - Hagit Feldman
- The Genetics Institute, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Marwan Ghosn
- Hôtel‐Dieu de France University Hospital Beirut Lebanon
| | | | | | - Heather Lau
- New York University School of Medicine New York New York USA
| | - Milan Petakov
- Clinical Center of Serbia Belgrade University Medical School Belgrade Serbia
| | | | - Manisha Balwani
- Icahn School of Medicine at Mt. Sinai Hospital New York New York USA
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Abraham SSC, Yoganathan S, Koshy B, Oommen SP, Simon A, Mathai S, Korula S, Mathew L, Sathishkumar D, Jasper A, George R, Danda S. Phenotypic variability of a TREX1 variant in Aicardi-Goutieres type 1 patients from the Indian subcontinent. Eur J Med Genet 2021; 64:104291. [PMID: 34303877 DOI: 10.1016/j.ejmg.2021.104291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 06/18/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
Aicardi-Goutieres Syndrome (AGS) is a heterogeneous genetic syndrome, manifesting early as encephalopathy and is associated with abnormal neurologic findings, hepatosplenomegaly, elevated liver enzymes, thrombocytopenia and intracranial calcification. The most severe neonatal type, AGS1, is caused by biallelic disease-causing variants in TREX1. In this study, we describe four patients with TREX1-related AGS1 whose phenotype overlaps with intra-uterine infections and neonatal lupus. Exome sequencing identified a previously reported TREX1 variant, c.223dup (NM_016381.5; p. Glu75GlyfsTer82) in all the four patients belonging to the Indian subcontinent. The functional consequence of the disease-causing variant was predicted by using a new combination of bioinformatics softwares. The recurrence of this pathogenic variant indicates a possible founder effect in TREX1 for AGS1 in this population. The phenotypic variability in those with this founder mutation can mimic intrauterine infections and neonatal lupus, thereby leading to misdiagnosis warranting a targeted genetic testing approach to be a part of the diagnostic workup to obtain a definite, early and cost-effective diagnosis in patients from Indian subcontinent with early onset encephalopathy.
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Affiliation(s)
| | - Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Beena Koshy
- Department of Developmental Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Samuel Philip Oommen
- Department of Developmental Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna Simon
- Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sarah Mathai
- Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sophy Korula
- Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lydia Mathew
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Anitha Jasper
- Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Renu George
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India.
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Shajil C, Sathishkumar D, Danda S, Thomas M. An unusual case of keratinopathic icthyosis: a diagnostic conundrum. Dermatol Online J 2021; 27. [PMID: 34387055 DOI: 10.5070/d327654054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/08/2022] Open
Abstract
Epidermolytic ichthyosis (EI) is a rare inherited ichthyosis related to heterozygous mutations in the Keratin 1 or Keratin 10 genes. Because of the broad phenotypic spectrum, it is sometimes difficult to differentiate it from other keratinopathic ichthyoses (KI) in clinical practice. We report an intriguing case of KI presenting as generalized ichthyosis in a reticulate pattern surrounding islands of normal skin, epidermolytic hyperkeratosis and binucleate cells on histopathology, and heterozygous mutation in KRT10. Through this case, we would like to demonstrate the importance of genetic studies and genotype-phenotype correlation in diagnosing such challenging cases.
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Affiliation(s)
| | - Dharshini Sathishkumar
- Department of Dermatology, Venereology and Leprology, Christian Medical College and Hospital, Vellore, Tamil Nadu.
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Malik P, Bidkar SU, Yoganathan S, Mathai S, Danda S, Koshy B. Imaging findings in TRPM6-Related hypomagnesemia with secondary hypocalcemia. Ann Indian Acad Neurol 2021; 24:247-248. [PMID: 34220071 PMCID: PMC8232497 DOI: 10.4103/aian.aian_243_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/09/2020] [Accepted: 04/15/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
- Prateek Malik
- Department of Radiodiagnosis, Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sayli Umakant Bidkar
- Department of Neurological Sciences, Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sangeetha Yoganathan
- Department of Neurological Sciences, Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sarah Mathai
- Division of Pediatric Endocrinology, Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Department of Medical Genetics, Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Beena Koshy
- Developmental Pediatrics Unit, Department of Child Health, Christian Medical College, Vellore, Tamil Nadu, India
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Yoganathan S, Arunachal G, Kratz L, Varman M, Thomas M, Sudhakar SV, Oommen SP, Danda S. Metabolic Or Ischemic Stroke in Succinic Semi-Aldehyde Dehydrogenase Deficiency Due to the Homozygous Variant c. 1343 + 1_1343 + 3delGTAinsTT in ALDH5A1. Ann Indian Acad Neurol 2021; 24:259-261. [PMID: 34220078 PMCID: PMC8232515 DOI: 10.4103/aian.aian_360_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gautham Arunachal
- Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lisa Kratz
- Biochemical Genetics Laboratory, Kennedy Krieger Institute, Baltimore, United States of America
| | - Mugil Varman
- Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sniya V Sudhakar
- Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Samuel P Oommen
- Developmental Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
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Yoganathan S, Srinivasaraghavan R, Chandran M, Kratz L, Koshy B, Sudhakar SV, Arunachal G, Thomas M, Danda S. Attenuated form of Glycine Encephalopathy: An Unusual Cause of Neurodevelopmental Disorder. Ann Indian Acad Neurol 2021; 24:261-264. [PMID: 34220079 PMCID: PMC8232503 DOI: 10.4103/aian.aian_361_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/27/2020] [Accepted: 07/07/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rangan Srinivasaraghavan
- Developmental Paediatrics Unit, Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mahalakshmi Chandran
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lisa Kratz
- Biochemical Genetics Laboratory, Kennedy Krieger Institute, Baltimore, USA
| | - Beena Koshy
- Developmental Paediatrics Unit, Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sniya Valsa Sudhakar
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gautham Arunachal
- Developmental Paediatrics Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sumita Danda
- Developmental Paediatrics Unit, Christian Medical College, Vellore, Tamil Nadu, India
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Varkki S, Benjamin AT, Athiyarath R, Danda S, Sowmya R, Connett G. Meconium Ileus due to GUCY2C gene mutations in three unrelated South Indian families. J Cyst Fibros 2021; 20:e84-e86. [PMID: 33883099 DOI: 10.1016/j.jcf.2021.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Sneha Varkki
- Department of Paediatrics, Christian Medical College, Vellore, India
| | | | - Rekha Athiyarath
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | | | - Gary Connett
- National Institute for Health Research, Southampton Respiratory Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
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Barney AM, Danda S, Abraham A, Fouzia NA, Gowdra A, Abraham SSC, Sony M, Das S, Korula S, Mathai S, Simon A, Kumar S. Clinicogenetic Profile, Treatment Modalities, and Mortality Predictors of Gaucher Disease: A 15-Year Retrospective Study. Public Health Genomics 2021; 24:139-148. [PMID: 33823526 DOI: 10.1159/000514507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/12/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Gaucher disease (GD) is a rare autosomal recessive lysosomal storage disorder, in which biallelic pathogenic variants in the Glucosidase beta acid (GBA) gene result in defective functioning of glucosylceramidase that causes deposition of glucocerebroside in cells. GD has 3 major types namely, non-neuronopathic (type I), acute neuronopathic (type II), and chronic neuronopathic (type III). Definite treatment options are limited and expensive. They succumb early to the disease, if untreated. There is paucity of studies from the Indian subcontinent, which elicit the factors resulting in their premature mortality. MATERIALS AND METHODS A retrospective study was carried out in a tertiary care setting of South India to assess the clinical profile, mutation spectrum, and various management strategies (only supportive therapy, enzyme replacement therapy [ERT], substrate reduction therapy [SRT] haematopoietic stem cell transplant [HSCT]), and mortality predictors of patients with GD from 2004 to 2019. A Kaplan-Meier survival curve was plotted. In silico predictions were performed for novel variants. RESULTS There were 60 patients with all types of GD seen over the study period of 15 years. Their median age at diagnosis was 2 years. The median follow-up was for 5 years (interquartile range [IQR] = 2-8). The overall mortality rate was 35%; however, it was only 10% in those receiving definite treatment. Mortality was higher (47.5%) by more than 4 folds in those only on supportive therapy. The median survival from the time of diagnosis was 6.3 years (IQR = 3.5-10.8) in the definite treatment group and 3.5 years (IQR = 1-5) in those on supportive therapy. The Kaplan-Meier survival analysis showed significant (p value 0.001) mortality difference between these groups. The multiple logistic regression analysis found the neuronopathic type (OR = 5) and only supportive therapy (OR = 6.3) to be the independent risk factors for premature mortality. CONCLUSION GD is a rare disease with a high mortality rate, if left untreated. ERT and SRT are the definitive treatments which increase the survival. In resource-limited settings like India, with higher prevalence of the neuronopathic type, HSCT may be a more suitable definitive treatment option, due to its one-time intervention and cost, assuming similar efficacy to ERT. However, the efficacy and safety of HSCT in GD needs to be established further by substantial patient numbers undergoing it.
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Affiliation(s)
- Anitha M Barney
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Aby Abraham
- Department of Clinical Haematology, Christian Medical College, Vellore, India
| | - N A Fouzia
- Department of Clinical Haematology, Christian Medical College, Vellore, India
| | - Aruna Gowdra
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | | | - Mohan Sony
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sweta Das
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sophy Korula
- Department of Child Health, Christian Medical College, Vellore, India
| | - Sarah Mathai
- Department of Child Health, Christian Medical College, Vellore, India
| | - Anna Simon
- Department of Child Health, Christian Medical College, Vellore, India
| | - Sathish Kumar
- Department of Child Health, Christian Medical College, Vellore, India
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Peter DCV, Smith FJD, Wilson NJ, Danda S. PSENEN Mutation in Coexistent Hidradenitis Suppurativa and Dowling-Degos Disease. Indian Dermatol Online J 2021; 12:147-149. [PMID: 33768038 PMCID: PMC7982026 DOI: 10.4103/idoj.idoj_218_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/26/2020] [Accepted: 06/28/2020] [Indexed: 12/27/2022] Open
Abstract
Hidradenitis suppurativa is a chronic relapsing disease with multiple abscesses, nodules, and scars in the apocrine bearing areas. Dowling-Degos is a rare autosomal dominant genodermatosis characterized by multiple hyperpigmented macules or papules in reticulate pattern, affecting mainly the flexures. We report a case of coexisting hidradenitis suppurativa and Dowling-Degos disease in a 31-year-old male in whom PSENEN mutation analysis revealed a splice site mutation c.62-1G>T.
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Affiliation(s)
- Dincy C V Peter
- Department of Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, Tamil Nadu, India
| | - Frances J D Smith
- Centre for Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, UK
| | - Neil J Wilson
- Centre for Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, UK
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
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Barney AM, Abraham VJ, Danda S, Cherian AG, Vanitha S. Prevalence of Vitamin B12 Deficiency and Its Associated Risk Factors among Pregnant Women of Rural South India: A Community-based Cross-sectional Study. Indian J Community Med 2021; 45:399-404. [PMID: 33623189 PMCID: PMC7877432 DOI: 10.4103/ijcm.ijcm_403_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction: Vitamin B12 is essential for the normal functioning of the nervous system and for the formation of red blood cells. Vegetarian diet, low socioeconomic status, and social and religious reasons are known risk factors of its deficiency. Pregnant women, children, and the elderly are vulnerable groups. Indians have the highest prevalence, but the data among pregnant women in the rural setting is lacking. Objectives: The objective of this study is to assess the prevalence of Vitamin B12 deficiency and its associated factors among pregnant women of rural South India. Materials and Methods: A cross-sectional study was conducted to recruit consecutive 120 multigravida women with ≤20 weeks of gestation, attending the mobile doctor run clinic of Kaniyambadi block, Vellore. A structured questionnaire was administered, and blood samples were collected. Results: The prevalence of Vitamin B12 deficiency (<200 pgm/ml) and anemia (Hb ≤10.5 g/dL) was 55% and 17.5%, respectively. Only 11.7% were B12 deficient and anemic. Past history of abortion (odds ratio [OR] = 0.5), fatigue (OR = 0.4), and low B12 intake (OR = 2) was associated only in the bivariate analysis. First trimester (OR = 3.9) and obesity (OR = 9.6) were found to be independent risk factors of Vitamin B12 deficiency. Conclusion: Our study showed a high prevalence of Vitamin B12 deficiency in pregnancy in rural India. Some risk factors were identified. However, studies with a higher sample size will be beneficial to study the associated risk factors better.
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Affiliation(s)
- Anitha Mohanraj Barney
- Department of Community Health, Vellore, Tamil Nadu, India.,Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anne George Cherian
- Department of Community Health, Vellore, Tamil Nadu, India.,Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Vanitha
- Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
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Das S, Godbole K, Abraham SSC, Ganesan P, Kamdar P, Danda S. Alazami syndrome: Report of three Indian patients with phenotypic spectrum from adolescence to adulthood. Am J Med Genet A 2021; 185:1606-1609. [PMID: 33569879 DOI: 10.1002/ajmg.a.62118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/10/2020] [Accepted: 01/18/2021] [Indexed: 11/09/2022]
Abstract
Alazami syndrome (ALAZS) (MIM 615071) is a rare autosomal recessive disorder characterized by short stature, dysmorphic facial features, developmental delay, and impaired intellect. It was first reported in a Saudi Arabian family in 2012. Three Indian patients affected with ALAZS, one boy aged 13 years and other two sisters in their 40s are presented. These patients had few unreported dysmorphic facial features: high arched eyebrows and dental overcrowding. No microcephaly was noted in the sisters. One of the sisters did not have short stature. The boy also presented with unilateral buphthalmos of left eye. All three of them have been identified to harbor novel variants in LARP7.
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Affiliation(s)
- Sweta Das
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | - Koumudi Godbole
- Department of Genetics, Deenanath Mangeshkar Hospital & Research Center, Pune, India
| | | | | | - Payal Kamdar
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, India
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Sathishkumar D, Muthusamy K, Gupta A, Malhotra M, Thomas M, Koshy B, Jasper A, Danda S, George R. Co-occurrence of Aicardi-Goutières syndrome type 6 and dyschromatosis symmetrica hereditaria due to compound heterozygous pathogenic variants in ADAR1: a case series from India. Clin Exp Dermatol 2021; 46:704-709. [PMID: 33289110 DOI: 10.1111/ced.14531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
Aicardi-Goutières syndrome type 6 (AGS6) and dyschromatosis symmetrica hereditaria (DSH) are allelic disorders caused respectively by biallelic and heterozygous pathogenic variants in ADAR1. We report three unrelated children presenting with features of both AGS6 and DSH, two of whom had compound heterozygous pathogenic variants in ADAR1. We also describe the novel genetic variants in our cases and review the literature on association of ADAR1-related AGS6 and DSH with these phenotypes.
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Affiliation(s)
- D Sathishkumar
- Departments of, Department of, Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - K Muthusamy
- Department of, Paediatric Neurology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - A Gupta
- Departments of, Department of, Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - M Malhotra
- Department of, Paediatric Neurology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - M Thomas
- Department of, Paediatric Neurology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - B Koshy
- Department of, Developmental Paediatrics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - A Jasper
- Department of, Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - S Danda
- Department of, Medical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - R George
- Departments of, Department of, Dermatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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