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Fang Z, Hu C, Zhou S, Yu L. PIGW-related glycosylphosphatidylinositol deficiency: A case report and literature review. Neurol Sci 2024; 45:2253-2260. [PMID: 38055078 DOI: 10.1007/s10072-023-07225-6] [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: 10/06/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION PIGW-related glycosylphosphatidylinositol deficiency is a rare disease that manifests heterogeneous clinical phenotypes. METHODS We describe a patient with PIGW deficiency and summarize the clinical characteristics of the case. In addition, we conducted a literature review of previously reported patients with pathogenic variants of PIGW. RESULTS A Chinese girl presented with refractory epilepsy, severe intellectual disability, recurrent respiratory infections, and hyperphosphatasia. Seizures worsened during fever and infections, making her more susceptible to epileptic status. She was found to carry a heterozygous variant of PIGW and a deletion of chromosome 17q12 containing PIGW. Only six patients with homozygous or compound heterozygous pathogenic variants of PIGW have been identified in the literature thus far. Epileptic seizures were reported in all patients, and the most common types of seizures were epileptic spasms. Distinctive facial and physical features and recurrent respiratory infections are common in these patients with developmental delays. Serum alkaline phosphatase (ALP) levels were elevated in four of the six patients. CONCLUSIONS PIGW-related glycosylphosphatidylinositol deficiency is characterized by developmental delay, epilepsy, distinctive facial features, and multiple organ anomalies. Genetic testing is an important method for diagnosing this disease, and flow cytometry and serum ALP level detection are crucial complements for genetic testing.
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Affiliation(s)
- Zhixu Fang
- Department of Neurology, National Children's Medical Center, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Chaoping Hu
- Department of Neurology, National Children's Medical Center, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Shuizhen Zhou
- Department of Neurology, National Children's Medical Center, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Lifei Yu
- Department of Neurology, National Children's Medical Center, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Minhang District, Shanghai, 201102, China.
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Pode-Shakked B, Heimer G, Vilboux T, Marek-Yagel D, Ben-Zeev B, Davids M, Ferreira CR, Philosoph AM, Veber A, Pode-Shakked N, Kenet G, Soudack M, Hoffmann C, Vernitsky H, Safaniev M, Lodzki M, Lahad A, Shouval DS, Levinkopf D, Weiss B, Barg AA, Daka A, Amariglio N, Malicdan MCV, Gahl WA, Anikster Y. Cerebral and portal vein thrombosis, macrocephaly and atypical absence seizures in Glycosylphosphatidyl inositol deficiency due to a PIGM promoter mutation. Mol Genet Metab 2019; 128:151-161. [PMID: 31445883 PMCID: PMC10569059 DOI: 10.1016/j.ymgme.2019.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 10/26/2022]
Abstract
Defects of the glycosylphosphatidylinositol (GPI) biosynthesis pathway constitute an emerging subgroup of congenital disorders of glycosylation with heterogeneous phenotypes. A mutation in the promoter of PIGM, resulting in a syndrome with portal vein thrombosis and persistent absence seizures, was previously described in three patients. We now report four additional patients in two unrelated families, with further clinical, biochemical and molecular delineation of this unique entity. We also describe the first prenatal diagnosis of PIGM deficiency, allowing characterization of the natural history of the disease from birth. The patients described herein expand the phenotypic spectrum of PIGM deficiency to include macrocephaly and infantile-onset cerebrovascular thrombotic events. Finally, we offer insights regarding targeted treatment of this rare disorder with sodium phenylbutyrate.
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Affiliation(s)
- Ben Pode-Shakked
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gali Heimer
- Pediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Thierry Vilboux
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA; Inova Functional Laboratory, Inova Health System, Fairfax, Virginia, USA
| | - Dina Marek-Yagel
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Israel
| | - Bruria Ben-Zeev
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Pediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Israel
| | - Mariska Davids
- NIH Undiagnosed Diseases Program, NIH, National Human Genome Research Institute, Bethesda, MD, USA
| | - Carlos R Ferreira
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Amit Mary Philosoph
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Alvit Veber
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Naomi Pode-Shakked
- Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Pediatrics, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gili Kenet
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Israeli National Hemophilia Center and Thrombosis Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Michalle Soudack
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Pediatric Imaging Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Chen Hoffmann
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Radiology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Helly Vernitsky
- Hematology Laboratory, Sheba Medical Center, Tel-Hashomer, Israel
| | - Marina Safaniev
- Hematology Laboratory, Sheba Medical Center, Tel-Hashomer, Israel
| | - Maya Lodzki
- Pharmaceutical Services, Sheba Medical Center, Tel-Hashomer, Israel
| | - Avishay Lahad
- NIH Undiagnosed Diseases Program, NIH, National Human Genome Research Institute, Bethesda, MD, USA; Department of Pediatrics, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Dror S Shouval
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Dana Levinkopf
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Pediatrics, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Batia Weiss
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Assaf Arie Barg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Israeli National Hemophilia Center and Thrombosis Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ayman Daka
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Pediatrics, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ninette Amariglio
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Hematology Laboratory, Sheba Medical Center, Tel-Hashomer, Israel
| | - May Christine V Malicdan
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA; NIH Undiagnosed Diseases Program, NIH, National Human Genome Research Institute, Bethesda, MD, USA
| | - William A Gahl
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA; NIH Undiagnosed Diseases Program, NIH, National Human Genome Research Institute, Bethesda, MD, USA.
| | - Yair Anikster
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Israel.
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