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A novel POLR3A genotype leads to leukodystrophy type-7 in two siblings with unusually late age of onset
- Source :
- BMC Neurology, Vol 20, Iss 1, Pp 1-6 (2020), BMC Neurology
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background Leukodystrophies are familial heterogeneous disorders primarily affecting the white matter, which are defined as hypomyelinating or demyelinating based on disease severity as assessed at MRI. Recently, a group of clinically overlapping hypomyelinating leukodystrophies (HL) has been associated with mutations in RNA polymerase III enzymes (Pol III) subunits. Case presentation In this manuscript, we describe two Italian siblings carrying a novel POLR3A genotype. MRI imaging, genetic analysis, and clinical data led to diagnosing HL type 7. The female sibling, at the age of 34, is tetra-paretic and suffers from severe cognitive regression. She had a disease onset at the age of 19, characterized by slow and progressive cognitive impairment associated with gait disturbances and amenorrhea. The male sibling was diagnosed during an MRI carried out for cephalalgia at the age of 41. After 5 years, he developed mild cognitive impairment, dystonia with 4-limb hypotonia, and moderate dysmetria with balance and gait impairment. Conclusions The present study provides the first evidence of unusually late age of onset in HL, describing two siblings with a novel POLR3A genotype which showed the first symptoms at the age of 41 and 19, respectively. This provides a powerful insight into clinical heterogeneity and genotype-phenotype correlation in POLR3A related HL.
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
Neurology
Genotype
Age of onset
POLR3A mutations
Case Report
Settore MED/26
lcsh:RC346-429
03 medical and health sciences
0302 clinical medicine
Cephalalgia
medicine
Humans
Sibling
book
lcsh:Neurology. Diseases of the nervous system
030304 developmental biology
Dystonia
0303 health sciences
book.periodical
business.industry
Siblings
Leukodystrophy
RNA Polymerase III
Brain
General Medicine
Hypomyelinating leukodystrophies
medicine.disease
Magnetic Resonance Imaging
White Matter
Hypotonia
Hereditary Central Nervous System Demyelinating Diseases
Mutation
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14712377
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Neurology
- Accession number :
- edsair.doi.dedup.....1f6efb72e48e4989f6a9d92a896d2d90