Paroxysmal kinesigenic dyskinesia（PKD） and myotonia congenita（MC） are independent disorders that share some clinical features. We aimed to investigate the sequences of PRRT2 and CLCN1 in a proband diagnosed with P...Paroxysmal kinesigenic dyskinesia（PKD） and myotonia congenita（MC） are independent disorders that share some clinical features. We aimed to investigate the sequences of PRRT2 and CLCN1 in a proband diagnosed with PKD and suspected MC. Clinical evaluation and auxiliary examinations were performed. Direct sequencing of the entire coding regions of the PRRT2 and CLCN1 genes was conducted. Haplotype analysis confirmed the relationships among the family members. The proband suffered choreoathetosis attacks triggered by sudden movements, and lower-limb weakness a n d s t i ff n e s s t h a t w o r s e n e d i n c o l d w e a t h e r. Carbamazepine monotherapy completely controlled his choreoathetosis and significantly relieved his limb weakness and stiffness. His father, when young, had similar limb stiffness, while his mother and brother were asymptomatic. Genetic analysis revealed that the proband and his father harbored a PRRT2 c.649 dup C mutation, and CLCN1 c.1723C〉T and c.2492A〉G mutations. His brother carried only the two CLCN1 mutations. None of these mutations were identified in his mother and 150 unrelated controls. This is the first report showing the coexistence ofPRRT2 and CLCN1 mutations. Our results also indicate that both the PRRT2 and CLCN1 genes need to be screened if we fail to identify PRRT2 mutations in PKD patients or CLCN1 mutations in MC patients.展开更多
目的鉴定一个富脯氨酸跨膜蛋白2(proline-rich transmembrane protein 2,PRRT2)相关发作性疾病家系的PRRT2基因突变类型,并分析其临床表型特点。方法该家系有3代7人,其中5人(先证者及其母亲、哥哥、舅舅、外婆)有抽搐史。对上述5名有抽...目的鉴定一个富脯氨酸跨膜蛋白2(proline-rich transmembrane protein 2,PRRT2)相关发作性疾病家系的PRRT2基因突变类型,并分析其临床表型特点。方法该家系有3代7人,其中5人(先证者及其母亲、哥哥、舅舅、外婆)有抽搐史。对上述5名有抽搐史的家系成员及先证者的父亲采集外周静脉血,提取全血基因组DNA,进行全外显子测序。根据全外显子测序结果筛选出的致病基因突变位点(位于PRRT2基因第2外显子),采用Sanger测序法对每个家系成员的目标位点进行验证。结果该家系5例患者中,2例符合良性家族性婴幼儿癫痫诊断,1例符合发作性运动诱发性运动障碍诊断,2例符合热性惊厥诊断。5例患者均存在PRRT2基因第2外显子c.649dup C(p.R217Pfs*8)杂合突变,先证者的父亲未发现该突变位点。结论该家系存在PRRT2基因c.649dupC杂合突变,导致PRRT2相关发作性疾病。展开更多
基金supported by grants from the National Natural Science Foundation of China (81330025 and 81125009)
文摘Paroxysmal kinesigenic dyskinesia（PKD） and myotonia congenita（MC） are independent disorders that share some clinical features. We aimed to investigate the sequences of PRRT2 and CLCN1 in a proband diagnosed with PKD and suspected MC. Clinical evaluation and auxiliary examinations were performed. Direct sequencing of the entire coding regions of the PRRT2 and CLCN1 genes was conducted. Haplotype analysis confirmed the relationships among the family members. The proband suffered choreoathetosis attacks triggered by sudden movements, and lower-limb weakness a n d s t i ff n e s s t h a t w o r s e n e d i n c o l d w e a t h e r. Carbamazepine monotherapy completely controlled his choreoathetosis and significantly relieved his limb weakness and stiffness. His father, when young, had similar limb stiffness, while his mother and brother were asymptomatic. Genetic analysis revealed that the proband and his father harbored a PRRT2 c.649 dup C mutation, and CLCN1 c.1723C〉T and c.2492A〉G mutations. His brother carried only the two CLCN1 mutations. None of these mutations were identified in his mother and 150 unrelated controls. This is the first report showing the coexistence ofPRRT2 and CLCN1 mutations. Our results also indicate that both the PRRT2 and CLCN1 genes need to be screened if we fail to identify PRRT2 mutations in PKD patients or CLCN1 mutations in MC patients.
文摘目的鉴定一个富脯氨酸跨膜蛋白2(proline-rich transmembrane protein 2,PRRT2)相关发作性疾病家系的PRRT2基因突变类型,并分析其临床表型特点。方法该家系有3代7人,其中5人(先证者及其母亲、哥哥、舅舅、外婆)有抽搐史。对上述5名有抽搐史的家系成员及先证者的父亲采集外周静脉血,提取全血基因组DNA,进行全外显子测序。根据全外显子测序结果筛选出的致病基因突变位点(位于PRRT2基因第2外显子),采用Sanger测序法对每个家系成员的目标位点进行验证。结果该家系5例患者中,2例符合良性家族性婴幼儿癫痫诊断,1例符合发作性运动诱发性运动障碍诊断,2例符合热性惊厥诊断。5例患者均存在PRRT2基因第2外显子c.649dup C(p.R217Pfs*8)杂合突变,先证者的父亲未发现该突变位点。结论该家系存在PRRT2基因c.649dupC杂合突变,导致PRRT2相关发作性疾病。
