A novel MBD5 mutation in an intellectually disabled adult female patient with epilepsy: Suggestive of early onset dementia?


Journal

Molecular genetics & genomic medicine
ISSN: 2324-9269
Titre abrégé: Mol Genet Genomic Med
Pays: United States
ID NLM: 101603758

Informations de publication

Date de publication:
08 2019
Historique:
received: 14 04 2019
revised: 27 05 2019
accepted: 05 06 2019
pubmed: 11 7 2019
medline: 1 7 2020
entrez: 11 7 2019
Statut: ppublish

Résumé

The minimal critical region in 2q23.1 deletion syndrome comprises one gene only, that is, the methyl-CpG-binding domain protein 5 (MBD5) gene. Since the phenotypes of patients with deletions, duplications or pathogenic variants of MBD5 show considerable overlap, the term MBD5-associated neurodevelopmental disorder (MAND) was proposed. These syndromes are characterized by intellectual disability, seizures of any kind and symptoms from the autism spectrum. In a very limited number of patients, MAND may be associated with regression starting either at early infancy or at midlife. The present paper describes a severely intellectually disabled autistic female with therapy resistant complex partial epilepsy starting at her 16the with gradual cognitive and behavioral regression towards her sixth decade. Cognitive and behavioral regression occurred towards the patient's sixth decade. Exome sequencing disclosed a novel heterozygous pathogenic frameshift mutation of MBD5 that was considered to be causative for the combination of intellectual disability, treatment-resistant epilepsy and autism. The presented patient is the second with a pathogenic MBD5 mutation in whom the course of disease is suggestive of early onset dementia starting in her fifth decade. These findings stress the importance of exome sequencing, also in elderly intellectually disabled patients, particularly in those with autism.

Sections du résumé

BACKGROUND
The minimal critical region in 2q23.1 deletion syndrome comprises one gene only, that is, the methyl-CpG-binding domain protein 5 (MBD5) gene. Since the phenotypes of patients with deletions, duplications or pathogenic variants of MBD5 show considerable overlap, the term MBD5-associated neurodevelopmental disorder (MAND) was proposed. These syndromes are characterized by intellectual disability, seizures of any kind and symptoms from the autism spectrum. In a very limited number of patients, MAND may be associated with regression starting either at early infancy or at midlife.
METHODS
The present paper describes a severely intellectually disabled autistic female with therapy resistant complex partial epilepsy starting at her 16the with gradual cognitive and behavioral regression towards her sixth decade.
RESULTS
Cognitive and behavioral regression occurred towards the patient's sixth decade. Exome sequencing disclosed a novel heterozygous pathogenic frameshift mutation of MBD5 that was considered to be causative for the combination of intellectual disability, treatment-resistant epilepsy and autism.
CONCLUSION
The presented patient is the second with a pathogenic MBD5 mutation in whom the course of disease is suggestive of early onset dementia starting in her fifth decade. These findings stress the importance of exome sequencing, also in elderly intellectually disabled patients, particularly in those with autism.

Identifiants

pubmed: 31290275
doi: 10.1002/mgg3.849
pmc: PMC6687664
doi:

Substances chimiques

DNA-Binding Proteins 0
MBD5 protein, human 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e849

Informations de copyright

© 2019 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

Références

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Auteurs

Willem Verhoeven (W)

Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.
Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, the Netherlands.

Jos Egger (J)

Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
Stevig Specialized and Forensic Care for People with Intellectual Disabilities, Dichterbij, Oostrum, the Netherlands.

Janneke Kipp (J)

ASVZ Institutes for Intellectual Disabilities, Leerdam, the Netherlands.

Jiska Verheul-Aan de Wiel (J)

ASVZ Institutes for Intellectual Disabilities, Leerdam, the Netherlands.

Charlotte Ockeloen (C)

Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.

Tjitske Kleefstra (T)

Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.

Rolph Pfundt (R)

Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.

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Classifications MeSH