Variants of ATP1A3 in residue 756 cause a separate phenotype of relapsing encephalopathy with cerebellar ataxia (RECA)-Report of two cases and literature review.


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:
09 2021
Historique:
received: 13 05 2021
accepted: 08 07 2021
pubmed: 4 8 2021
medline: 17 3 2022
entrez: 3 8 2021
Statut: ppublish

Résumé

Variants in ATP1A3 cause well-known phenotypes-alternating hemiplegia of childhood (AHC), rapid-onset dystonia-parkinsonism (RDP), cerebellar ataxia, areflexia, pes cavus, optic atrophy, sensorineural hearing loss (CAPOS), and severe early infantile epileptic encephalopathy. Recently, there has been growing evidence for genotype-phenotype correlations in the ATP1A3 variants, and a separate phenotype associated with variants in residue 756-two acronyms are proposed for the moment-FIPWE (fever-induced paroxysmal weakness and encephalopathy) and RECA (relapsing encephalopathy with cerebellar ataxia). Herein, we are describing two new pediatric cases with a p.Arg756His change in the ATP1A3 gene. Both patients have had more than one episode of a neurological decompensation triggered by fever with severe hypotonia and followed by ataxia. Thirty-three cases from literature were analyzed to define and strengthen the genotype-phenotype correlation of variants located in residue 756 (p.Arg756His, p.Arg756Cys, p.Arg756Leu). Patients with a ATP1A3 variant in residue 756 are characterized by recurrent paroxysmal episodes of neurological decompensations triggered by fever, with severe hypotonia, ataxia, dysarthria, symptoms from the orofacial area (dysphagia, drooling) as well as with altered consciousness. Recovery is slow and usually not full with the persistent symptoms of cerebellar ataxia, dysarthria, dystonic and choreiform movements.

Sections du résumé

BACKGROUND
Variants in ATP1A3 cause well-known phenotypes-alternating hemiplegia of childhood (AHC), rapid-onset dystonia-parkinsonism (RDP), cerebellar ataxia, areflexia, pes cavus, optic atrophy, sensorineural hearing loss (CAPOS), and severe early infantile epileptic encephalopathy. Recently, there has been growing evidence for genotype-phenotype correlations in the ATP1A3 variants, and a separate phenotype associated with variants in residue 756-two acronyms are proposed for the moment-FIPWE (fever-induced paroxysmal weakness and encephalopathy) and RECA (relapsing encephalopathy with cerebellar ataxia).
MATERIALS AND METHODS
Herein, we are describing two new pediatric cases with a p.Arg756His change in the ATP1A3 gene. Both patients have had more than one episode of a neurological decompensation triggered by fever with severe hypotonia and followed by ataxia. Thirty-three cases from literature were analyzed to define and strengthen the genotype-phenotype correlation of variants located in residue 756 (p.Arg756His, p.Arg756Cys, p.Arg756Leu).
CONCLUSIONS
Patients with a ATP1A3 variant in residue 756 are characterized by recurrent paroxysmal episodes of neurological decompensations triggered by fever, with severe hypotonia, ataxia, dysarthria, symptoms from the orofacial area (dysphagia, drooling) as well as with altered consciousness. Recovery is slow and usually not full with the persistent symptoms of cerebellar ataxia, dysarthria, dystonic and choreiform movements.

Identifiants

pubmed: 34342181
doi: 10.1002/mgg3.1772
pmc: PMC8457706
doi:

Substances chimiques

ATP1A3 protein, human 0
Sodium-Potassium-Exchanging ATPase EC 7.2.2.13

Types de publication

Case Reports Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1772

Informations de copyright

© 2021 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC.

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Auteurs

Mateusz Biela (M)

Department of Pediatrics, Division Pediatric Propedeutics and Rare Disorders, Wroclaw Medical University, Wrocław, Poland.

Malgorzata Rydzanicz (M)

Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland.

Krystyna Szymanska (K)

Department of Experimental and Clinical Neuropathology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.

Karolina Pieniawska-Smiech (K)

Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland.

Aleksandra Lewandowicz-Uszynska (A)

Third Department and Clinic of Pediatrics, Immunology and Rheumatology of Developmental Age, Wroclaw Medical University, Wroclaw, Poland.

Joanna Chruszcz (J)

Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland.

Lucyna Benben (L)

Department of Paediatric Neurology, J. Gromkowski Regional Specialist Hospital, Wrocław, Poland.

Malgorzata Kuzior-Plawiak (M)

Department of Paediatric Neurology, J. Gromkowski Regional Specialist Hospital, Wrocław, Poland.

Pawel Szyld (P)

Cancer Genetics Unit Cancer Prevention Department, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

Aleksandra Jakubiak (A)

Department of Pediatrics, Division Pediatric Propedeutics and Rare Disorders, Wroclaw Medical University, Wrocław, Poland.

Leszek Szenborn (L)

Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland.

Rafal Ploski (R)

Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland.

Robert Smigiel (R)

Department of Pediatrics, Division Pediatric Propedeutics and Rare Disorders, Wroclaw Medical University, Wrocław, Poland.

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