Hereditary gelsolin amyloidosis – clinical symptoms and molecular genetic cause

2021 ◽  
Vol 84/117 (5) ◽  
Author(s):  
Pavlína Skalická ◽  
Lubica Ďuďáková ◽  
Aneta Klímová ◽  
Lukáš Huňa ◽  
Cerys J. Evans ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Molecular Genetic

scholarly journals Clinical and genetic spectrum of glycogen storage disease in Iranian population using targeted gene sequencing

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zahra Beyzaei ◽  
Fatih Ezgu ◽  
Bita Geramizadeh ◽  
Mohammad Hadi Imanieh ◽  
Mahmood Haghighat ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Gene Sequencing ◽  
Glycogen Storage ◽  
Loss Of Function ◽  
Retrospective Case ◽  
Complex Disorders ◽  
Glycogen Storage Diseases ◽  
Targeted Gene Sequencing ◽  
Retrospective Case Study

AbstractGlycogen storage diseases (GSDs) are known as complex disorders with overlapping manifestations. These features also preclude a specific clinical diagnosis, requiring more accurate paraclinical tests. To evaluate the patients with particular diagnosis features characterizing GSD, an observational retrospective case study was designed by performing a targeted gene sequencing (TGS) for accurate subtyping. A total of the 15 pediatric patients were admitted to our hospital and referred for molecular genetic testing using TGS. Eight genes namely SLC37A4, AGL, GBE1, PYGL, PHKB, PGAM2, and PRKAG2 were detected to be responsible for the onset of the clinical symptoms. A total number of 15 variants were identified i.e. mostly loss-of-function (LoF) variants, of which 10 variants were novel. Finally, diagnosis of GSD types Ib, III, IV, VI, IXb, IXc, X, and GSD of the heart, lethal congenital was made in 13 out of the 14 patients. Notably, GSD-IX and GSD of the heart-lethal congenital (i.e. PRKAG2 deficiency) patients have been reported in Iran for the first time which shown the development of liver cirrhosis with novel variants. These results showed that TGS, in combination with clinical, biochemical, and pathological hallmarks, could provide accurate and high-throughput results for diagnosing and sub-typing GSD and related diseases.

scholarly journals Geno-phenotypic characteristics of Ehlers–Danlos syndrome: difficulties of disease type identification and approaches to pathogenetic treatment

2021 ◽  
Vol 66 (1) ◽  
pp. 22-30
Author(s):  
E. A. Nikolaeva ◽  
A. N. Semyachkina
Keyword(s):  
Connective Tissue ◽  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Symptomatic Treatment ◽  
Pathological Process ◽  
Social Adaptation ◽  
Molecular Defect ◽  
Ehlers Danlos Syndrome ◽  
Pathogenetic Therapy ◽  
Danlos Syndrome

Veltischev Researchand Clinical Institutefor Pediatricsofthe Pirogov Russian National Research Medical University, Moscow, Russia The article presents modern data on the most common monogenic connective tissue disease – Ehlers–Danlos syndrome. The authors describe two previous classifications of the syndrome: Berlin (1988) classification, which distinguishes 11 types of the disease, and Beyton (1998) classification, which includes 6 types of the syndrome and takes into account the results of molecular genetic studies. Particular attention is paid to a new classification, proposed by the International Consortium in 2017. This classification is based on the clinical and molecular genetic data and unites 13 types of Ehlers–Danlos syndrome, divided in 7 groups (A–G), depending on the main molecular defect. This defect determines the violation of various collagen structures (primary, spatial, cross-linking) and others constituents of the connective tissue (myomatrix, glycosaminoglycans, complement component, etc.). The classification provides general clinical symptoms for all types of the disease and comprehensive information on the specific signs of each of the 13 types of the syndrome.The authors discuss approaches to the pathogenetic therapy of the syndrome, the possibilities of symptomatic treatment, including both medications of different spectrum of action, and physiotherapeutic measures, exercise therapy. The complex of the listed therapeutic measures is aimed at stabilizing the main pathological process, preventing complications, improving the patient’s quality of life and social adaptation. The authors emphasize that correct patient management, targeted medical supervision and medical genetic counseling requires molecular genetic verification of the diagnosis.

Marfan Syndrome

2005 ◽  
Vol 44 (04) ◽  
pp. 487-497 ◽  
Author(s):  
G. Mátyás ◽  
B. Steinmann ◽  
D. Baumgartner ◽  
C. Baumgartner
Keyword(s):  
Medical Treatment ◽  
Marfan Syndrome ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Molecular Genetic ◽  
Clinical Manifestations ◽  
Hierarchical Cluster ◽  
Molecular Genetic Analysis ◽  
Missense Mutations ◽  
Surgical Interventions

Summary Objectives: Marfan syndrome (MFS) is an autosomal dominant inherited connective tissue disorder caused by mutations in the fibrillin-1 (FBN1) gene with variable clinical manifestations in the cardiovascular, musculoskeletal and ocular systems. Methods: Data of molecular genetic analysis and a catalogue of clinical manifestations including aortic elastic parameters were mined in order to (i) assess aortic abnormality before and during medical treatment, and to (ii) identify novel correlations between the genotype and phenotype of the disease using hierarchical cluster analysis and logistic regression analysis. A score measure describing the similarity between a patient’s clinical symptoms and a characteristic phenotype class was introduced. Results: A probabilistic model for monitoring the loss of aortic elasticity was built on merely aortic parameters of 34 patients with classic MFS and 43 control subjects showing a sensitivity of 82% and a specificity of 96%. The clinical phenotypes of 100 individuals with classical or suspected MFS were clustered yielding four different phenotypic expressions. The highest correlation was found between FBN1 missense mutations, which manifested as ectopia lentis, skeletal major and skin minor criteria, and two out of four clustered phenotypes. The probability of the presence of a missense mutation in both phenotype classes is approximately 70%. Conclusions: Monitoring of aortic elastic properties during medical treatment may serve as additional criterion to indicate elective surgical interventions. Genotype-phenotype correlation may contribute to anticipate the clinical consequences of specific FBN1 mutations more comprehensively and may be helpful to identify MFS patients at risk at an early stage of disease.

scholarly journals Fiatal felnőtt korban diagnosztizált familiáris mediterrán láz

2020 ◽  
Vol 53 (4) ◽  
pp. 201-205
Author(s):  
Henrietta Poset ◽  
Judit Kárteszi ◽  
Tibor Kalmár ◽  
Zoltán Maróti ◽  
Julianna Fekete ◽  
...  
Keyword(s):  
Familial Mediterranean Fever ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Molecular Genetic ◽  
Mefv Gene ◽  
Young Female ◽  
C1 Inhibitor Deficiency ◽  
First Line Therapy ◽  
Hereditary Autoinflammatory Diseases ◽  
Mediterranean Fever

Összefoglaló. A familiáris mediterrán láz a herediter autoinflammatorikus betegségek közé tartozik. Klinikai tüneteit döntően a savós hártyák akut gyulladása (serositis: peritonitis, pleuritis, synovitis, ritkán pericarditis, meningitis) határozza meg. A betegség hátterében a pyrin fehérjét kódoló MEFV-gén többségében autoszómális recesszív módon öröklődő mutációi állnak. Legfontosabb szövődménye az amyloidosis, amely veseelégtelenséghez vezethet. Kezelésében első vonalbeli terápiaként a colchicin szerepel. Fiatal nőbetegünket 12 éves kora óta több intézetben vizsgálták intenzív hasi fájdalommal és lázzal járó attakok miatt. A tünettan részeként hányás, hasmenés és mellkasi fájdalom jelentkezett. A gyulladásos epizódok 5–14 napig tartottak, a köztes időszakokban viszont teljesen jól volt. A rohamok alatt készült laboratóriumi vizsgálatok során leukocitózis, valamint emelkedett süllyedés és CRP mutatkozott. Intravazális hemolízisre utalt az anémia, retikulocitózis, magas Sebi, szérum szabad hemoglobin és LDH együttes megjelenése. Az EKG-én inferior és az anteroseptalis elvezetésekben átmenetileg negatív T-hullámok jelentek meg, ami pericarditis lehetőségét vetette fel. Fizikális státuszából kiemelendő a diszkrét, de progrediáló splenomegalia. Kizártuk a porphyriat, glucose-6-phosphat dehydrogenase-hiányt, PNH-t és C1-inhibitorhiányt. Az autoinflammatorikus betegség miatt elvégzett molekuláris genetikai vizsgálat az MEFV-génmutáció homozigóta formáját, a Familiáris mediterrán láz diagnózisát igazolta. Summary. The familial Mediterranean fever is one of the hereditary autoinflammatory diseases. Its clinical symptoms are mainly determined by acute inflammation of the serous membranes (serositis: peritonitis, pleurisy, synovitis, rarely, pericarditis, meningitis). The background of the disease is mostly represented by autosomal recessively inherited mutations in the MEFV gene encoding the pyrine protein. Its most important complication is amyloidosis, which can lead to renal failure. Colchicine is included in its treatment, as a first-line therapy. Our young female patient has been examined in several institutions since the age of 12 for attacks of intense abdominal pain and fever. The symptoms included vomiting, diarrhea, and chest pain. The inflammatory episodes lasted 5–14 days, but in the intervening periods she was free of symptoms. Laboratory tests performed during the inflammatory periods showed leukocytosis as well as increased ESR and CRP. Intravascular hemolysis was indicated by anemia, reticulocytosis, co-occurrence of high Sebi, serum free hemoglobin and LDH. On the ECG, transiently negative T waves appeared in the inferior and anteroseptal leads, raising the possibility of pericarditis. Of her clinical status, discrete but progressive splenomegaly should be highlighted. Porphyria, glucose-6-phosphat dehydrogenase deficiency, PNH, and C1 inhibitor deficiency were excluded during our examinations. Molecular genetic testing urged by autoinflammatory disease confirmed a homozygous form of the MEFV gene mutation and established the diagnosis of familial Mediterranean fever.

First Results of Russian Multicenter Population Base Study of the Incidence of Chronic Myeloid Leukemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4431-4431
Author(s):  
Sergey M. Kulikov ◽  
Olga Yu. Vinogradova ◽  
Ekaterina Yu. Chelysheva ◽  
Marya V. Galayko ◽  
Irina A. Titshenko ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Research Funding ◽  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Age Groups ◽  
Chronic Phase ◽  
Newly Diagnosed ◽  
Advisory Committees ◽  
First Results ◽  
Collection Data

Abstract Abstract 4431 The European Treatment Outcome Study (EUTOS) is register based international investigation started in June 2007. [1] The aim is to study the epidemiology of CML and to gain insight into the ‘real world’ treatment of patients with CML. Population base section (EUTOS-PBS) is the prospective study directed mostly to epidemiology aims. Russian part of the EUTOS-PBS registry collect data of newly diagnosed patients lived in 7 large regions of about 10 millions of population totally. EUTOS-PBS inclusion criteria are following: newly diagnosed CML (Ph +/BCR-ABL) started form 1st October 2009, age: older than 18. Russian CML group includes additional protocol for collection data for patients with clinical symptoms of CML. These patients are included into the roster table and after laboratory confirmation are enrolled into the main phase of the study. Thus, 174 patients were included in pre-phase, 142 (82%) had the diagnosis of CML which was confirmed by cytogenetic/molecular-genetic tests (Ph +/BCR-ABL +), 32 (18%) was not confirmed as CML. Among them 87% (n = 20) - have other Ph–negative chronic myeloproliferative diseases, and also acute leukemia (n = 1), cancer (n = 1), chronic inflammatory processes (n = 1). 142 patients with CML are 73 men, 69 women have the age from 18 to 82 (Me 49) years. 136 (96%) of patients are in the chronic phase, 6 (4%) -in the phase of acceleration, nobody in a blast ñrisis. The standard frequency analysis with adjustment to the standard population of WHO was carried out to estimate distribution. The results was presented in the table 1. As shown registered morbidity in 6 regions is not varied so much: source incidence is 0,58 (0,44–0,69); standardized on WHO incidence is: 0,7 (0,57 – 0,85); per 100 thousands per year. Estimated registered morbidity of CML in Russian regions are in 1.5–2 times less, than published morbidity in western countries. The analysis of the incidence in age stratums (table 2) shows that there is no much growth of age morbidity as expected. It obviously points to low detectability of new CML incidents in senior age categories (are more senior 60 years). This fact is probably the main reason of low total registered morbidity. Tabl.1. Incidence rate of new CML cases in 6 regions of Russia Region population (mln.) N CML for 100000. in year Standard of WHO Mordovia Republic 0.87 14 0.69 0.85 Kirov region 1.46 18 0.53 0.6 Perm territory 2.77 45 0.68 0.8 Bryansk region 1.35 17 0.53 0.65 Irkutsk region 2.55 36 0.56 0.68 Zabaikal's territory 1.36 12 0.44 0.57 Total 10.13 142 0.58 0.7 Table 2.CML incidence in age groups Age groups Male Female Maleandfemale 18–29 0.65 0.57 0.61 30–39 0.86 0.39 0.62 40–49 0.50 0.57 0.54 Conclusion: The CML incidence in Russia regions is underestimated. The main reason is an insufficient CML diagnostic screening in the senior age groups of population. References. 1. http://www.eutos.org/content/registry/documents/documents/e940/infoboxContent941/CML-Registry_February09.pdf Disclosures: Vinogradova: BMS: Consultancy, Speakers Bureau; Novartis: Consultancy, Research Funding, Speakers Bureau. Chelysheva:Novartis Pharma: Research Funding, Speakers Bureau; Bristol Myers Squibb: Research Funding, Speakers Bureau; MSD: Speakers Bureau. Senderova:Novartis: Consultancy. Turkina:Novartis Pharma: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau.

scholarly journals Advances in Hemophagocytic Lymphohistiocytosis: Pathogenesis, Early Diagnosis/Differential Diagnosis, and Treatment

2011 ◽  
Vol 11 ◽  
pp. 697-708 ◽  
Author(s):  
Yong-Min Tang ◽  
Xiao-Jun Xu
Keyword(s):  
Immune Response ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Hematopoietic Stem ◽  
Curative Therapy ◽  
New Finding ◽  
Life Threatening

Hemophagocytic lymphohistiocytosis (HLH) is a histiocytic disorder characterized by a highly stimulated, but ineffective, immune response to antigens, which results in life-threatening cytokine storm and inflammatory reaction. Considerable progress has been made during the past 2 decades. Detection of molecular genetic abnormalities in genes involved in immune response pathways, such as PRF1, STX11, UNC13D, STXBP2, RAB27A, LYST, AP3B1, SH2D1A, and BIRC4, is confirmatory for the diagnosis. Clinical diagnosis is largely made according to HLH-2004 criteria. However, a new finding of the Th1/Th2 cytokine pattern (significant increase of IFN-γ and IL-10 with slightly increased or normal level of IL-6) is a useful biomarker for the early diagnosis, differential diagnosis, and the monitoring of the disease. Intensive immunosuppressive therapy is generally accepted as treatment for the relief of clinical symptoms/signs, while allogeneic hematopoietic stem cell transplantation is currently the only potentially curative therapy option for severe familial forms of HLH.

scholarly journals GNAO1 encephalopathy

2017 ◽  
Vol 3 (2) ◽  
pp. e143 ◽  
Author(s):  
Federica Rachele Danti ◽  
Serena Galosi ◽  
Marta Romani ◽  
Martino Montomoli ◽  
Keren J. Carss ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
De Novo ◽  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Cerebral Atrophy ◽  
Epileptic Encephalopathy ◽  
Causative Role ◽  
Diffuse Astrocytoma ◽  
Who Grade ◽  
Wide Range

Objective:To describe better the motor phenotype, molecular genetic features, and clinical course of GNAO1-related disease.Methods:We reviewed clinical information, video recordings, and neuroimaging of a newly identified cohort of 7 patients with de novo missense and splice site GNAO1 mutations, detected by next-generation sequencing techniques.Results:Patients first presented in early childhood (median age of presentation 10 months, range 0–48 months), with a wide range of clinical symptoms ranging from severe motor and cognitive impairment with marked choreoathetosis, self-injurious behavior, and epileptic encephalopathy to a milder phenotype, featuring moderate developmental delay associated with complex stereotypies, mainly facial dyskinesia and mild epilepsy. Hyperkinetic movements were often exacerbated by specific triggers, such as voluntary movement, intercurrent illnesses, emotion, and high ambient temperature, leading to hospital admissions. Most patients were resistant to drug intervention, although tetrabenazine was effective in partially controlling dyskinesia for 2/7 patients. Emergency deep brain stimulation (DBS) was life saving in 1 patient, resulting in immediate clinical benefit with complete cessation of violent hyperkinetic movements. Five patients had well-controlled epilepsy and 1 had drug-resistant seizures. Structural brain abnormalities, including mild cerebral atrophy and corpus callosum dysgenesis, were evident in 5 patients. One patient had a diffuse astrocytoma (WHO grade II), surgically removed at age 16.Conclusions:Our findings support the causative role of GNAO1 mutations in an expanded spectrum of early-onset epilepsy and movement disorders, frequently exacerbated by specific triggers and at times associated with self-injurious behavior. Tetrabenazine and DBS were the most useful treatments for dyskinesia.

scholarly journals A case of severe neonatal hyperparathyroidism due to defect in calcium receptors

2010 ◽  
Vol 56 (4) ◽  
pp. 27-33
Author(s):  
A V Vitebskaia ◽  
E E Petriaĭkina ◽  
A Iu Razumovskiĭ ◽  
A A Pavlov ◽  
A N Tiul'pakov
Keyword(s):  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Familial Hypocalciuric Hypercalcemia ◽  
General Health Status ◽  
Casr Gene ◽  
Patient Diagnosis ◽  
First Case ◽  
High Calcium ◽  
Calcium Receptors ◽  
Very High

The first case of severe neonatal hyperparathyroidism in the Russian population verified by molecular-genetic testing is described. The patient presented with very high calcium and parathyroid hormone (PTH) levels and showed characteristic clinical symptoms of hyperparathyroidism in the absence of lesions in long tubular bones. Removal of all parathyroid glands resulted in normalization of laboratory parameters and general health status of the patient. Diagnosis of severe neonatal hyperparathyroidism was confirmed by sequencing the CASR gene while parents of the child were shown to suffer familial hypocalciuric hypercalcemia.

scholarly journals Hypophosphatasia in children. Three faces of one disease

2020 ◽  
Vol 3 (2) ◽  
pp. 136-141
Author(s):  
S.A. Boykov ◽  
◽  
I.Yu. Chernyak ◽  
N.S. Shatokhina ◽  
E.Yu. Gurkina ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Clinical Symptoms ◽  
Bone Mineralization ◽  
Case Reports ◽  
Molecular Genetic ◽  
Case Series ◽  
Alp Activity ◽  
Systemic Manifestations ◽  
Molecular Genetic Test ◽  
Reduced Mobility

Hypophosphatasia (HPP) is a rare multisystem inherited metabolic disorder caused by mutations in ALPL gene that encodes tissue nonspecific alkaline phosphatase responsible for bone mineralization. HPP is characterized by impaired bone mineralization, skeletal abnormalities, and systemic manifestations which result in significant morbidity and mortality. Clinical presentations of HPP vary greatly. Early (perinatal and infantile) HPP is characterized by the most severe symptoms, i.e., respiratory and neurological disorders are of crucial importance being the leading causes of death. Progressive skeletal impairment, rickets-like deformities, reduced mobility, and severe disability are typical of childhood-onset HPP. The biochemical hallmark of HPP is low alkaline phosphatase (ALP) activity. HPP diagnosis is verified by clinical symptoms in combination with persistently low ALP activity (adjusted for age and sex). Molecular genetic test to identify ALPL gene mutation is performed as needed. Three case reports addresses authors’ experience with the diagnosis and treatment for HPP.Keywords: hypophosphatasia, case series, alkaline phosphatase, impaired bone mineralization, asfotase alfa.For citation: Boykov S.A., Chernyak I.Yu., Shatokhina N.S. et al. Hypophosphatasia in children. Three faces of one disease. Russian Journal of Woman and Child Health. 2020;3(2):136–141. DOI: 10.32364/2618-8430-2020-3-2-136-141.

scholarly journals Frequency of Fabry Disease in a Juvenile Idiopathic Arthritis Cohort

2020 ◽  
Author(s):  
Luciana Paim-Marques ◽  
Amanda Virginia Cavalcante ◽  
Islane Verçosa ◽  
Paula Carneiro ◽  
Marcia Souto-Maior ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Fabry Disease ◽  
Clinical Symptoms ◽  
Molecular Genetic ◽  
Disease Onset ◽  
Pathogenic Mutation ◽  
Lysosomal Storage ◽  
Variant Of Uncertain Significance ◽  
Alpha Galactosidase ◽  
Intronic Variants

Abstract Background: Fabry disease (FD) is a rare, X-linked, multisystemic lysosomal storage disorder (LSD) that results from a deficiency in the hydrolase alpha-galactosidase A (⍺-GalA). In childhood, classic FD symptomatology is rare. Majority of children present with mild non-specific symptoms, including the musculoskeletal system. The prevalence of FD among juvenile idiopathic arthritis (JIA) patients is unknown. Objective: The aim was to identify the frequency of FD in a JIA cohort, characterizing early clinical symptoms, enzyme titers and GLA genotyping. Methods: Children with JIA followed in tertiary Children Hospital cohort were selected. Clinical, laboratorial, and familiar information was recorded. Molecular genetic testing to detect GLA gene mutations was performed in the girls and enzymatic analysis in the boys. Results: In 89 patients (56.2% female, age at disease onset: 8.93 ± 4.35 years), one male (1.12%) patient presented pathogenic mutation in GLA gene, c.1244T>C p.L415P, one female patient had a variant of uncertain significance c.38C>T (p.Ala13Val). The enzymatic activity of alpha galactosidase was slightly decreased in 3 additional (3.4%) patients. We observed the presence of intronic variants in 44.44% of our cohort: c.1000-22C> T; c.370-81_-77del; c.640-16A> G; c.10C>T; c.548-125C> G and c.-12G> A. These variants and their combination were associated with clinical symptoms in our cohort. Conclusions: The incidence of FD in our cohort was 1.12%. Intronic variants were associated with symptomatology described in the literature. Screening for FD in JIA may be a reasonable strategy for those with atypical pattern pain.

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