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Sürücü Kara İ, Köse E, Çavdarlı B, Eminoğlu FT. Neuronal ceroid lipofuscinosis type 11 diagnosed patient with bi-allelic variants in GRN gene: case report and review of literature. J Pediatr Endocrinol Metab 2024; 37:280-288. [PMID: 38253347 DOI: 10.1515/jpem-2023-0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVES Neuronal ceroid lipofuscinosis type 11 (NCL11) is a rare disease that presents with progressive cognitive decline, epilepsy, visual impairment, retinal atrophy, cerebellar ataxia and cerebellar atrophy. We present herein a case of NCL11 in a patient diagnosed with neuromotor developmental delay, epilepsy, bronchiolitis obliterans and hypothyroidism. CASE PRESENTATION A 4-year-old male patient was admitted to our clinic with global developmental delay and a medical history that included recurrent hospitalizations for pneumonia at the age of 17 days, and in months 4, 5 and 7. Family history revealed a brother with similar clinical findings (recurrent pneumonia, hypothyroidism, hypotonicity, swallowing dysfunction and neuromotor delay) who died from pneumonia at the age of 22 months. Computed tomography of the thorax was consistent with bronchiolitis obliterans, while epileptic discharges were identified on electroencephalogram with a high incidence of bilateral fronto-centro-temporal and generalized spike-wave activity but no photoparoxysmal response. Cranial MRI revealed T2 hyperintense areas in the occipital periventricular white matter and volume loss in the white matter, a thin corpus callosum and vermis atrophy. A whole-exome sequencing molecular analysis revealed compound heterozygous c.430G>A (p.Asp144Asn) and c.415T>C (p.Cys139Arg) variants in the GRN gene. CONCLUSIONS The presented case indicates that NCL11 should be taken into account in patients with epilepsy and neurodegenerative diseases.
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Affiliation(s)
- İlknur Sürücü Kara
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
| | - Engin Köse
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
- Ankara University Rare Diseases Application and Research Center, Ankara, Türkiye
| | - Büşranur Çavdarlı
- Department of Medical Genetics, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Fatma Tuba Eminoğlu
- Department of Pediatric Metabolism, Faculty of Medicine, Ankara University, Ankara, Türkiye
- Ankara University Rare Diseases Application and Research Center, Ankara, Türkiye
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Ocampo-Chih C, Dennis H, Lall N, Pham N, Liang B, Verma S, Neira Fresneda J. PEBAT, an Intriguing Neurodegenerative Tubulinopathy Caused by a Novel Homozygous Variant in TBCD: A Case Series and Literature Review. Pediatr Neurol 2023; 139:59-64. [PMID: 36527993 DOI: 10.1016/j.pediatrneurol.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/20/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022]
Abstract
Progressive encephalopathy with brain atrophy and thin corpus callosum (PEBAT) is a severe and rare progressive neurodegenerative disease (OMIM 617913). This condition has been described in individuals with pathogenic variants affecting tubulin-specific chaperone protein D (TBCD), which is responsible for proper folding and assembly of tubulin subunits. Here we describe two unrelated infants from Central America presenting with worsening neuromuscular weakness, respiratory failure, polyneuropathy, and neuroimaging findings of severe cerebral volume loss with thin corpus callosum. These individuals harbored the same homozygous variant of uncertain significance in the TBCD gene on whole exome sequencing (WES). Predicted protein modeling of this variant confirmed disruption of the protein helix at the surface of TBCD. The goal of this report is to emphasize the importance of rapid WES, careful interpretation of uncertain variants, prognostication, and family counseling especially when faced with a neurodegenerative clinical course.
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Affiliation(s)
- Claudia Ocampo-Chih
- Monroe Carell Jr. Children's Hospital, Vanderbilt University, Nashville, Tennessee
| | - Hailey Dennis
- Department of Medical Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Neil Lall
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Department of Radiology, Emory University School of Medicine, Atlanta, Georgia
| | - Nga Pham
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Department of Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Bo Liang
- Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia
| | - Sumit Verma
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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Bican R, Ferrante R, Hendershot S, Byars M, Lo W, Heathcock JC. Daily Outpatient Physical Therapy for a Toddler With a Neurodegenerative Disease: A Case Report. Pediatr Phys Ther 2022; 34:261-267. [PMID: 35385464 PMCID: PMC9102785 DOI: 10.1097/pep.0000000000000884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE This case report highlights the potential value of delivering a high-dose physical therapy (PT) intervention for a child with a neurodegenerative disease. We include developmental outcomes for a 23-month-old toddler with biallelic TBCD gene mutations following daily outpatient PT. SUMMARY OF KEY POINTS The child had clinical improvements in gross and fine motor, cognition, expressive and receptive language, socioemotional, and adaptive behavior function as determined through Goal Attainment Scaling, Gross Motor Function Measure, and Bayley Scales of Infant and Toddler Development following daily PT intervention. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE High-dose outpatient PT may be beneficial for a child with a neurodegenerative disease at some time frames. In selected cases, if the neurodegenerative disease slowly progresses, high-dose PT may be a treatment option to promote motor change.
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Affiliation(s)
- Rachel Bican
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Rachel Ferrante
- Nationwide Children’s Hospital, Columbus, Ohio, United States
| | | | - Michelle Byars
- Nationwide Children’s Hospital, Columbus, Ohio, United States
| | - Warren Lo
- Nationwide Children’s Hospital, Columbus, Ohio, United States
| | - Jill C. Heathcock
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, United States
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Quitmann CM, Rust S, Reunert J, Biskup S, Fiedler B, Marquardt T. Tubulin Folding Cofactor D Deficiency: Missing the Diagnosis With Whole Exome Sequencing. Child Neurol Open 2021; 8:2329048X211034969. [PMID: 34423067 PMCID: PMC8370890 DOI: 10.1177/2329048x211034969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022] Open
Abstract
Two siblings with an early onset of a neurodegenerative disease were presented
with muscular hypotonia, secondary microcephaly, and severe developmental delay.
Seizures were refractory to treatment but could be controlled with a ketogenic
diet. Over the course of 5 years, whole exome sequencing (WES) was performed
twice in both children. The first time the diagnosis was missed. The next one
revealed compound heterozygous mutations in the gene coding for the tubulin
folding cofactor D. Technical improvements in WES mandated a new investigation
after a few years in children where the diagnosis has not been found.
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Affiliation(s)
| | - Stephan Rust
- University Children's Hospital Muenster, Muenster, Germany
| | - Janine Reunert
- University Children's Hospital Muenster, Muenster, Germany
| | - Saskia Biskup
- Center for Genomics and Transcriptomics, Tübingen, Germany
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Neuray C, Sultan T, Alvi JR, Franca MC, Assmann B, Wagner M, Canafoglia L, Franceschetti S, Rossi G, Santana I, Macario MC, Almeida MR, Kamate M, Parikh S, Elloumi HZ, Murphy D, Efthymiou S, Maroofian R, Houlden H. Early-onset phenotype of bi-allelic GRN mutations. Brain 2021; 144:e22. [PMID: 33351065 DOI: 10.1093/brain/awaa414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Caroline Neuray
- UCL Queen Square Institute of Neurology, University College London, London, UK.,Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Tipu Sultan
- Department of Paediatric Neurology, Children's Hospital and Institute of Child Health, Lahore, Pakistan
| | - Javeira Raza Alvi
- Department of Paediatric Neurology, Children's Hospital and Institute of Child Health, Lahore, Pakistan
| | - Marcondes C Franca
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, Sao Paulo, Brazil
| | - Birgit Assmann
- Department of Paediatrics, Medizinische Universität Heidelberg, Germany
| | - Matias Wagner
- Institute of Neurogenomics, Helmholtz Zentrum Munich, Neuherberg, Germany.,Institute of Human Genetics, Technical University Munich, Munich, Germany
| | - Laura Canafoglia
- Neurolophysiopathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvana Franceschetti
- Neurolophysiopathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giacomina Rossi
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Isabel Santana
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Maria C Macario
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Maria R Almeida
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Laboratory of Neurogenetics, Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Mahesh Kamate
- Division of Pediatric Neurology, Department of Pediatrics, Kaher-University's J N Medical College, Belgaum, India
| | - Sumit Parikh
- Department of Mitochondrial Medicine and Neurogenetics, Cleveland Clinic, Cleveland, USA
| | | | - David Murphy
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Stephanie Efthymiou
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Reza Maroofian
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Henry Houlden
- UCL Queen Square Institute of Neurology, University College London, London, UK
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