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Puente-Ruiz N, Ellis I, Bregu M, Chen C, Church HJ, Tylee KL, Gladston S, Hackett R, Oldham A, Virk S, Hendriksz C, Morris AA, Jones SA, Stepien KM. Long-term outcomes in two adult siblings with Fucosidosis - Diagnostic odyssey and clinical manifestations. Mol Genet Metab Rep 2023; 37:101009. [PMID: 38053939 PMCID: PMC10694746 DOI: 10.1016/j.ymgmr.2023.101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 12/07/2023] Open
Abstract
Fucosidosis (OMIN# 230000) is a rare lysosomal storage disorder (LSDs) caused by mutations in the FUCA1 gene, leading to alpha-L-fucosidase deficiency; it is inherited as an autosomal recessive trait. Fucosidosis represents a disease spectrum with a wide variety of clinical features, but most affected patients have slow neurologic deterioration. Many patients die young and the long-term clinical outcomes in adult patients are poorly documented. Here, we report the long-term follow up of two Caucasian siblings, a 31-year-old man and 25-year-old woman. We describe the clinical, biochemical, radiological and genetic findings in two siblings affected by Fucosidosis and the differences between them after 19-years follow up. The dermatological features of the younger sibling have been reported previously by Bharati et al. (2007). Both patients have typical features of Fucosidosis, such as learning difficulties, ataxia, and angiokeratomas with differing severity. Case 1 presents severe ataxia with greater limitation of mobility, multiple dysostoses, angiokeratomas on his limbs, retinal vein enlargement and increased tortuosity in the eye and gastrointestinal symptoms. Biochemical analysis demonstrated a deficiency of alpha-fucosidase in leucocytes. Case 2 has a greater number of angiokeratomas and has suffered three psychotic episodes. The diagnosis of Fucosidosis was confirmed in cultured skin fibroblast at the age of 12 years. Molecular analysis of the FUCA1 gene showed a heterozygous mutation c.998G > A p.(Gly333Asp), with a pathogenic exon 4 deletion in the other allele in both patients. Conclusion. Fucosidosis presents a wide clinical heterogeneity and intrafamilial variability of symptoms. Psychosis and gastrointestinal symptoms have not been reported previously in Fucosidosis.
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Affiliation(s)
- Nuria Puente-Ruiz
- Adult Inherited Metabolic Diseases, Salford Royal NHS Foundation Trust, UK
- Department of Clinical Medicine, Marqués de Valdecilla University Hospital, López-Albo Post Residency Program, Santander, Spain
| | - Ian Ellis
- Clinical Genetics, Royal Liverpool Children Hospital, Alder Hey, Liverpool, UK
| | - Marsel Bregu
- Ophthalmology Department, Warrington Hospital, Warrington, UK
| | - Cliff Chen
- Clinical Neuropsychology Department, Salford Royal Hospital NHS Foundation Trust, Salford, UK
| | - Heather J. Church
- Willink Metabolic Unit, St Mary's Hospital, Manchester Foundation Trust, Manchester, UK
| | - Karen L. Tylee
- Willink Metabolic Unit, St Mary's Hospital, Manchester Foundation Trust, Manchester, UK
| | | | - Richard Hackett
- Neurology Department, Salford Royal Hospital NHS Foundation Trust, Salford, UK
| | - Andrew Oldham
- Adult Inherited Metabolic Diseases, Salford Royal NHS Foundation Trust, UK
| | - Surinder Virk
- Cardiology Department, Warrington Hospital, Warrington, UK
| | - Christian Hendriksz
- University of Pretoria, Steve Biko Academic Unit, Department of Paediatrics, Pretoria, South Africa
| | - Andrew A.M. Morris
- Willink Metabolic Unit, St Mary's Hospital, Manchester Foundation Trust, Manchester, UK
| | - Simon A. Jones
- Willink Metabolic Unit, St Mary's Hospital, Manchester Foundation Trust, Manchester, UK
| | - Karolina M. Stepien
- Adult Inherited Metabolic Diseases, Salford Royal NHS Foundation Trust, UK
- Division of Cardiovascular Sciences, University of Manchester, Manchester M13 9PL, UK
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Khaladkar SM, Dhirawani S, Agarwal A, Chanabasanavar V, Singh T. A case of type II fucosidosis-diagnosed with neuroradiological and dysmorphological findings. CURRENT JOURNAL OF NEUROLOGY 2023; 22:265-267. [PMID: 38425357 PMCID: PMC10899539 DOI: 10.18502/cjn.v22i4.14534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/10/2023] [Indexed: 03/02/2024]
Abstract
The Article Abstract is not available.
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Affiliation(s)
- Sanjay M Khaladkar
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Research Centre, Pune, Maharashtra, India
| | - Satvik Dhirawani
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Research Centre, Pune, Maharashtra, India
| | - Aastha Agarwal
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Research Centre, Pune, Maharashtra, India
| | - Vijetha Chanabasanavar
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Research Centre, Pune, Maharashtra, India
| | - Tejvir Singh
- Department of Radiodiagnosis, Dr. D. Y. Patil Medical College and Research Centre, Pune, Maharashtra, India
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El-Amawy HS, Dawoud H. Lysosomal storage diseases in the era of COVID-19: a report of an Egyptian case of alpha-fucosidosis and a summary of the lysosomal storage diseases-COVID-19 relationship. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022; 23:138. [PMID: 37521839 PMCID: PMC9483389 DOI: 10.1186/s43042-022-00350-5] [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: 02/18/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background We present a case of alpha-fucosidosis, a lysosomal storage disorder, from Egypt. The report also includes a brief review of the COVID-19 and lysosomal storage diseases relationship. Case presentation A female patient aged 18 years, diagnosed with type II fucosidosis, based on the cutaneous signs, characteristic facies, and systemic symptoms, and diagnosis was confirmed using genetic analysis. The patient died from COVID-19 pneumonia during the COVID-19 pandemic after getting the infection from her father and being hospitalized. Conclusions Patients with lysosomal storage diseases with local or systemic immune suppression may be predisposed to respiratory complications of COVID-19. Intense care with protective guidelines should be applied to those patients.
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Affiliation(s)
| | - Heba Dawoud
- Faculty of Medicine, Tanta University, Tanta, Egypt
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Mao SJ, Zhao J, Shen Z, Zou CC. An unusual presentation of fucosidosis in a Chinese boy: a case report and literature review (childhood fucosidosis). BMC Pediatr 2022; 22:403. [PMID: 35820891 PMCID: PMC9277805 DOI: 10.1186/s12887-022-03414-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Fucosidosis is one of the rare autosomal recessive lysosomal storage diseases (LSDs) attributed to FUCA1 variants causing the deficiency of α-L-fucosidase in vivo. Α-L-fucosidase deficiency will cause excessive accumulation of fucosylated glycoproteins and glycolipids, which eventually leads to dysfunction in all tissue systems and presents with multiple symptoms. Fucosidosis is a rare disease which is approximately 120 cases have been reported worldwide (Wang, L. et al., J Int Med Res 48, 1-6, 2020). The number of reported cases in China is no more than 10 (Zhang, X. et al., J Int Med Res 49:3000605211005975, 2021). Case presentation The patient was an 8-year-old Chinese boy who presented with postnatal motor retardation, intellectual disability, short stature, language development retardation, coarse facial features, hepatomegaly, and diffuse angiokeratoma of both palms. His genetic testing showed the presence of a homozygous pathogenic variant (c.671delC) in the FUCA1 gene. In addition, the enzymatic activity of α-L-fucosidase was low. Ultimately, the patient was diagnosed with fucosidosis. Conclusions Fucosidosis is a rare lysosomal storage disease because of FUCA1 variants that cause the deficiency of α-L-fucosidase in vivo. An explicit diagnosis requires a combination of clinical manifestations, imaging examination, genetic testing and enzyme activity analysis. Early diagnosis plays an important role in fucosidosis.
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Affiliation(s)
- Shao-Jia Mao
- Department of Endocrinology, the Children's Hospital of Zhejiang University School of Medicine, No 3333 Binsheng Road, Hangzhou, 310051, Zhejiang Province, China
| | - Jia Zhao
- Department of Endocrinology, the Children's Hospital of Zhejiang University School of Medicine, No 3333 Binsheng Road, Hangzhou, 310051, Zhejiang Province, China.,Department of Pediatrics, the People's Hospital of Zhuji, Shaoxing, Zhejiang Province, China
| | - Zheng Shen
- Department of Endocrinology, the Children's Hospital of Zhejiang University School of Medicine, No 3333 Binsheng Road, Hangzhou, 310051, Zhejiang Province, China
| | - Chao-Chun Zou
- Department of Endocrinology, the Children's Hospital of Zhejiang University School of Medicine, No 3333 Binsheng Road, Hangzhou, 310051, Zhejiang Province, China.
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Fucosidosis-Clinical Manifestation, Long-Term Outcomes, and Genetic Profile-Review and Case Series. Genes (Basel) 2020; 11:genes11111383. [PMID: 33266441 PMCID: PMC7700486 DOI: 10.3390/genes11111383] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/10/2020] [Accepted: 11/19/2020] [Indexed: 12/21/2022] Open
Abstract
Fucosidosis is a neurodegenerative disorder which progresses inexorably. Clinical features include coarse facial features, growth retardation, recurrent upper respiratory infections, dysostosis multiplex, and angiokeratoma corporis diffusum. Fucosidosis is caused by mutations in the FUCA1 gene resulting in α-L-fucosidase deficiency. Only 36 pathogenic variants in the FUCA1 gene are related to fucosidosis. Most of them are missense/nonsense substitutions; six missense and 11 nonsense mutations. Among deletions there were eight small and five gross changes. So far, only three splice site variants have been described—one small deletion, one complete deletion and one stop-loss mutation. The disease has a significant clinical variability, the cause of which is not well understood. The genotype–phenotype correlation has not been well defined. This review describes the genetic profile and clinical manifestations of fucosidosis in pediatric and adult cases.
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