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Farnè M, Tedesco GM, Bedetti C, Mencarelli A, Rogaia D, Colavito D, Di Cara G, Stangoni G, Troiani S, Ferlini A, Prontera P. A patient with novel MBOAT7 variant: The cerebellar atrophy is progressive and displays a peculiar neurometabolic profile. Am J Med Genet A 2020; 182:2377-2383. [PMID: 32744787 DOI: 10.1002/ajmg.a.61773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/13/2020] [Accepted: 05/30/2020] [Indexed: 12/26/2022]
Abstract
Mutations in the MBOAT7 gene have been described in 43 patients, belonging to 18 families, showing nonspecific clinical features (intellectual disability [ID], seizures, microcephaly or macrocephaly, and mild to moderate cerebellar atrophy) that make the clinical diagnosis difficult. Here we report the first Italian patient, a 22.5-year-old female, one of the oldest reported, born to apparently consanguineous parents. She shows severe ID, macrocephaly, seizures, aggressive outbursts, hyperphagia. We also documented progressive atrophy of the cerebellar vermis, that appeared not before the age of 7. The whole-exome sequencing of the trio identified a novel homozygous variant c.1057_1058delGCinsCA (p.Ala353His) in the MBOAT7 gene. The variant is considered to be likely pathogenic, since it is absent from population database and it lies in a highly conserved amino acid residue. This disorder has a neurometabolic pathogenesis, implicating a phospholipid remodeling abnormalities. A brain hydrogen-magnetic resonance spectroscopy (H-MRS) examination in our patient disclosed a peculiar neurometabolic profile in the cerebellar hemispheric region. This new finding could address the clinical suspicion of MBOAT7-related disorder, among the wide range of genetic conditions associated with ID and cerebellar atrophy. Moreover, the documented progression of cerebellar atrophy and the worsening of the disease only after some years open to the possibility of a therapeutic window after birth.
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Affiliation(s)
- Marianna Farnè
- Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.,Medical Genetics Unit, Department of Medical Sciences, Ferrara University Hospital, Italy
| | - Giovanna M Tedesco
- Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.,Clinical Genetics Unit, Department of Women and Children's Health, University of Padova, Padova, Italy.,Genetics Unit, "Mauro Baschirotto" Institute for Rare Diseases (B.I.R.D.), Costozza di Longare, Vicenza, Italy
| | | | - Amedea Mencarelli
- Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Daniela Rogaia
- Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | | | - Giuseppe Di Cara
- Pediatric Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Gabriela Stangoni
- Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Stefania Troiani
- Division of Neonatology and Neonatal Intensive Care Unit, Santa Maria della Misericordia Hospital of Perugia, Perugia, Italy
| | - Alessandra Ferlini
- Medical Genetics Unit, Department of Medical Sciences, Ferrara University Hospital, Italy
| | - Paolo Prontera
- Medical Genetics Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
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