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Yousaf H, Rehmat S, Jameel M, Ibrahim R, Hashmi SN, Makhdoom EUH, Iwaszkiewicz J, Saadi SM, Tariq M, Baig SM, Toft M, Fatima A, Iqbal Z. A homozygous founder variant in PDE2A causes paroxysmal dyskinesia with intellectual disability. Clin Genet 2023. [PMID: 37317634 DOI: 10.1111/cge.14386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/22/2023] [Accepted: 05/28/2023] [Indexed: 06/16/2023]
Abstract
Intellectual developmental disorder with paroxysmal dyskinesia or seizures (IDDPADS, OMIM#619150) is an ultra-rare childhood-onset autosomal recessive movement disorder manifesting paroxysmal dyskinesia, global developmental delay, impaired cognition, progressive psychomotor deterioration and/or drug-refractory seizures. We investigated three consanguineous Pakistani families with six affected individuals presenting overlapping phenotypes partially consistent with the reported characteristics of IDDPADS. Whole exome sequencing identified a novel missense variant in Phosphodiesterase 2A (PDE2A): NM_002599.4: c.1514T > C p.(Phe505Ser) that segregated with the disease status of individuals in these families. Retrospectively, we performed haplotype analysis that revealed a 3.16 Mb shared haplotype at 11q13.4 among three families suggesting a founder effect in this region. Moreover, we also observed abnormal mitochondrial morphology in patient fibroblasts compared to controls. Belonging to diverse age groups (13 years-60 years), patients presented paroxysmal dyskinesia, developmental delay, cognitive abnormalities, speech impairment, and drug-refractory seizures with variable onset of disease (as early as 3 months of age to 7 years). Together with the previous reports, we observed that intellectual disability, progressive psychomotor deterioration, and drug-refractory seizures are consistent outcomes of the disease. However, permanent choreodystonia showed variability. We also noticed that the later onset of paroxysmal dyskinesia manifests severe attacks in terms of duration. Being the first report from Pakistan, we add to the clinical and mutation spectrum of PDE2A-related recessive disease raising the total number of patients from six to 12 and variants from five to six. Together, with our findings, the role of PDE2A is strengthened in critical physio-neurological processes.
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Affiliation(s)
- Hammad Yousaf
- National Institute for Biotechnology and Genetic Engineering College, Pakistan Institute of Engineering and Applied Sciences (NIBGE-C, PIEAS), Faisalabad, Pakistan
| | - Shagufta Rehmat
- Center for Regenerative Medicine and Stem Cell Research (CRM), The Aga Khan University, Karachi, Pakistan
| | - Muhammad Jameel
- National Institute for Biotechnology and Genetic Engineering College, Pakistan Institute of Engineering and Applied Sciences (NIBGE-C, PIEAS), Faisalabad, Pakistan
- Center for Regenerative Medicine and Stem Cell Research (CRM), The Aga Khan University, Karachi, Pakistan
| | - Rabab Ibrahim
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
| | - Sohana Nadeem Hashmi
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
| | - Ehtisham Ul Haq Makhdoom
- Neurochemicalbiology and Genetics Laboratory (NGL), Department of Physiology, Faculty of Life Sciences, Government College University, Faisalabad, Pakistan
| | - Justyna Iwaszkiewicz
- Molecular Modeling Group, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Saadia Maryam Saadi
- National Institute for Biotechnology and Genetic Engineering College, Pakistan Institute of Engineering and Applied Sciences (NIBGE-C, PIEAS), Faisalabad, Pakistan
| | - Muhammad Tariq
- National Institute for Biotechnology and Genetic Engineering College, Pakistan Institute of Engineering and Applied Sciences (NIBGE-C, PIEAS), Faisalabad, Pakistan
| | - Shahid M Baig
- National Institute for Biotechnology and Genetic Engineering College, Pakistan Institute of Engineering and Applied Sciences (NIBGE-C, PIEAS), Faisalabad, Pakistan
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
| | - Mathias Toft
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Ambrin Fatima
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
| | - Zafar Iqbal
- Department of Neurology, Oslo University Hospital, Oslo, Norway
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Saleem N, Mubarik A, Qureshi AH, Siddiq M, Ahmad M, Afzal S, Hussain AB, Hashmi SN. Is there a correlation between degree of viremia and liver histology in chronic hepatitis C? J PAK MED ASSOC 2004; 54:476-9. [PMID: 15518372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To determine the correlation between degree of histological liver damage and serum HCV RNA level in patients of chronic hepatitis C, in order to evaluate the usefulness of HCV RNA estimation as an alternate to liver biopsy. METHODS This non-interventional descriptive study, was carried out at the department of Pathology, Army Medical College, Rawalpindi, Pakistan between April and September 2002. Core needle liver biopsies of fifty five patients of chronic hepatitis C were evaluated according to Knodell's histological activity index system. The patients were categorized into four subgroups depending upon the grade and stage of disease according to Desmet's classification, and into three groups according to degree of viremia. RESULTS Five patients had mild viremia, 43 moderate and 7 had severe viremia. Seven patients had minimal disease, 9 mild, 22 moderate and 17 had severe chronic hepatitis. Eight patients had no fibrosis, 20 had fibrous portal expansion, 19 bridging fibrosis, and 8 patients had cirrhosis. No significant correlation was found between serum HCV RNA levels and grade or stage of the disease, with correlation coefficients of rs = -.054 and rs = .034 respectively. Moreover, no individual component of the HAI correlated with serum HCV RNA levels. CONCLUSION Serum HCV RNA level does not determine the degree of hepatic injury precisely and liver biopsy is necessary to accurately evaluate the extent of liver damage.
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Affiliation(s)
- N Saleem
- Department of Pathology, Army Medical College, Military Hospital, Rawalpindi
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Muzaffar M, Mushtaq S, Hashmi SN, Mamoon N. Morphological study of liver in patients of chronic hepatitis C treated with interferon. J PAK MED ASSOC 1998; 48:325-8. [PMID: 10323051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The effect of interferon therapy on liver morphology was assessed in ten patients with serologically proven chronic hepatitis C. All these patients received 3 million units of alpha interferon three times a week. Six patients received therapy for 6 months, two patients for 12 months, one patient each for 3 and 9 months. All patients underwent a second liver biopsy 1 to 6 months after cessation of therapy. Alanine aminotransferase levels were determined before, during and after therapy. Each biopsy was assessed histologically by revised classification of chronic hepatitis proposed by Desmet et al and Kondell histological activity index was determined. Four patients showed significant reduction in the necroinflammatory activity with decrease in the HAI and normalisation of ALT level. Three patients showed partial reduction in the necroinflammatory activity with partial reduction of ALT levels. Two patients did not show any change in the grade of disease while one patient showed worsening of necroinflammatory activity with rising ALT levels. One patient showed a significant reduction in fibrosis with conversion of early developing cirrhosis into bridging fibrosis. A second liver biopsy is extremely useful for assessing the response of interferon treatment, however, it must be done at a suitable time after cessation of therapy.
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Affiliation(s)
- M Muzaffar
- Department of Pathology, Armed Forces Institute of Pathology, Rawalpindi
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