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Ilyas M, Holzwarth D, Ishaq R, Ali Y, Habiba U, Raja AM, Saeed S, Abdullah U, Khan SN, Ullah A, Raja GK, Baig SM, Fazeli W, Kunz WS, Shaiq PA. Whole-Exome sequencing identifies GYS2 biallelic variants in individuals with suspected epilepsy. Seizure 2024; 116:74-80. [PMID: 37574425 DOI: 10.1016/j.seizure.2023.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/04/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Adequate glucose supply is essential for brain function, therefore hypoglycemic states may lead to seizures. Since blood glucose supply for brain is buffered by liver glycogen, an impairment of liver glycogen synthesis by mutations in the liver glycogen synthase gene (GYS2) might result in a substantial neurological involvement. Here, we describe the phenotypes of affected siblings of two families harboring biallelic mutations in GYS2. METHODS Two suspected families - a multiplex Pakistani family (family A) with three affected siblings and a family of Moroccan origin (family B) with a single affected child who presented with seizures and reduced fasting blood glucose levels were genetically characterized. Whole exome sequencing (WES) was performed on the index patients, followed by Sanger sequencing-based segregation analyses on all available members of both families. RESULTS The variant prioritization of WES and later Sanger sequencing confirmed three mutations in the GYS2 gene (12p12.1) consistent with an autosomal recessive pattern of inheritance. A homozygous splice acceptor site variant (NM_021957.3, c. 1646 -2A>G) segregated in family A. Two novel compound heterozygous variants (NM_021957.3: c.343G>A; p.Val115Met and NM_021957.3: c.875A>T; p.Glu292Val) were detected in family B, suggesting glycogen storage disorder. A special diet designed to avoid hypoglycemia, in addition to change of the anti-seizure medication led to reduction in seizure frequency. CONCLUSIONS This study suggests that the seizures in patients initially diagnosed with epilepsy might be directly caused, or influenced by hypoglycemia due to pathogenic variants in the GYS2 gene.
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Affiliation(s)
- Muhammad Ilyas
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan; Department of Medical laboratory technology, Riphah International University, Malakand Campus, Pakistan; Department of Epileptology, University of Bonn, Germany
| | - Dorothea Holzwarth
- Department of Neuropediatrics, Children's Hospital, University of Bonn, Germany
| | - Rafaqat Ishaq
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan
| | - Yasir Ali
- Institute of Chemistry, Slovak Academy of Sciences, 845 38 Bratislava, Slovakia
| | - Umme Habiba
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan
| | - Asad Mehmood Raja
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan
| | - Sadia Saeed
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan; Department of Clinical Molecular Biology, EpiGen, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Uzma Abdullah
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan
| | - Sadiq Noor Khan
- Department of Medical Laboratory Technology, University of Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Ata Ullah
- Applied Genomics Centre and State Key Laboratory of Molecular Neuroscience, Hongkong University of Science and Technology, Division of Life Sciences, Hong Kong
| | - Ghazala Kaukab Raja
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan
| | | | - Walid Fazeli
- Department of Neuropediatrics, Children's Hospital, University of Bonn, Germany
| | | | - Pakeeza Arzoo Shaiq
- University Institute of Biochemistry and Biotechnology, Pir Mehr Ali Arid Agriculture University Rawalpindi, Pakistan.
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Shafieipour N, Jafari Khamirani H, Kamal N, Tabei SMB, Dianatpour M, Dastgheib SA. The third patient of ACACA-related acetyl-CoA carboxylase deficiency with seizure and literature review. Eur J Med Genet 2023; 66:104707. [PMID: 36709796 DOI: 10.1016/j.ejmg.2023.104707] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/30/2022] [Accepted: 01/15/2023] [Indexed: 01/27/2023]
Abstract
Pathogenic variants in ACACA are the cause of acetyl-CoA carboxylase deficiency with an autosomal recessive inheritance that is identified by hypotonia, motor, and intellectual developmental delay. In this article, we describe a seven-year-old boy who is the child of consanguineous parents with a homozygous variant in ACACA (NM_198834.3:c.6641C > A, p.P2214H) that was detected by Whole-Exome Sequencing and confirmed by Sanger sequencing. This is the first reported patient of acetyl-CoA carboxylase deficiency that results from a homozygous pathogenic variant in the ACACA gene in the Iranian family. The proband presents with motor and intellectual developmental delay, muscle weakness, language disorder, facial dysmorphism, and poor growth. The patient discussed here is similar to other patients that were previously published; however, we were able to identify seizure that has hitherto not been reported. This paper describes the third person with a novel variant in the ACACA gene in the world that accounts for acetyl-CoA carboxylase deficiency and implicates the clinical spectrum of the disease. Finally, we describe an individual-based review of the symptoms associated with acetyl-CoA carboxylase deficiency. So far, only two acetyl-CoA carboxylase deficiency patients have been reviewed in the literature.
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Affiliation(s)
- Negin Shafieipour
- Department of Medical Genetics, Shiraz University of Medical Sciences, Iran
| | | | - Neda Kamal
- Department of Medical Genetics, Shiraz University of Medical Sciences, Iran
| | - Seyed Mohammad Bagher Tabei
- Department of Medical Genetics, Shiraz University of Medical Sciences, Iran; Maternal-fetal Medicine Research Center, Shiraz University of Medical Sciences, Iran
| | - Mehdi Dianatpour
- Department of Medical Genetics, Shiraz University of Medical Sciences, Iran; Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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