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Kazakova E, Téllez-Martínez JA, Flores-Lagunes L, Sosa-Ortiz AL, Carillo-Sánchez K, Molina-Garay C, González-Domínguez CA, Jimenez-Olivares M, Fernandez-Valverde F, Vargas-Cañas ES, Vázquez-Memije ME, Garcia-Latorre EA, Martínez-Duncker I, Alaez-Verson C. Uterus infantilis: a novel phenotype associated with AARS2 new genetic variants. A case report. Front Neurol 2023; 14:878446. [PMID: 37456626 PMCID: PMC10343430 DOI: 10.3389/fneur.2023.878446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/10/2023] [Indexed: 07/18/2023] Open
Abstract
Objectives To report the first Mexican case with two novel AARS2 mutations causing primary ovarian failure, uterus infantilis, and early-onset dementia secondary to leukoencephalopathy. Methods Detailed clinical, clinimetric, neuroimaging features, muscle biopsy with biochemical assays of the main oxidative phosphorylation complexes activities, and molecular studies were performed on samples from a Mexican female. Results We present a 41-year-old female patient with learning difficulties since childhood and primary amenorrhea who developed severe cognitive, motor, and behavioral impairment in early adulthood. Neuroimaging studies revealed frontal leukoencephalopathy with hypometabolism at the fronto-cerebellar cortex and caudate nucleus. Uterus infantilis was detected on ultrasound study. Clinical exome sequencing identified two novel variants, NM_020745:c.2864G>A (p.W955*) and NM_020745:c.1036C>A (p.P346T, p.P346Wfs*18), in AARS2. Histopathological and biochemical studies on muscle biopsy revealed mitochondrial disorder with cytochrome C oxidase (COX) deficiency. Conclusions Several adult-onset cases of leukoencephalopathy and ovarian failure associated with AARS2 variants have been reported. To our best knowledge, none of them showed uterus infantilis. Here we enlarge the genetic and phenotypic spectrum of AARS2-related dementia with leukoencephalopathy and ovarian failure and contribute with detailed clinical, clinometric, neuroimaging, and molecular studies to disease and novel molecular variants characterization.
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Affiliation(s)
- Ekaterina Kazakova
- Centro de Diagnóstico en Metabolismo Energético y Medicina Mitocondrial, Mexico City, Mexico
| | - José Alberto Téllez-Martínez
- Clínica de Cognición, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Leonardo Flores-Lagunes
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Ana Luisa Sosa-Ortiz
- Clínica de Cognición, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Karol Carillo-Sánchez
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Carolina Molina-Garay
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Carlos Alberto González-Domínguez
- Laboratorio de Glicobiología Humana y Diagnóstico Molecular, Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Morelos, Mexico
| | - Marco Jimenez-Olivares
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Francisca Fernandez-Valverde
- Laboratorio de Patología Experimental, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | - Edwin Steven Vargas-Cañas
- Clínica de Nervio y Músculo, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
| | | | | | - Iván Martínez-Duncker
- Laboratorio de Glicobiología Humana y Diagnóstico Molecular, Centro de Investigación en Dinámica Celular, Instituto de Investigación en Ciencias Básicas y Aplicadas, Universidad Autónoma del Estado de Morelos, Morelos, Mexico
| | - Carmen Alaez-Verson
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
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Restrepo-Martínez M, Espinola-Nadurille M, López-Hernández JC, Martínez V, Téllez-Martínez JA, Bustamante-Gómez PA, Bautista-Gómez P, Bayliss L, Ramírez-Bermúdez J. [Neuropsychiatric aspects of anti-NMDA receptor encephalitis]. Rev Alerg Mex 2021; 68:251-263. [PMID: 34904561 DOI: 10.29262/ram.v68i4.953] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 11/24/2022] Open
Abstract
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a potentially lethal clinical entity that belongs to the group of antibody-mediated encephalitis against synaptic proteins. It shows IgG antibodies against the NR1 subunit of the NMDA receptor (NMDA-R), which have been associated with psychiatric and neurological symptoms that develop in stages in the course of the disease. The predominance of neuropsychiatric symptoms in the early stages of the disease results in an increased number of patients that search for psychiatric evaluation as their first contact with the health system. For this reason, it is vital for physicians to recognize this entity as an important differential diagnosis in their clinical practice because, despite the severity of this condition, more than 75 % of patients achieve a substantial recovery with appropriate and timely treatment. We present a review of the literature on this disease, with special emphasis on the neuropsychiatric aspects.
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Affiliation(s)
- Miguel Restrepo-Martínez
- Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez, Departamento de Neuropsiquiatría, Ciudad de México, México.
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Restrepo-Martínez M, López-Hernández JC, Espinola-Nadurille M, Bayliss L, Medina-Rioja R, Martínez-Ángeles V, Galnares-Olalde J, Téllez-Martínez JA, Ramírez-Bermúdez J. [Autoinmune psychosis]. Rev Alerg Mex 2021; 68:276-290. [PMID: 34904563 DOI: 10.29262/ram.v68i4.981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
With the advent of the description of autoimmune encephalitis by different neuronal cell-surface antibodies (anti-NMDAr, among others) and that psychosis may be the only manifestation without neurological symptoms (epilepsy, movement disorders, autonomic dysfunction, altered state of consciousness) in 6.5 % of patients, the term "autoimmune psychosis" has become remarkably interesting among researchers. In 2020, an international consensus for the description and diagnostic approach of autoimmune psychosis was created. Through this consensus, by taking different criteria into account, the definition of autoimmune psychosis was proposed at different degrees of certainty (possible, probable, and defined). The purpose of these criteria is to underpin the autoimmune origin in patients who present psychosis with atypical characteristics, thus justifying the realization of laboratory studies and complementary clinical tests (lumbar puncture, electroencephalogram, and magnetic resonance imaging of the brain); in addition, these criteria are applied in patients with psychosis without neurological symptoms that do not fully meet the criteria of autoimmune encephalitis. As in autoimmune encephalitis, the early initiation of immunotherapy has a direct impact on the functional prognosis of patients, so an early initiation of treatment must be considered in clinical scenarios of probable or definite autoimmune psychosis.
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Affiliation(s)
- Miguel Restrepo-Martínez
- Instituto Nacional de Neurología y Neurocirugía, Departamento de Neuropsiquiatría, Ciudad de México, México.
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Téllez-Martínez JA, Martínez-Magaña JJ, Nicolini-Sanchez H, Sosa-Ortíz AL. P3-256: THE P.E318G VARIANT OF PSEN1 AND P.H157Y OF TREM2 GENES AND ITS RISK OF DEVELOPING PSYCHOTIC SYMPTOMS IN MEXICAN MESTIZO PATIENTS WITH ALZHEIMER DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Genis-Mendoza AD, Martínez-Magaña JJ, Bojórquez C, Téllez-Martínez JA, Jiménez-Genchi J, Roche A, Bojorge A, Chávez M, Castañeda C, Guzmán R, Zapata L, Aguilar-Méndez D, Lanzagorta N, Rebolledo I, Castro-Chavira S, Fernández T, Orozco L, Nicolini H, Martínez-Hernández AG. [Programa de detección del alelo APOE-E4 en adultos mayores mexicanos con deterioro cognitivo]. GAC MED MEX 2019; 154:555-560. [PMID: 30464349 DOI: 10.24875/gmm.18003784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction In Mexico, the prevalence of neurocognitive disorders (NCDs) has increased in parallel with the increase in life expectancy. The E4 allele of the gene that encodes apolipoprotein E (APOE) is the main genetic risk factor for cognitive impairment. Objective To replicate the association of APOE-E4 allele with neurocognitive impairment in a Mexican population, as well as to implement a genetic risk-detection program with the APOE-E4 allele. Method A program was structured for the detection of APOE-E4 allele risk in different recruiting centers from the central zone of the Mexican Republic, with three stages: recruitment and selection of candidates for the detection of the risk-allele, genetic risk analysis and delivery of results. Results In the genetic-association study to replicate the association with neurocognitive disorders by means of multivariate logistic models, the APOE-E4 allele increased the risk for cognitive impairment in the Mexican populations by approximately 6 % (OR: 5.83, p = 0.0025). In addition, 367 genetic risk results were delivered. Conclusions The present program is the first one to be implemented in Mexico with the purpose to inform on a genetic risk factor for neurocognitive disorders in several centers of the country.
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Affiliation(s)
- Alma Delia Genis-Mendoza
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, México
| | - José Jaime Martínez-Magaña
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, México
| | - Carolina Bojórquez
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, México
| | - José Alberto Téllez-Martínez
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, México
| | - Janett Jiménez-Genchi
- Secretaría de Salud, Hospital "Fray Bernardino Álvarez", Servicios de Atención Psiquiátrica, Ciudad de México, México
| | - Andrés Roche
- Secretaría de Salud, Hospital "Fray Bernardino Álvarez", Servicios de Atención Psiquiátrica, Ciudad de México, México
| | - Alexis Bojorge
- Secretaría de Salud, Hospital "Fray Bernardino Álvarez", Servicios de Atención Psiquiátrica, Ciudad de México, México
| | - Mariana Chávez
- Secretaría de Salud, Hospital "Fray Bernardino Álvarez", Servicios de Atención Psiquiátrica, Ciudad de México, México
| | - Carlos Castañeda
- Secretaría de Salud, Hospital "Fray Bernardino Álvarez", Servicios de Atención Psiquiátrica, Ciudad de México, México
| | - Rafael Guzmán
- Secretaría de Salud, Hospital General de México, Clínica de Geriatría, Ciudad de México, México
| | - Leonor Zapata
- Secretaría de Salud, Hospital General de México, Clínica de Geriatría, Ciudad de México, México
| | - Dione Aguilar-Méndez
- Secretaría de Salud, Hospital General de México, Clínica de Geriatría, Ciudad de México, México
| | | | | | | | - Thalía Fernández
- Universidad Nacional Autónoma de México, Instituto de Neurología, Querétaro, México
| | - Lorena Orozco
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Ciudad de México, México
| | - Humberto Nicolini
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, México
| | - Angélica Graciela Martínez-Hernández
- Secretaría de Salud, Instituto Nacional de Medicina Genómica, Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Ciudad de México, México
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Genis-Mendoza AD, Martínez-Magaña JJ, Bojórquez C, Téllez-Martínez JA, Jiménez-Genchi J, Roche A, Bojorge A, Chávez M, Castañeda C, Guzmán R, Zapata L, Aguilar-Méndez D, Lanzagorta N, Rebolledo I, Castro-Chavira S, Fernández T, Orozco L, Nicolini H, Martínez-Hernández AG. Program for APOE-E4 allele detection in a Mexican population of older patients with cognitive impairment. GAC MED MEX 2019. [DOI: 10.24875/gmm.m18000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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