The eldest case of MICPCH with CASK mutation exhibiting gross motor regression
Autor: | Shinya Hara, Tomohiko Nakata, Yosuke Nishio, Kotaro Narita, Tadashi Kaname, Fumi Sawamura, Hajime Narita, Yoshihiko Kawano, Hideki Muramatsu, Toshiki Takeo, Hiroyuki Kidokoro, Jun Natsume |
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Rok vydání: | 2021 |
Předmět: |
Pediatrics
medicine.medical_specialty Microcephaly business.industry Gross motor skill Pontocerebellar hypoplasia Rett syndrome General Medicine medicine.disease 03 medical and health sciences 0302 clinical medicine Developmental Neuroscience Pediatrics Perinatology and Child Health medicine Neurology (clinical) Global developmental delay CASK business Developmental regression Cerebellar hypoplasia 030217 neurology & neurosurgery |
Zdroj: | Brain and Development. 43:459-463 |
ISSN: | 0387-7604 |
Popis: | Background MICPCH is manifested as microcephaly associated with pontocerebellar hypoplasia and global developmental delay but developmental regression has never been reported. We describe the detailed clinical history of a woman with intellectual disability and microcephaly with pontine and cerebellar hypoplasia (MICPCH) with a CASK mutation who exhibited gross motor regression after adolescence. Case: The patient experienced severe motor and intellectual developmental delay with microcephaly from infancy. The initial diagnosis was Rett syndrome based on her clinical features, including hand stereotypes and the absence of structural abnormality on magnetic resonance imaging (MRI) performed at the age of 5 years. Although gross motor abilities developed slowly and she could walk independently, she never acquired speech or understanding of languages. After adolescence, her motor ability gradually regressed so that she was unable to stand without support and moved with a wheelchair. At the age of 31 years, because of her atypical clinical course for Rett syndrome, whole exome sequencing was performed, which revealed a de novo heterozygous c.2068 + 1G > A mutation in the CASK gene (NM_001126055). Brain MRI revealed mild pontocerebellar hypoplasia compatible with the clinical phenotype of MICPCH. Discussion This case suggests that MICPCH with a CASK mutation might cause developmental regression after adolescence and might be regarded as a neurodegenerative disorder. |
Databáze: | OpenAIRE |
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