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- Title
A novel POLR3A genotype leads to leukodystrophy type-7 in two siblings with unusually late age of onset.
- Authors
Campopiano, Rosa; Ferese, Rosangela; Zampatti, Stefania; Giardina, Emiliano; Biagioni, Francesca; Colonnese, Claudio; Centonze, Diego; Storto, Marianna; Buttari, Fabio; Fraviga, Edoardo; Broccoli, Vania; Fanelli, Mirco; Fornai, Francesco; Gambardella, Stefano
- Abstract
<bold>Background: </bold>Leukodystrophies are familial heterogeneous disorders primarily affecting the white matter, which are defined as hypomyelinating or demyelinating based on disease severity as assessed at MRI. Recently, a group of clinically overlapping hypomyelinating leukodystrophies (HL) has been associated with mutations in RNA polymerase III enzymes (Pol III) subunits.<bold>Case Presentation: </bold>In this manuscript, we describe two Italian siblings carrying a novel POLR3A genotype. MRI imaging, genetic analysis, and clinical data led to diagnosing HL type 7. The female sibling, at the age of 34, is tetra-paretic and suffers from severe cognitive regression. She had a disease onset at the age of 19, characterized by slow and progressive cognitive impairment associated with gait disturbances and amenorrhea. The male sibling was diagnosed during an MRI carried out for cephalalgia at the age of 41. After 5 years, he developed mild cognitive impairment, dystonia with 4-limb hypotonia, and moderate dysmetria with balance and gait impairment.<bold>Conclusions: </bold>The present study provides the first evidence of unusually late age of onset in HL, describing two siblings with a novel POLR3A genotype which showed the first symptoms at the age of 41 and 19, respectively. This provides a powerful insight into clinical heterogeneity and genotype-phenotype correlation in POLR3A related HL.
- Subjects
LEUKODYSTROPHY; AGE of onset; SIBLINGS; MILD cognitive impairment; COGNITION disorders; RNA polymerases; HEREDITARY central nervous system demyelinating diseases; BRAIN; GENETIC mutation; MAGNETIC resonance imaging; TRANSFERASES; GENOTYPES; AGE factors in disease
- Publication
BMC Neurology, 2020, Vol 20, Issue 1, p1
- ISSN
1471-2377
- Publication type
journal article
- DOI
10.1186/s12883-020-01835-9