Co-occurrence of CLCN2-related leukoencephalopathy and SPG56

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Almasoudi, WejdanLund University,Lunds universitet,Klinisk neurogenetik,Forskargrupper vid Lunds universitet,Clinical Neurogenetics,Lund University Research Groups,Skåne University Hospital (author)

Co-occurrence of CLCN2-related leukoencephalopathy and SPG56

Article/chapterEnglish2023

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Elsevier BV,2023

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LIBRIS-ID:oai:lup.lub.lu.se:45a72a64-04e8-40d2-9735-50191408a102
https://lup.lub.lu.se/record/45a72a64-04e8-40d2-9735-50191408a102URI
https://doi.org/10.1016/j.prdoa.2023.100189DOI

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Language:English
Summary in:English

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Family Report: Two rare autosomal recessive neurological disorders, leukoencephalopathy with ataxia and spastic paraplegia 56 (SPG56), were found in members of the same family. Two siblings presented with spastic paraplegia, cognitive impairment, bladder and bowel dysfunction and gait ataxia; their consanguineous parents were unaffected. Ophthalmological examination revealed chorioretinopathy. Brain MRI showed T2 hyperintensities and T1 hypointensities in the internal capsules, cerebral peduncles, pyramidal tracts and middle cerebellar peduncles. Both affected siblings were homozygous for CYP2U1 c.947A > T p.(Asp316Val), a known cause for SPG56. However, they were also homozygous for the novel variant CLCN2 c.607G > T, p.(Gly203Cys), classified as a variant of unknown significance. Testing of additional family members revealed homozygosity for both variants in an additional brother, whom we initially considered unaffected. Both male CLCN2 carriers were infertile, and review of the literature revealed one reported case with azoospermia, however the brother had no overt signs of SPG56. His testicular biopsy revealed incomplete maturation arrest in spermatogenesis; clinically we found mild memory impairment and hand tremor and MRI showed similar changes as his siblings. We consider CLCN2 c.607G > T pathogenic because of the neuroradiological and clinical findings, including azoospermia. Conclusion: Considerable workup may be required to determine the pathogenicity of novel variants, and to unambiguously associate phenotype with genotype. In very rare disorders, highly specific clinical or biomarker combinations provide sufficient evidence for a variant's pathogenicity. Phenotypic variation of monogenic disorders described in the literature may be attributed to a second co-occurring monogenic disorder, especially in consanguineous families. SPG56 may have reduced penetrance.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Medicinsk genetik hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Medical Genetics hsv//eng
CLCN2
CYP2U1
Electroretinography
Hereditary spastic paraplegia
Leukoencephalopathy
Male infertility
SPG56

Added entries (persons, corporate bodies, meetings, titles ...)

Nilsson, ChristerSkåne University Hospital(Swepub:lu)neur-cni (author)
Kjellström, UlrikaLund University,Lunds universitet,Klinisk forskning kring familjer med ärftliga näthinnesjukdomar,Forskargrupper vid Lunds universitet,Clinical research in families with inherited retinal degeneration,Lund University Research Groups,Skåne University Hospital(Swepub:lu)oft-ukt (author)
Sandeman, KevinRegion Skåne(Swepub:lu)ke0063sa (author)
Puschmann, AndreasLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk neurogenetik,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Neurogenetics,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-aps (author)
Klinisk neurogenetikForskargrupper vid Lunds universitet (creator_code:org_t)

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