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A novel POLG gene mutation in 4 children with Alpers-like hepatocerebral syndromes.

Authors: Kurt, Bulent  Jaeken, Jaak  Van Hove, Johan  Lagae, Lieven  Löfgren, Ann  Everman, David B  Jayakar, Parul  Naini, Ali  Wierenga, Klaas J  Van Goethem, Gert  Copeland, William C  DiMauro, Salvatore 
Citation: Kurt B, etal., Arch Neurol. 2010 Feb;67(2):239-44. doi: 10.1001/archneurol.2009.332.
Pubmed: (View Article at PubMed) PMID:20142534
DOI: Full-text: DOI:10.1001/archneurol.2009.332

OBJECTIVE: To describe a novel POLG missense mutation (c.3218C>T; p.P1073L) that, in association with 2 previously described mutations, caused an Alpers-like hepatocerebral syndrome in 4 children.
DESIGN: Genotype-phenotype correlation.
SETTING: Tertiary care universities.
PATIENTS: Four children, 2 related and 2 unrelated, with the novel p.P1073L mutation (all patients) and either the p.A467T (2 patients), p.G848S (1 patient), or p.W748S (1 patient) mutation presented with psychomotor delay, encephalopathy, and liver failure.
INTERVENTIONS: Detailed clinical and laboratory examinations including brain magnetic resonance imaging, muscle biopsy, measurement of mitochondrial DNA, and sequencing of the POLG gene.
MAIN OUTCOME MEASURES: Definition of clinical variability.
RESULTS: All 4 patients had psychomotor delay, seizures, and liver disease. Three patients had severe gastrointestinal dysmotility, which may be associated with the new p.P1073L mutation.
CONCLUSIONS: The heterozygous presence of the novel p.P1073L mutation in trans with another recessive POLG mutation causes a hepatocerebral disorder identical or very similar to Alpers syndrome. This adds to the already striking clinical heterogeneity of POLG mutations. In the Belgian patients, the familial occurrence without consanguinity is related to the high frequency of the recessive p.A467T and p.W748S mutations in northwestern Europe and reveals a pitfall for diagnosis and genetic counseling.


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CRRD Object Information
CRRD ID: 15039298
Created: 2019-11-27
Species: All species
Last Modified: 2019-11-27
Status: ACTIVE


RGD is funded by grant HL64541 from the National Heart, Lung, and Blood Institute on behalf of the NIH.