Evidence for synergistic effects of PRNP and ATP7Bmutations in severe neuropsychiatric deterioration

BMC Medical Genetics

Case Report

David G Morgan¹  Nauzer Forbes¹  Kevin Woodward¹  Susan Goodwin¹  Mark A Tarnopolsky²  Lauren Brady³  Michael B Coulthart⁴ 

[1] Department of Medicine, McMaster University, Hamilton, Canada;Department of Medicine, McMaster University, Hamilton, Canada;Department of Pediatrics, McMaster University, Hamilton, Canada;Neuromuscular and Neurometabolic Disease, Department of Pediatrics, McMaster University, 1200 Main St. W., HSC-2H26, L8N 3Z5, Hamilton, ON, Canada;Department of Pediatrics, McMaster University, Hamilton, Canada;National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada;

关键词: Wilson’s disease;    Prion disease;    Copper;    ATP7B;    PRNP;    Prion protein;    PrP;    Synergistic mutations;    Movement disorder;   

DOI  :  10.1186/1471-2350-15-22

 received in 2013-03-05, accepted in 2014-02-12,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWilson’s disease (WD), a rare cause of neuropsychiatric deterioration, is associated with mutations in the ATP7B gene. Prion diseases are also rare causes of neuropsychiatric deterioration that can occur sporadically without an identifiable cause, or can be attributed to mutations in the PRNP gene.Case presentationHere we describe a biological “experiment of nature” in which a patient presented with severe neuropsychiatric decline and strong biochemical evidence of WD. Genetic analysis revealed that he was a compound heterozygote for two ATP7B sequence variants (c.2165dupT, p.Arg723Glufs*32; and c.4039G > A, p.Gly1347Ser), the first having been reported once previously, and the second being novel. In addition, the patient was heterozygous for a PRNP variant, c.160G > A, p.Gly54Ser, that has been reported in a neuropsychiatric patient only once previously in association with a similarly severe clinical course of neuropsychiatric disease and early age of onset, but no accompanying information on ATP7B genotype. Of particular interest was the observation that the patient’s older sister, who carried the same ATP7B genotype and laboratory evidence for biochemical WD but was clinically asymptomatic, lacked the PRNP variant allele.ConclusionsWe propose that synergism may occur between at least some allelic variants of ATP7B and PRNP, possibly exerted through effects on cellular copper metabolism.

【 授权许可】

Unknown   
© forbes et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.