Retinal abiotrophy in mitochondrial pathology: NARP sindrome (a clinical case)
https://doi.org/10.21516/2072-0076-2019-12-1-97-101
Abstract
Purpose: to present a clinical case of retinal abiotrophy in mitochondrial pathology (NARP syndrome) caused by the mutation m.8993T>G in the ATPase gene type 6 in order to improve the diagnosis of hereditary abiotrophies. Material and methods. The results of a clinical molecular genetic examination of the patient’s family, undertaken in order to clarify the diagnosis and determine the genetic risk, are presented. The family was found to have an isolated pathology of the eye. Results. DNA studies by MLPA method and the analysis of clinical data in the family revealed a hereditary syndromic pathology which caused changes in the eyes. The inheritance type was found to be maternal. Conclusion. NARP syndrome
is a syndrome with the maternal type of inheritance in which retinal abiotrophy is primarily associated with the mutation m.8993T>G mtDNA and can be considered as the main diagnostic feature among other clinical manifestations. The case demonstrates the difficulties of diagnosing hereditary syndromes accompanied by eye pathology.
About the Authors
O. V. KhlebnikovaRussian Federation
Dr. Med. Sci., leading researcher
1, Moskvorechye St., Moscow, 115522, Russia
I. V. Sharkova
Russian Federation
Cand. Med. Sci., senior researcher
1, Moskvorechye St., Moscow, 115522, Russia
References
1. Tatuch Y., Christodoulou J., Feigenbaum A.,et al. Heteroplasmic mtDNA mutation (TG) at 8993 can cause Leigh disease when the percentage of abnormal mtDNA is high. Am. J. Hum. Genet. 1992; 50: 852–8.
2. Makela-Bengs P., Suomalainen A., Majander A., et al. Correlation between the clinical symptoms and the proportion of mitochondrial DNA carrying the 8993 point mutation in the NARP syndrome. Pediatr. Res. 1995; 37: 634–9.
3. Tatuch Y., Pagon R.A., Vlcek B., et al. The 8993 mtDNA mutation: heteroplasmy and clinical presentation in three families. Eur. J. Hum. Genet .1994; 2: 35–43.
4. McKusick V.A. Online Mendelian inheritance in man. Catalogs of Human Genes and Genetic Disorders. Baltimore; London: John Hopkins, Univ. press; 2010. Avaibe at: http://www.ncbi.nlm.nih.gov/OMIM
5. Holt I.J., Harding A.E., Petty R.K.H., Morgan-Hughes J.A. A new mitochondrial disease associated with mitochondrial DNA heteroplasmy. Am. J. Hum. Genet. 1990; 46: 428–33.
6. Puddu P., Barboni P., Mantovani V., et al. Retinitis pigmentosa, ataxia, and mental retardation associated with mitochondrial DNA mutation in an Italian family. Br. J. Ophthalmol. 1993; 77: 84–8.
7. Santorelli F.M., Tanji K., Sano M., et al. Maternally inherited encephalopathy associated with a single-base insertion in the mitochondrial tRNATrp gene. Ann. Neurol. 1997; 42: 256–60.
8. Sembrano E., Barthlen G.M., Wallace S., Lamm C. Polysomnographic findings in a patient with the mitochondrial encephalomyopathy NARP. Neurology. 1997; 49: 1714–7.
9. Lopez-Gallardo E., Solano A., Herrero-Martin M.D., et al. NARP syndrome in a patient harboring an insertion in the MT-ATP6 gene that results in a truncated protein. J. Med. Genet. 2009; 45: 64–7.
10. Rawle M.J., Larner A.J. NARP syndrome: a 20-year follow-up. Case Rep. Neurol. 2013; 5: 204–7.
11. Rudenskaya G.E., Zakharova E.Yu. Hereditary neurometabolic disorders of young and adult age. Moscow: Geotar-Media; 2018 (in Russian).
12. Kerrison J.B., Biousse V., Newman N.J. Retinopathy of NARP syndrome. Arch. Ophthal. 2000; 118: 298–9.
13. Kearns T.P., Sayre G.P. Retinitis pigmentosa, external ophthalmoplegia and complete heart block; unusual syndrome with histologic study in one of two cases. Arch. Ophthalmol. 1958; 60: 280–9.
14. Eagle R.C., Hedges T.R., Yano V.M. The atypical pigmentary retinopathy of Kearns — Sayre syndrome. Ophthalmology. 1982; 89: 1433–40.
15. Moraes T.C., DiMauro S., Zeviani M., et al. Mitochondrial DNA deletions in progressive external ophthalmoplegia and Kearns — Sayre syndrome. N. Engl. J. Med. 1989; 320: 1293–9.
16. Mullie M.A., Harding A.E., Petty R.K.H., et al. The retinal manifestations of mitochondrial myopathy. Arch. Ophthalmol. 1985; 103: 1825–30.
17. Bosche J., Hammerstein W., Neuen-Jacob E., et al. Variation in retinal changes and muscle pathology in mitochondriopathies. Graefes Arch. Clin.Exp. Ophthalmol. 1989; 227: 578–83.
18. Chang T.S., Johns D.R., Walker D., et al. Ocular clinicopathologic study of the mitochondrial encephalomyopathy overlap syndrome. Arch. Ophthalmol. 1993; 111: 1254–62.
19. Thorburn D.R., Rahman S. Mitochondrial DNA-Associated Leigh Syndrome and NARP. 2003 Oct 30 [updated 2014 Apr 17]. In: Pagon R.A., Adam M.P., Ardinger H.H., et al., eds. Gene Reviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017. Available at: http://www.ncbi.nlm.nih.gov/books/NBK1173
20. Claeys K.G., Abicht A., Hausler M., et al. Novel genetic and neuropathological insights in neurogenic muscle weakness, ataxia, and retinitis pigmentosa (NARP). Muscle Nerve. 2016; 54: 328–33.
21. Ciafaloni E., Santorelli F.M., Shanske S., et al. Maternally inherited Leigh syndrome. J Pediatr. 1993; 122: 419–22.
22. Aldinger K.A., Mosca S.J., Tetreault M., et al. Mutations in LAMA1 cause cerebellar dysplasia and cysts with and without retinal dystrophy. Am. J. Hum. Genet. 2014; 95: 227–34. Note: Erratum: Am. J. Hum. Genet. 2014; 95: 472.
Review
For citations:
Khlebnikova O.V., Sharkova I.V. Retinal abiotrophy in mitochondrial pathology: NARP sindrome (a clinical case). Russian Ophthalmological Journal. 2019;12(1):97-101. (In Russ.) https://doi.org/10.21516/2072-0076-2019-12-1-97-101