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Expanding the phenotype of DYNC1H1-associated diseases with a rare variant resulting in spinal muscular atrophy with lower extremity predominance (SMA-LED) and upper motor neuron signs

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dc.contributor.author Lee, J.
dc.contributor.author Millington, P.
dc.contributor.author Dayasiri, K.
dc.contributor.author Ramdas, S.
dc.contributor.author Jayawant, S.
dc.contributor.author Anand, G.
dc.date.accessioned 2023-07-04T06:39:14Z
dc.date.available 2023-07-04T06:39:14Z
dc.date.issued 2023
dc.identifier.citation The Turkish Journal of Pediatrics.2023;65(3):531-535. en_US
dc.identifier.issn 0041-4301
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/26405
dc.description indexed in MEDLINE. en_US
dc.description.abstract BACKGROUND: Spinal muscular atrophy with lower extremity predominance (SMA-LED) is an autosomal dominant disorder. Since SMA-LED affects lower motor neurons, the disease is characterized by weakness and atrophy of lower limb muscles. We present a familial case series of SMA-LED with upper motor neuron signs associated with a rare variant in DYNC1H1. CASE: The index case was referred to Pediatric Neurology at the age of two and half years, due to delayed mobility. The child was diagnosed with congenital vertical talus at birth, which was managed with serial bilateral casting and surgery. The delayed mobility was initially attributed to lower limb weakness secondary to prolonged periods of immobilization from casting of his lower limbs. He had a striking waddling gait and proximal muscle weakness on neurological assessment. He had lower motor neuron signs predominantly in his lower limbs that were in keeping with SMA-LED. Surprisingly, he also demonstrated a brisk crossed adductor response that was not in keeping with an isolated primary neuro-muscular disorder and suggested a mixed upper and lower motor neuron pathology. The inherited neuropathy gene panel revealed a heterozygous sequence change in the DYNC1H1 gene which was present in all affected family members. CONCLUSIONS: We present the first report of a familial case series of SMA-LED with upper motor neuron signs associated with an extremely rare variant in DYNC1H1: c.1808A > T (p.Glu603Val). As per the American College of Medical Genetics and Genomics (ACMG) guidelines for variant classification, we would recommend that this variant be reclassified as `Likely Pathogenic` due to matching 1 moderate (PM1-PM6) and ≥4 supporting (PP1-PP5) criteria in the reported case series. en_US
dc.language.iso en en_US
dc.publisher Hacettepe Medical Center en_US
dc.subject spinal muscular atrophy with lower extremity predominance en_US
dc.subject upper motor neuron signs. en_US
dc.title Expanding the phenotype of DYNC1H1-associated diseases with a rare variant resulting in spinal muscular atrophy with lower extremity predominance (SMA-LED) and upper motor neuron signs en_US
dc.type Article en_US


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