1. A novel protein truncating mutation in L2HGDH causes L-2-hydroxyglutaric aciduria in a consanguineous Pakistani family
- Author
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Christian Enzinger, Jasmin Blatterer, Christian Windpassinger, Saadullah Khan, Klaus Wagner, Safeer Ahmad, Muhammad Zeeshan Ali, Muzammil Ahmad Khan, Erwin Petek, Syed Khizar Shah, Sundas Taj, Beatrice A. Brugger, and Muhammad Muzammal
- Subjects
Male ,Intellectual disability ,Biochemistry ,Frameshift mutation ,Cellular and Molecular Neuroscience ,symbols.namesake ,Consanguinity ,medicine ,Humans ,Pakistan ,L2HGDH ,Exome ,Exome sequencing ,Genetics ,Sanger sequencing ,Cerebellar ataxia ,business.industry ,Macrocephaly ,Whole exome sequencing ,Leukoaraiosis ,N-terminal frameshift mutation ,Brain Diseases, Metabolic, Inborn ,Disease gene identification ,Alcohol Oxidoreductases ,L-2-hydroxyglutaric aciduria ,Mutation ,symbols ,Original Article ,Neurology (clinical) ,medicine.symptom ,business - Abstract
Background L-2-hydroxyglutaric aciduria (L2HGA) is a rare neurometabolic disorder that occurs due to accumulation of L-2-hydroxyglutaric acid in the cerebrospinal fluid (CSF), plasma and urine. The clinical manifestation of L2HGA includes intellectual disability, cerebellar ataxia, epilepsy, speech problems and macrocephaly. Methods In the present study, we ascertained a multigenerational consanguineous Pakistani family with 5 affected individuals. Clinical studies were performed through biochemical tests and brain CT scan. Locus mapping was carried out through genome-wide SNP genotyping, whole exome sequencing and Sanger sequencing. For in silico studies protein structural modeling and docking was done using I-TASSER, Cluspro and AutoDock VINA tools. Results Affected individuals presented with cognitive impairment, gait disturbance, speech difficulties and psychomotor delay. Radiologic analysis of a male patient revealed leukoaraiosis with hypoattenuation of cerebral white matter, suggestive of hypomyelination. Homozygosity mapping in this family revealed a linkage region on chromosome 14 between markers rs2039791 and rs781354. Subsequent whole exome analysis identified a novel frameshift mutation NM_024884.3:c.180delG, p.(Ala62Profs*24) in the second exon of L2HGDH. Sanger sequencing confirmed segregation of this mutation with the disease phenotype. The identification of the most N-terminal loss of function mutation published thus far further expands the mutational spectrum of L2HGDH.
- Published
- 2021