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Novel Mutations of the Tymp Gene in Mitochondrial Neurogastrointestinal Encephalomyopathy: Case Series and Literature Review Publisher Pubmed



Mojtabavi H1, 2, 3 ; Fatehi F1, 3 ; Shahkarami S4, 5 ; Rezaei N6, 7, 8 ; Nafissi S1, 3
Authors
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Authors Affiliations
  1. 1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  3. 3. Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pediatrics, Hauner Children’s Hospital, Ludwig-Maximilians-Universitat Munchen, Dr. von, Munich, Germany
  5. 5. Medical Genetics Network (MeGeNe), Universal Scientific Education and Research Network (USERN), Munich, Germany
  6. 6. Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran

Source: Journal of Molecular Neuroscience Published:2021


Abstract

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a multi-system disorder caused by several homozygous or compound heterozygous mutations, mostly in the nuclear gene of TYMP. Our current knowledge on the underlying pathology of the disease is derived through the study of about 200 cases of different ethnicities. Clinical presentations include severe cachexia, weakness, ptosis, diplopia, abdominal cramps or digestive tract disorders, hearing impairment, and paresthesia. Herein, we aim to present five novel mutations of the nuclear gene of TYMP in six Iranian patients diagnosed with MNGIE. In our population, age at the time of diagnosis was 18 to 49 years, while the onset of the symptoms varied from 13 to 20 years. We detected two pathogenic non-frameshift nonsense premature stop codon mutations (c.1013C > A, and c.130C > T), one variant of uncertain significance (VUS) non-frameshift missense mutation (c.345G > T), one likely pathogenic frameshift insertion (c.801_802insCGCG), and one likely benign homozygous non-frameshift deletion (c.1176_1187del) from two siblings. Our findings also confirm the autosomal recessive inheritance pattern of MNGIE in the Iranian population. The lack of knowledge in the area of nuclear gene-modifier genes shadows the genotype–phenotype relationships of MNGIE. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.