Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report

The incidence of hypomyelinating leukodystrophies is approximately 1 in every 250,000–500,000 individuals in the population. Hypomyelinating leukodystrophy-8 (HLD-8) is characterized by classical clinical features, including modest intellectual deficits and early-onset progressive cerebellar ataxia,...

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Main Authors: Shalesh Rohatgi, Pranit Khandait, Satish Nirhale, Prajwal Rao, Pravin Naphade
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Medical Journal of Dr. D.Y. Patil Vidyapeeth
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Online Access:https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_843_23
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author Shalesh Rohatgi
Pranit Khandait
Satish Nirhale
Prajwal Rao
Pravin Naphade
author_facet Shalesh Rohatgi
Pranit Khandait
Satish Nirhale
Prajwal Rao
Pravin Naphade
author_sort Shalesh Rohatgi
collection DOAJ
description The incidence of hypomyelinating leukodystrophies is approximately 1 in every 250,000–500,000 individuals in the population. Hypomyelinating leukodystrophy-8 (HLD-8) is characterized by classical clinical features, including modest intellectual deficits and early-onset progressive cerebellar ataxia, with or without oligodontia and/or hypogonadotropic hypogonadism. In this case report, we present a 34-year-old male who experienced gradually progressive behavioral and memory disturbances over the past 10 years, accompanied by imbalance while walking and complex partial seizures. The patient also exhibited oligodontia and moderate intellectual disability (IQ score: 45). Spasticity was observed in the lower limbs, with exaggerated deep tendon reflexes in all four limbs, and bilaterally extensor plantar responses were noted. Sensory examination results were within normal limits. Bilateral cerebellar signs were present, including gaze-evoked nystagmus in all directions, which was non-fatigable. MRI brain revealed generalized cerebral and cerebellar atrophy, as well as diffuse hyperintensities in T2-weighted images (T2W) and fluid-attenuated inversion recovery (FLAIR) in the bilateral cerebral white matter, with no basal ganglia involvement. The sagittal T1-weighted image (T1W) showed diffuse thinning of the corpus callosum. Whole-exome sequencing revealed a novel variant mutation of the POLR3B gene in HLD-8, specifically in Exon 20 [c.2125A>G (p.Met709Val)] and Exon 23 [c.2699G>A (p.Arg900His)]. Very few case reports and variant mutations on the POLR3B gene on chromosome 12q23.3 have been reported thus far.
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series Medical Journal of Dr. D.Y. Patil Vidyapeeth
spelling doaj-art-86058e24036e4d47b5b529c688f6ebf82024-12-09T09:31:30ZengWolters Kluwer Medknow PublicationsMedical Journal of Dr. D.Y. Patil Vidyapeeth2589-83022589-83102024-11-011761251125410.4103/mjdrdypu.mjdrdypu_843_23Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case ReportShalesh RohatgiPranit KhandaitSatish NirhalePrajwal RaoPravin NaphadeThe incidence of hypomyelinating leukodystrophies is approximately 1 in every 250,000–500,000 individuals in the population. Hypomyelinating leukodystrophy-8 (HLD-8) is characterized by classical clinical features, including modest intellectual deficits and early-onset progressive cerebellar ataxia, with or without oligodontia and/or hypogonadotropic hypogonadism. In this case report, we present a 34-year-old male who experienced gradually progressive behavioral and memory disturbances over the past 10 years, accompanied by imbalance while walking and complex partial seizures. The patient also exhibited oligodontia and moderate intellectual disability (IQ score: 45). Spasticity was observed in the lower limbs, with exaggerated deep tendon reflexes in all four limbs, and bilaterally extensor plantar responses were noted. Sensory examination results were within normal limits. Bilateral cerebellar signs were present, including gaze-evoked nystagmus in all directions, which was non-fatigable. MRI brain revealed generalized cerebral and cerebellar atrophy, as well as diffuse hyperintensities in T2-weighted images (T2W) and fluid-attenuated inversion recovery (FLAIR) in the bilateral cerebral white matter, with no basal ganglia involvement. The sagittal T1-weighted image (T1W) showed diffuse thinning of the corpus callosum. Whole-exome sequencing revealed a novel variant mutation of the POLR3B gene in HLD-8, specifically in Exon 20 [c.2125A>G (p.Met709Val)] and Exon 23 [c.2699G>A (p.Arg900His)]. Very few case reports and variant mutations on the POLR3B gene on chromosome 12q23.3 have been reported thus far.https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_843_23hld-8hypomyelinating leukodystrophy-8novel variantpolr3b
spellingShingle Shalesh Rohatgi
Pranit Khandait
Satish Nirhale
Prajwal Rao
Pravin Naphade
Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report
Medical Journal of Dr. D.Y. Patil Vidyapeeth
hld-8
hypomyelinating leukodystrophy-8
novel variant
polr3b
title Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report
title_full Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report
title_fullStr Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report
title_full_unstemmed Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report
title_short Novel Gene Mutation Variant in Hypomyelinating Leukodystrophy-8: A Case Report
title_sort novel gene mutation variant in hypomyelinating leukodystrophy 8 a case report
topic hld-8
hypomyelinating leukodystrophy-8
novel variant
polr3b
url https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_843_23
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AT satishnirhale novelgenemutationvariantinhypomyelinatingleukodystrophy8acasereport
AT prajwalrao novelgenemutationvariantinhypomyelinatingleukodystrophy8acasereport
AT pravinnaphade novelgenemutationvariantinhypomyelinatingleukodystrophy8acasereport