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Muscle Nerve. 2017 Nov;56(5):1001-1005. doi: 10.1002/mus.25550. Epub 2017 Mar 23.

Exome sequencing establishes a gelsolin mutation as the cause of inherited bulbar-onset neuropathy.

Author information

1
Department of Neurology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, North Carolina, 27157, USA.
2
Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA.
3
Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, United Kingdom.
4
Neuromuscular Diseases Research Section Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA.
5
Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC.
6
Computational Biology Core, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA.
7
Department of Molecular Neuroscience, MRC Centre for Neuromuscular Diseases and the Reta Lila Weston Institute of Neurological Studies, Institute of Neurology, University College London, Queen Square, London, United Kingdom.
8
Neurology Associates, Merit Health Medical Group, Hattiesburg, Mississippi, USA.
9
Neurological Associates, New Westminster, BC, Canada, V3L 3W4.

Abstract

INTRODUCTION:

Progressive bulbar motor neuropathy is primarily caused by bulbar-onset ALS. Hereditary amyloidosis type IV also presents with a bulbar neuropathy that mimics motor neuron disease. The disease is prevalent in Finland only and is not commonly included in the differential diagnosis of ALS.

METHODS:

We studied 18 members of a family in which some had bulbar motor neuropathy, and we performed exome sequencing.

RESULTS:

Five affected family members were found to have a D187Y substitution in the GSN gene known to cause hereditary amyloidosis type IV.

CONCLUSIONS:

This American family presented with progressive bulbar neuropathy due to a gelsolin mutation not found in Finland. Hereditary amyloidosis type IV presents with bulbar motor neuropathy and not with peripheral neuropathy as occurs with common forms of amyloidosis. This report demonstrates the power of exome sequencing to determine the cause of rare hereditary diseases with incomplete or atypical phenotypes. Muscle Nerve 56: 1001-1005, 2017.

KEYWORDS:

amyloidosis; amyotrophic lateral sclerosis; bulbar neuropathy; corneal dystrophy; exome sequencing; gelsolin; motor neuron disease

PMID:
28039894
PMCID:
PMC5494018
[Available on 2018-11-01]
DOI:
10.1002/mus.25550
[Indexed for MEDLINE]

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