Correlation Between Vanishing White Matter Disease and Novel Heterozygous EIF2B3 Variants Using Next-Generation Sequencing: A Case Report
10.5535/arm.2019.43.2.234
- Author:
Sung Eun HYUN
1
;
Byung Se CHOI
;
Ja Hyun JANG
;
Inpyo JEON
;
Dae Hyun JANG
;
Ju Seok RYU
Author Information
1. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Vanishing white matter;
Leukoencephalopathies;
Genes;
Exome
- MeSH:
Brain;
Central Nervous System;
Coma;
Eukaryotic Initiation Factor-2B;
Exome;
Exons;
Humans;
Leukoencephalopathies;
Magnetic Resonance Imaging;
Patient Care;
White Matter
- From:Annals of Rehabilitation Medicine
2019;43(2):234-238
- CountryRepublic of Korea
- Language:English
-
Abstract:
Vanishing white matter (VWM) disease is an autosomal recessive disorder that affects the central nervous system of a patient, and is caused by the development of pathogenic mutations in any of the EIF2B1-5 genes. Any dysfunction of the EIF2B1-5 gene encoded eIF2B causes stress-provoked episodic rapid neurological deterioration in the patient, followed by a chronic progressive disease course. We present the case of a patient with an infantile-onset VWM with the pre-described specific clinical course, subsequent neurological aggravation induced by each viral infection, and the noted consequent progression into a comatose state. Although the initial brain magnetic resonance imaging did not reveal specific pathognomonic signs of VWM to distinguish it from other types of demyelinating leukodystrophy, the next-generation sequencing studies identified heterozygous missense variants in EIF2B3, including a novel variant in exon 7 (C706G), as well as a 0.008% frequency reported variant in exon 2 (T89C). Hence, the characteristic of unbiased genomic sequencing can clinically affect patient care and decisionmaking, especially in terms of the consideration of genetic disorders such as leukoencephalopathy in pediatric patients.
