Familial amyloidotic polyneuropathy with late-onset and well-preserved autonomic function: a Japanese kindred with novel mutant transthyretin (Ala97 to Gly).
We report the characteristics of one patient and two asymptomatic carriers from a Japanese family with familial amyloidotic polyneuropathy (FAP). The clinical features were somatic sensory and motor neuropathy with well-preserved autonomic function and late onset with slow insidious progression. These symptoms and signs are different from those of type 1 FAP. There were massive amyloid deposits with transthyretin (TTR) in the myocardium and the sural nerve. DNA sequencing of the TTR gene and amino acid sequence analysis of serum TTR revealed a new mutation in which Gly97 was substituted for Ala. We suggest that patients with somatic sensory and motor neuropathy of unknown origin without apparent autonomic dysfunction should be further studied for TTR mutation.
Yasuda
T
T
Department of Neurology, Nagoya Daini Red Cross Hospital, Japan.
Sobue
G
G
Doyu
M
M
Nakazato
M
M
Shiomi
K
K
Yanagi
T
T
Mitsuma
T
T
D017668:Age of Onset; D000686:Amyloidosis / Q000453:epidemiology* / Q000235:genetics* / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001483:Base Sequence; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation; D009206:Myocardium / Q000473:pathology; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000235:genetics* / Q000503:physiopathology; D010375:Pedigree; D016133:Polymerase Chain Reaction; D011228:Prealbumin / Q000032:analysis / Q000235:genetics*; D013497:Sural Nerve / Q000473:pathology
D011228:Prealbumin