title: FA2H-related disorders: a novel c.270+3A>T splice-site mutation leads to a complex neurodegenerative phenotype.
abstract: Homozygous mutations in the gene for fatty acid 2-hydroxylase (FA2H) have been associated in humans with three neurodegenerative disorders: complicated spastic paraplegia (SPG35), leukodystrophy with spastic paraparesis and dystonia, and neurodegeneration with brain iron accumulation. Here, we describe a novel homozygous c.270+3A>T mutation in an Italian consanguineous family. In two affected brothers (age at molecular diagnosis 22y and 15y; age at last follow-up 24y and 17y), altered FA2H function led to a severe phenotype, with clinical features overlapping those of the three FA2H-associated disorders. Both patients showed childhood onset progressive spastic paraparesis, mild pyramidal and cerebellar upper limb signs, severe cognitive impairment, white-matter disease, and cerebellar, brainstem, and spinal cord atrophy. However, absence of dystonia, drowsiness episodes, and a subtle globus pallidus involvement suggested that FA2H mutations result in a clinical spectrum, rather than causing distinct disorders. Although clinical heterogeneity is apparent, larger numbers of patients are needed to establish more accurate genotype-phenotype correlations.
authors: Child Neuropsychiatric Unit, St Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors: Caterina
authors: C
authors: Garone
authors: Tommaso
authors: T
authors: Pippucci
authors: Duccio M
authors: DM
authors: Cordelli
authors: Roberta
authors: R
authors: Zuntini
authors: Giovanni
authors: G
authors: Castegnaro
authors: Caterina
authors: C
authors: Marconi
authors: Claudio
authors: C
authors: Graziano
authors: Valentina
authors: V
authors: Marchiani
authors: Alberto
authors: A
authors: Verrotti
authors: Marco
authors: M
authors: Seri
authors: Emilio
authors: E
authors: Franzoni