title: Novel POLG splice site mutation and optic atrophy.
abstract: OBJECTIVE
  To investigate the molecular etiology of 2 unrelated patients with a multisystem mitochondrial disorder accompanied by optic atrophy in one of them.
  
  
  METHODS
  Clinical examination and neurophysiological, radiological, morphological, and molecular analyses.
  
  
  METHODS
  Tertiary care neuromuscular clinic and molecular genetics laboratory.
  
  
  METHODS
  A 65-year-old man (patient 1) with dyschromatopsia and vision loss since childhood developed progressive external ophthalmoplegia, ptosis, and myopathy in the seventh decade of life and was found to have optic atrophy. A 63-year-old man (patient 2) with a similar phenotype, without visual symptoms, experienced also hearing loss and parkinsonism.
  
  
  METHODS
  Description of the clinical and molecular findings.
  
  
  RESULTS
  A muscle biopsy specimen showed ragged-red, ragged-blue, and cytochrome c oxidase-negative fibers in both patients. Because optic atrophy in patient 1 suggested an autosomal dominant OPA1-related disorder, the OPA1 gene was first sequenced, the results of which did not detect any mutations. Southern blot and polymerase chain reaction analyses of muscle mitochondrial DNA revealed multiple deletions. Sequencing of POLG detected a novel variant, c.3104 + 3A>T, in both patients. Patient 1 was compound heterozygous for a known p.F749S mutation; patient 2 had p.G848S as the second mutation. Analysis of POLG complementary DNA showed that c.3104 + 3A>T results in skipping of exon 18.
  
  
  CONCLUSIONS
  Early-onset dyschromatopsia and optic atrophy can occur not only in OPA1-related but also in POLG-related disorders with significant impact on genetic counseling.
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Milone.Margherita@mayo.edu
authors.forename: Margherita
authors.initials: M
authors.lastname: Milone
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Teerin
authors.initials: T
authors.lastname: Liewluck
authors.forename: Li-Chieh
authors.initials: LC
authors.lastname: Chen
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Leavitt
authors.forename: Lee-Jun
authors.initials: LJ
authors.lastname: Wong
mesh_terms: D000368:Aged; D000074002:DNA Polymerase gamma; D004259:DNA-Directed DNA Polymerase / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D028361:Mitochondrial Diseases / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D009154:Mutation / Q000235:genetics*; D015418:Optic Atrophies, Hereditary / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D022821:RNA Splice Sites / Q000235:genetics*
chemical_list: D022821:RNA Splice Sites; D000074002:DNA Polymerase gamma; D004259:DNA-Directed DNA Polymerase; C413027:POLG protein, human