title: Lafora disease: severe phenotype associated with homozygous deletion of the NHLRC1 gene.
abstract: Lafora disease (LD) is a severe, autosomal recessive, latechildhood- to teenage-onset, progressive myoclonic epilepsy. It is due to either EPM2A or NHLRC1 mutations. We describe a patient with homozygous deletion encompassing the entire NHLRC1 gene, not previously reported, and with clinical course more progressive than in the most patients with NHLRC1 mutations. The diagnosis of LD in our patient was based on the typical clinic, neurophysiological presentation, as well as skin biopsy followed by molecular genetics findings. She developed normally until the age of 15, when she had her first occipital and generalized seizures. Four years after the first seizure the patient became bedridden, demented and presented with severe clinical condition. She died of pneumonia at age 20. This report is the first case of homozygosity for NHLRC1 deletion and thus adds to mutational heterogeneity of LD. Besides, it widens the spectrum of LD patients with severe phenotype and NHLRC1 mutations.
authors: Faculty of Biology, University of Belgrade, Studentski trg 16, P.O. Box 52, 11000 Belgrade, Serbia. miljana@bio.bg.ac.rs
authors: Miljana
authors: M
authors: Kecmanović
authors: Nebojša
authors: N
authors: Jović
authors: Mirjana
authors: M
authors: Cukić
authors: Milica
authors: M
authors: Keckarević-Marković
authors: Dušan
authors: D
authors: Keckarević
authors: Galina
authors: G
authors: Stevanović
authors: Stanka
authors: S
authors: Romac
mesh_terms: D002352:Carrier Proteins / Q000235:genetics*; D005260:Female; D006720:Homozygote; D006801:Humans; D020192:Lafora Disease / Q000175:diagnosis* / Q000235:genetics*; D010641:Phenotype; D017384:Sequence Deletion / Q000235:genetics*; D012720:Severity of Illness Index; D044767:Ubiquitin-Protein Ligases; D055815:Young Adult
chemical_list: D002352:Carrier Proteins; C478960:NHLRC1 protein, human; D044767:Ubiquitin-Protein Ligases