Novel TUBB4A mutations and expansion of the neuroimaging phenotype of hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC).
Hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC) has recently been associated with a single heterozygous p.D249N mutation in TUBB4A. We describe two novel mutations in this gene. A p.C239F mutation was found in one of the originally described H-ABC patients, for whom we provide follow-up 11 years after the original publication. The second novel mutation, p.R262H, was found in a patient with a typical clinical presentation for H-ABC, but with a novel neuroimaging phenotype, given the absence of atrophy of the putamen and caudate nucleus despite 7 years of follow-up. The recent recognition of TUBB4A mutations as the underlying etiology of H-ABC will likely lead to the identification of subtler clinical and neuroimaging presentations of this disorder, like in our third patient. Thus mutations in this gene should be suspected in any patient with hypomyelination, regardless of the long-term presence of neostriatal atrophy.
National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland.
Carlos
C
Ferreira
Andrea
A
Poretti
Julie
J
Cohen
Ada
A
Hamosh
Sakkubai
S
Naidu
D001284:Atrophy; D001479:Basal Ganglia / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D020271:Heredodegenerative Disorders, Nervous System / Q000175:diagnosis* / Q000235:genetics*; D006579:Heterozygote; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009154:Mutation; D059906:Neuroimaging; D010641:Phenotype; D017422:Sequence Analysis, DNA; D014404:Tubulin / Q000235:genetics*
C582076:TUBB4A protein, human; D014404:Tubulin
TUBB4A; hypomyelination with atrophy of the basal ganglia and cerebellum; tubulin beta 4