Familial visceral myopathy diagnosed by exome sequencing of a patient with chronic intestinal pseudo-obstruction.
A 55-year-old woman with a history of bowel dysmotility presented with abdominal distension and peritonitis. Family history included premature deaths with intestinal symptomatology, suggesting autosomal dominant inheritance. Computed tomography showed a distended small bowel. Symptoms were alleviated by enterocutaneous stomas. Initial ileal biopsy suggested neuropathy; however, exome sequencing revealed an Arg148Ser mutation in the enteric smooth muscle actin gamma 2 (ACTG2) gene. Histological reassessment showed abnormal muscularis propria and smooth muscle actin, with the same findings in sibling, confirming familial visceral myopathy. Thus, noninvasive genomic analysis can provide early and specific diagnosis of familial visceral myopathy, which may help to avoid inappropriate surgery.
Department of Medical Genetics, Telemark Hospital, Skien, Norway.
Oystein L
OL
Holla
Department of Gastrointestinal Surgery, Telemark Hospital, Skien, Norway.
Gunter
G
Bock
Department of Medical Genetics, Telemark Hospital, Skien, Norway.
Oyvind L
OL
Busk
Department of Pathology, Telemark Hospital, Skien, Norway.
Björn Logi
BL
Isfoss
D000199:Actins / Q000235:genetics*; D004252:DNA Mutational Analysis; D004386:Duodenum / Q000002:abnormalities* / Q000473:pathology; D059472:Exome; D005260:Female; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000235:genetics* / Q000473:pathology*; D008875:Middle Aged; D010375:Pedigree; D001743:Urinary Bladder / Q000002:abnormalities* / Q000473:pathology
C579475:ACTG2 protein, human; D000199:Actins