title: A novel mutation in COL4A1 gene: a possible cause of early postnatal cerebrovascular events.
abstract: COL4A1 is located in humans on chromosome13q34 and it encodes the alpha 1 chain of type IV collagen, a component of basal membrane. It is expressed mainly in the brain, muscles, kidneys and eyes. Different COL4A1 mutations have been reported in many patients who present a very wide spectrum of clinical symptoms. They typically show a multisystemic phenotype. Here we report on the case of a patient carrying a novel de novo splicing mutation of COL4A1 associated with a distinctive clinical picture characterized by onset in infancy and an unusual evolution of the neuroradiological features. At three months of age, the child was diagnosed with a congenital cataract, while his brain MRI was normal. Over the following years, the patient developed focal epilepsy, mild diplegia, asymptomatic microhematuria, raised creatine kinase levels, MRI white matter abnormalities and brain calcification on CT. During the neuroradiological follow-up the extension and intensity of the brain lesions progressively decreased. The significance of a second variant in COL4A1 carried by the child and inherited from his father remains to be clarified. In conclusion, our patient shows new aspects of this collagenopathy and possibly a COL4A1 compound heterozygosity.
authors.affiliation: Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Decio
authors.forename: Davide
authors.initials: D
authors.lastname: Tonduti
authors.forename: Anna
authors.initials: A
authors.lastname: Pichiecchio
authors.forename: Annalisa
authors.initials: A
authors.lastname: Vetro
authors.forename: Roberto
authors.initials: R
authors.lastname: Ciccone
authors.forename: Ivan
authors.initials: I
authors.lastname: Limongelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Giorda
authors.forename: Lorella
authors.initials: L
authors.lastname: Caffi
authors.forename: Umberto
authors.initials: U
authors.lastname: Balottin
authors.forename: Orsetta
authors.initials: O
authors.lastname: Zuffardi
authors.forename: Simona
authors.initials: S
authors.lastname: Orcesi
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging* / Q000235:genetics; D001483:Base Sequence; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000235:genetics; D002648:Child; D024141:Collagen Type IV / Q000235:genetics*; D004252:DNA Mutational Analysis; D056726:Genetic Association Studies; D006801:Humans; D008297:Male; D009154:Mutation; D011859:Radiography; D066127:White Matter / Q000002:abnormalities / Q000000981:diagnostic imaging
chemical_list: C547475:COL4A1 protein, human; D024141:Collagen Type IV
keywords: COL4A1 gene; cerebral calcification; infants; leukoencephalopathy