title: Rapid Progression of Sporadic ALS in a Patient Carrying SOD1 p.Gly13Arg Mutation.
abstract: Amyotrophic lateral sclerosis (ALS), the most common adult onset motor neuron disease, is pathologically characterized by progressive loss of the upper and lower motor neurons. Mutations in the Cu/Zn superoxide dismutase gene (SOD1) account for about 20% of familial ALS cases and a small percentage of sporadic ALS (SALS) cases, and have revealed a validated genotype-phenotype correlation. Herein, we report a p.Gly13Arg mutation in SOD1 exon 1 in a patient with SALS who presented with a rapidly progressive course, predominantly affecting the lower motor neurons. A 48-year-old man presented with progressive weakness and muscle atrophy of the left upper and lower limbs, followed by muscle fasciculation and cramping. The clinical features of the patient were clearly suggestive of ALS, and implied a sporadic form with rapid progression, predominantly affecting the lower motor neurons. Sequencing of the SOD1 gene by PCR revealed a missense mutation of G to C (c.37G>C) in exon 1, and amino acid substitution of glycine by arginine (p.Gly13Arg). This is the first case identifying the p.Gly13Arg mutation of SOD1 in the Korean population, and clinical assessments of this patient revealed a different phenotype compared with other cases.
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Myung-Jin
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Jae-Han
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Hye Ryoun
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Korea.
authors.forename: Byung-Nam
authors.initials: BN
authors.lastname: Yoon
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.
authors.forename: Jung-Joon
authors.initials: JJ
authors.lastname: Sung
authors.affiliation: Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
authors.forename: Suk-Won
authors.initials: SW
authors.lastname: Ahn
keywords: ALS; Amyotrophic lateral sclerosis; Cu/Zn superoxide dismutase 1; Exon 1; SOD1