Aicardi-Goutières syndrome: unusual neuro-radiological manifestations.
Aicardi-Goutières syndrome (AGS) is one of the expanding group of inherited congenital infection like syndromes. Here, we describe the detailed clinical and imaging findings of two sibs with AGS. Each shows scattered periventricular intracranial calcifications, severe global delay, seizures, microcephaly and spasticity. Interestingly, chilblains were observed in the two sisters as well as their parents and a paternal uncle. The brain MRI of the older sister showed marked ventricular dilatation as a result of unusual associated porencephalic cysts. Unexpectedly, unilateral cerebellar hypoplasia was also noted. In comparison, her younger sister displayed the classic atrophic changes and white matter loss of AGS. The diagnosis of AGS was confirmed by sequence analysis, which identified a previously reported homozygous RNASEH2B mutation, c.554 T > G (p.V185G). Parents were heterozygous for the same mutation. Further molecular analysis excluded mutations in potentially related manifestations of COL4A1 gene. This is the first report of chilblains associated with heterozygous RNASEH2B mutation. Further, the brain imaging findings appear particularly interesting, which until now has not been reported in any AGS patient. We discuss the possible reasons for this unusual presentation.
Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt. ghada.abdelsalam@yahoo.com.
Ghada M H
GMH
Abdel-Salam
Medical Molecular Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.
Mohamed S
MS
Abdel-Hamid
Department of Radiodiagnosis, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Shaimaa A
SA
Mohammad
Medical Molecular Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.
Sherif F
SF
Abdel-Ghafar
Department of Pediatrics, Faculty of Medicine, Benha University, Benha, Egypt.
Doaa R
DR
Soliman
Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.
Hala T
HT
El-Bassyouni
Medical Molecular Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.
Laila
L
Effat
Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo, Egypt.
Maha S
MS
Zaki
D020274:Autoimmune Diseases of the Nervous System / Q000150:complications / Q000000981:diagnostic imaging* / Q000235:genetics; D001921:Brain / Q000000981:diagnostic imaging*; D002647:Chilblains / Q000150:complications / Q000000981:diagnostic imaging* / Q000235:genetics; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D009421:Nervous System Malformations / Q000150:complications / Q000000981:diagnostic imaging* / Q000235:genetics; D014057:Tomography, X-Ray Computed / Q000379:methods
Aicardi–Goutières syndrome; Chilblains; Dysmorphic ventricles; Neuro-radiologic; Porencephalic cysts; RNASEH2B; Unilateral cerebellar hypoplasia; Unusual