Association between homozygous c.318A>GT mutation in exon 2 of the EIF2B5 gene and the infantile form of vanishing white matter leukoencephalopathy [Asociación entre la mutación homocigota c.318A>T en el exón 2 del gen EIF2B5 y la forma infantil de la leucoencefalopatía con sustancia blanca evanescente]
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Background Vanishing white matter disease is one of the most frequent leukodystrophies in childhood with an autosomal recessive inheritance. A mutation in one of the genes encoding the five subunits of the eukaryotic initiation factor 2 (EIF2B5) is present in 90%25 of the cases. The diagnosis can be accomplished by the clinical and neuroradiological findings and molecular tests. Case report We describe a thirteen-month-old male with previous normal neurodevelopment, who was hospitalized for vomiting, hyperthermia and irritability. On examination, cephalic perimeter and cranial pairs were normal. Hypotonia, increased muscle stretching reflexes, generalized white matter hypodensity on cranial tomography were found. Fifteen days after discharge, he suffered minor head trauma presenting drowsiness and focal seizures. Magnetic resonance showed generalized hypointensity of white matter. Vanishing white matter disease was suspected, and confirmed by sequencing of the EIF2B5 gene, revealing a homozygous c.318A> T mutation in exon 2. Subsequently, visual acuity was lost and cognitive and motor deterioration was evident. The patient died at six years of age due to severe pneumonia. Conclusions This case contributes to the knowledge of the mutational spectrum present in Mexican patients and allows to extend the phenotype associated to this mutation. © 2017
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EIF2B5 gene; Leukodystrophy; Magnetic resonance; Vanishing white matter disease initiation factor; initiation factor 2B5; unclassified drug; EIF2B5 protein, human; guanine nucleotide exchange factor; Article; brain tomography; case report; child; clinical article; drowsiness; EIF2B5 gene; exon; focal epilepsy; gene; gene mutation; genetic association; head injury; homozygosity; human; hyperthermia; irritability; leukoencephalopathy; male; mental deterioration; motor dysfunction; muscle hypotonia; myotatic reflex; nuclear magnetic resonance imaging; preschool child; visual acuity; vomiting; white matter; fatality; genetics; infant; leukoencephalopathy; mutation; pathophysiology; phenotype; procedures; x-ray computed tomography; Child; Child, Preschool; Eukaryotic Initiation Factor-2B; Exons; Fatal Outcome; Humans; Infant; Leukoencephalopathies; Magnetic Resonance Imaging; Male; Mutation; Phenotype; Tomography, X-Ray Computed
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