Title Clinical Diagnosis, Treatment, and ALDH7A1 Mutations in Pyridoxine-Dependent Epilepsy in Three Chinese Infants
Authors Yang, Zhixian
Yang, Xiaoling
Wu, Ye
Wang, Jingmin
Zhang, Yuehua
Xiong, Hui
Jiang, Yuwu
Qin, Jiong
Affiliation Peking Univ, Hosp 1, Dept Pediat, Beijing 100871, Peoples R China.
Keywords TERM-FOLLOW-UP
RESPONSIVE SEIZURES
PIPECOLIC ACID
MRI FINDINGS
ANTIQUITIN
EEG
EPIDEMIOLOGY
DEFICIENCY
PATIENT
MARKER
Issue Date 2014
Publisher plos one
Citation PLOS ONE.2014,9,(3).
Abstract Pyridoxine-dependent epilepsy (PDE) is a rare autosomal recessive disorder that causes seizures in neonates and infants. Mutations of the ALDH7A1 gene are now recognized as the molecular basis PDE and help to define this disease. Three Chinese children with PDE were clinically analyzed, followed by treatment and examination of the ALDH7A1 mutations. The seizures of the 3 patients were all resistant to multiple anticonvulsants (2 to 7 types). For case 1, onset of seizures was at the age of 2 months. His seizures were well controlled by intravenous pyridoxine for several days at the age of 3 months 20 days and recurred at intervals of 13, 14 and 38 days after pyridoxine withdrawn for 3 times. At the age of 7 months, symptoms of PDE appeared and uninterrupted oral pyridoxine started. For case 2, her seizures occurred at 8 days after birth. After administration of multiple antiepileptic drugs observed ineffective, high-dose pyridoxine continuous therapy was taken at the age of 10 months and the significant treatment effect induced a diagnostic PDE. Seizure onset in case 3 was at the first day of birth. He experienced inadvertently pyridoxine therapy several times (first time at 2 days after birth) and achieved good therapeutic effect, which was confirmed by physicians until 4 months 10 days. The treatment process in our 3 patients suggested that pyridoxine should be early and purposefully used in patients with early onset seizures. ALDH7A1 gene mutation analysis revealed compound heterozygous mutations in each case: heterozygous c.410G>A (p.G137E) and IVS11+1G>A in case 1, heterozygous c.952G>C (p.A318P) and heterozygous c.965C>T (p.A322V) in case 2, and heterozygous c.902A>T (p.N301I) and IVS11+1G>A in case 3. Only p.N301I was reported previously, all other mutations were novel. This is the first time to report cases of Chinese patients diagnosed with PDE by molecular genetic analysis.
URI http://hdl.handle.net/20.500.11897/159944
ISSN 1932-6203
DOI 10.1371/journal.pone.0092803
Indexed SCI(E)
PubMed
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