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DOI: 10.1055/s-0042-1745809
A Case Report of Two Bahraini Siblings Presenting with Different Rare Neurogenetic Disorders: Congenital Insensitivity to Pain with Anhidrosis and Rigid Spine Muscular Dystrophy
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Abstract
Congenital insensitivity to pain and anhidrosis (CIPA) is a rare autosomal recessive disease and can pose a diagnostic challenge, as the initial presentation of the disease is varied and can be attributed to different causes. Muscular dystrophies are genetically and clinically heterogeneous. We describe a 2-year-old Bahraini boy who was evaluated in the neonatal period for pyrexia of unknown origin, and then noticed to have recurrent respiratory and gastrointestinal infections during infancy and abnormal behavior (self-mutilation). Whole-exome sequencing identified homozygous pathogenic variant in the NTRK1 gene. His 4 years old sister was followed by the pediatric neurology team for unexplained fluctuating muscle weakness since the age of 2 years. A genetic etiology was suspected in her case, in view of positive family history with similar presentation and the whole-exome sequencing revealed homozygous likely pathogenic variant in the SELENON gene, consistent with a genetic diagnosis of autosomal recessive disorders associated with SELENON gene.
Keywords
congenital insensitivity to pain with anhidrosis - CIPA - NTRK1 gene - rigid spine - muscular dystrophy - RSMD1Publication History
Received: 21 September 2021
Accepted: 24 February 2022
Article published online:
06 May 2022
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References
- 1 Orphanet: The portal for rare diseases and orphan drugs.. Accessed February 10, 2021 at: https://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=935&Disease_Disease_Search_diseaseType=ORPHA&Disease_Disease_Search_diseaseGroup=642&Disease(s)/group%20of%20diseases=Insensitivity-to-pain—anhidrosis&title=Insensitivity-to-pain—anhidrosis&search=Disease_Search_Simple
- 2 Axelrod FB. Hereditary sensory and autonomic neuropathies. Familial dysautonomia and other HSANs. Clin Auton Res 2002; 12 (Suppl. 01) I2-I14
- 3 Flanigan KM, Kerr L, Bromberg MB. et al. Congenital muscular dystrophy with rigid spine syndrome: a clinical, pathological, radiological, and genetic study. Ann Neurol 2000; 47 (02) 152-161
- 4 Morita H, Kondo K, Hoshino K, Maruyama K, Yanagisawa N. Rigid spine syndrome with respiratory failure. J Neurol Neurosurg Psychiatry 1990; 53 (09) 782-784
- 5 Bonkowsky JL, Johnson J, Carey JC, Smith AG, Swoboda KJ. An infant with primary tooth loss and palmar hyperkeratosis: a novel mutation in the NTRK1 gene causing congenital insensitivity to pain with anhidrosis. Pediatrics 2003; 112 (3 Pt 1): e237-e241
- 6 Durham PL. Calcitonin gene-related peptide (CGRP) and migraine. Headache 2006; 46 (Suppl. 01) S3-S8
- 7 Indo Y, Mardy S, Miura Y. et al. Congenital insensitivity to pain with anhidrosis (CIPA): novel mutations of the TRKA (NTRK1) gene, a putative uniparental disomy, and a linkage of the mutant TRKA and PKLR genes in a family with CIPA and pyruvate kinase deficiency. Hum Mutat 2001; 18 (04) 308-318
- 8 Mardy S, Miura Y, Endo F. et al. Congenital insensitivity to pain with anhidrosis: novel mutations in the TRKA (NTRK1) gene encoding a high-affinity receptor for nerve growth factor. Am J Hum Genet 1999; 64 (06) 1570-1579
- 9 Sawal HA, Ullah MI, Ahmad A. et al. Homozygous mutations in NTRK1 gene underlie congenital insensitivity to pain with anhidrosis in Pakistani families. Neurol Asia 2016;21(02):
- 10 Scoto M, Cirak S, Mein R. et al. SEPN1-related myopathies: clinical course in a large cohort of patients. Neurology 2011; 76 (24) 2073-2078
- 11 Noury J-B, Maisonobe T, Richard P, Delague V, Malfatti E, Stojkovic T. Rigid spine syndrome associated with sensory-motor axonal neuropathy resembling Charcot-Marie-Tooth disease is characteristic of Bcl-2-associated athanogene-3 gene mutations even without cardiac involvement. Muscle Nerve 2018; 57 (02) 330-334