Expanding the Clinical Spectrum of UBTF -Related Neurodevelopmental Disorder

• Published in: Neurology. Genetics 2023-12, Vol.9 (6), p.e200098-e200098
• Main Authors: Pietra, Andrea, Palombo, Flavia, Giannotta, Melania, Maffei, Monica, Fiorini, Claudio, Costa, Roberta, Cenacchi, Giovanna, Carelli, Valerio, Cordelli, Duccio Maria, Pini, Antonella, Garone, Caterina
• Format: Article
• Language: English
• Subjects: Clinical/Scientific Note
• ISSN: 2376-7839; 2376-7839
• DOI: 10.1212/NXG.0000000000200098

gene encodes for Upstream Binding Transcription Factor, an essential protein for RNA metabolism. A recurrent de novo variant (c.628G>A; p.Glu210Lys) has recently been associated with a childhood-onset neurodegenerative disorder characterized by motor and language regression, ataxia, dystonia, and acquired microcephaly. In this study, we report the clinical, metabolic, molecular genetics and neuroimaging findings and histologic, histochemical, and electron microscopy studies in muscle samples of 2 patients from unrelated families with a neurodevelopmental disorder. Data were retrospectively analyzed by medical charts revision. Patient 1, a 16-year-old boy, presented a childhood-onset slowly progressive neurodegenerative disorder mainly affecting language skills, behavior, and motor coordination. Patient 2, a 22-year-old woman, presented with a severe and rapidly progressive disease with dystonic tetra paresis, acquired microcephaly, and severe cognitive deficit complicated by pseudobulbar syndrome characterized by involuntary and uncontrollable outbursts of laughing, dysphagia requiring tube feeding, and nocturnal hypoventilation treated with noninvasive ventilation. Both patients carried the recurrent previously described de novo variant and had signs of mitochondrial dysfunction at muscle biopsy. The metabolic profile of patient 2 also revealed a decrease in CSF biopterin. These case reports add new insights to the disease spectrum instrumental to improving the diagnostic rate in neurodevelopmental disorders.