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Alexander Disease: Report of Two Unrelated Infantile Form Cases, Identified by GFAP Mutation Analysis and Review of Literature; The First Report from Iran.
[alexander disease]
Alexander
disease
(
AD
)
is
a
sporadic
leukodystrophy
that
predominantly
affects
infants
and
children
and
usually
results
in
death
within
ten
years
after
onset
.
The
infantile
form
comprises
the
most
of
affected
individuals
.
It
presents
in
the
first
two
years
of
life
,
typically
with
progressive
psychomotor
retardation
with
loss
of
developmental
milestones
,
megalencephaly
and
frontal
bossing
,
seizures
,
pyramidal
signs
and
ataxia
.
The
diagnosis
is
based
on
magnetic
resonance
imaging
(
MRI
)
findings
and
confirmed
by
GFAP
gene
molecular
testing
.
GFAP
gene
encodes
glial
fibrillary
acidic
protein
,
is
the
only
gene
in
which
mutation
is
currently
known
to
cause
AD
which
is
inherited
in
autosomal
dominant
manner
.
In
this
article
we
report
the
first
two
Iranian
cases
of
infantile
AD
and
their
clinical
,
brain
MRI
and
molecular
findings
.
We
report
two
novel
mutations
too
in
the
GFAP
gene
that
are
associated
with
infantile
form
of
AD
.
GFAP
gene
mutations
are
a
reliable
marker
for
infantile
AD
diagnosed
according
to
clinical
and
MRI
defined
criteria
.
A
genotype-phenotype
correlation
had
been
discerned
for
the
two
most
frequently
reported
GFAP
gene
mutations
in
infantile
type
of
AD
(
R
79
and
R
239
)
,
with
the
phenotype
of
the
R
79
mutations
appearing
much
less
severe
than
that
of
the
R
239
mutations
.
Our
findings
confirm
this
theory
.
Diseases
Validation
Diseases presenting
"psychomotor retardation"
symptom
alexander disease
aniridia
canavan disease
cohen syndrome
kabuki syndrome
monosomy 21
neonatal adrenoleukodystrophy
oculocutaneous albinism
pyruvate dehydrogenase deficiency
zellweger syndrome
This symptom has already been validated