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A common PEX1 frameshift mutation in patients with disorders of peroxisome biogenesis correlates with the severe Zellweger syndrome phenotype.
[neonatal adrenoleukodystrophy]
Peroxisome
biogenesis
disorders
are
a
heterogeneous
group
of
human
neurodegenerative
diseases
caused
by
peroxisomal
metabolic
dysfunction
.
At
the
molecular
level
,
these
disorders
arise
from
mutations
in
PEX
genes
that
encode
proteins
required
for
the
import
of
proteins
into
the
peroxisomal
lumen
.
The
Zellweger
syndrome
spectrum
of
diseases
is
a
major
sub-set
of
these
disorders
and
represents
a
clinical
continuum
from
Zellweger
syndrome
(
the
most
severe
)
through
neonatal
adrenoleukodystrophy
to
infantile
Refsum
disease
.
The
PEX
1
gene
,
which
encodes
a
cytoplasmic
AAA
ATPase
,
is
the
responsible
gene
in
more
than
half
of
the
Zellweger
syndrome
spectrum
patients
,
and
mutations
in
PEX
1
can
account
for
the
full
spectrum
of
phenotypes
seen
in
these
patients
.
In
these
studies
,
we
have
undertaken
mutation
analysis
of
PEX
1
in
skin
fibroblast
cell
lines
from
Australasian
Zellweger
syndrome
spectrum
patients
.
A
previously
reported
common
PEX
1
mutation
that
gives
rise
to
a
G
8
43
D
substitution
and
correlates
with
the
less
severe
disease
phenotypes
has
been
found
to
be
present
at
high
frequency
in
our
patient
cohort
.
We
also
report
a
novel
PEX
1
mutation
that
occurs
at
high
frequency
in
Zellweger
syndrome
spectrum
patients
.
This
mutation
produces
a
frameshift
in
exon
13
,
a
change
that
leads
to
the
premature
truncation
of
the
PEX
1
protein
.
A
Zellweger
syndrome
patient
who
was
homozygous
for
this
mutation
and
who
survived
for
less
than
two
months
from
birth
had
undetectable
levels
of
PEX
1
mRNA
.
This
new
common
mutation
therefore
correlates
with
a
severe
disease
phenotype
.
We
have
adopted
procedures
for
the
detection
of
this
mutation
for
successful
prenatal
diagnosis
.
Diseases
Validation
Diseases presenting
"high frequency"
symptom
alpha-thalassemia
canavan disease
classical phenylketonuria
cohen syndrome
cowden syndrome
cystinuria
erdheim-chester disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hirschsprung disease
homocystinuria without methylmalonic aciduria
inclusion body myositis
kabuki syndrome
kallmann syndrome
krabbe disease
lymphangioleiomyomatosis
neonatal adrenoleukodystrophy
papillon-lefèvre syndrome
pyruvate dehydrogenase deficiency
waldenström macroglobulinemia
x-linked adrenoleukodystrophy
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