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A novel gross deletion caused by non-homologous recombination of the PDHX gene in a patient with pyruvate dehydrogenase deficiency.
[pyruvate dehydrogenase deficiency]
We
report
here
the
molecular
analysis
of
a
pyruvate
dehydrogenase
E
3
-
binding
protein
(
PDH
-
E
3
BP
)
deficiency
in
a
new
patient
,
born
to
first
cousin
parents
.
She
has
initially
presented
with
a
non-
progressive
and
unspecific
encephalopathy
,
followed
by
an
acute
neurological
deterioration
at
14
years
of
age
.
E
3
BP
subunit
was
undetectable
on
Western
blot
.
The
sequence
of
exons
1
-
9
and
exon
11
of
the
PDHX
gene
were
normal
,
but
exon
10
was
impossible
to
amplify
with
standard
PCR
.
Long
-range
PCR
including
exons
9
-
11
(
11
.
5
kb
)
was
performed
.
The
patient
's
sample
displayed
a
unique
PCR
product
of
7
.
5
kb
,
whereas
the
parents
'
samples
displayed
two
bands
(
11
.
5
and
7
.
5
kb
)
.
The
deletion
breakpoints
were
determined
by
restriction
analysis
followed
by
direct
sequencing
.
The
homozygous
deletion
covered
the
end
of
intron
9
,
exon
10
and
the
beginning
of
intron
10
and
was
found
to
be
3913
bp
long
.
The
cDNA
sequencing
confirmed
the
deletion
of
exon
10
.
The
most
probable
mechanism
for
this
gross
deletion
appears
to
be
a
slipped
mispairing
mediated
by
an
exact
direct
repeat
CCACTG
.
It
is
the
first
time
that
a
non-homologous
recombination
is
reported
in
the
PDHX
gene
causing
pyruvate
dehydrogenase
complex
(
PDHc
)
deficiency
.
Diseases
Validation
Diseases presenting
"born to first cousin parents"
symptom
pyruvate dehydrogenase deficiency
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