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PURA Syndrome

MedGen UID:
1634675
Concept ID:
C4708498
Disease or Syndrome
Synonyms: PURA (purine rich element binding protein A) syndrome; PURA syndrome; PURA-related neurodevelopmental disorder; PURA-related severe neonatal hypotonia, seizure, encephalopathy syndrome; Purine rich element binding protein A syndrome
SNOMED CT: Purine rich element binding protein A syndrome (768473009); PURA-related neurodevelopmental disorder (768473009); PURA (purine rich element binding protein A) syndrome (768473009); PURA syndrome (768473009); PURA-related severe neonatal hypotonia, seizure, encephalopathy syndrome (768473009)

Definition

Syndrome with manifestations of intellectual disability and delayed development of speech and motor skills with expressive language skills generally more severely affected. Individuals may be unable to speak, learn to walk later or may never walk. In infancy hypotonia and feeding difficulties may be present along with dysphagia, hypersomnolence, hypothermia and hypoventilation. Recurrent seizures are common. Caused by mutations in the PURA gene, which provides instructions for the protein Pur-alpha. This protein has multiple roles in cells, including gene transcription and replication of DNA. The disease is inherited in an autosomal dominant pattern, however most cases result from de novo mutation. [from SNOMEDCT_US]

Professional guidelines

PubMed

Mroczek M, Iyadurai S
Int J Mol Sci 2023 Jan 23;24(3) doi: 10.3390/ijms24032260. PMID: 36768582Free PMC Article
Dai W, Sun Y, Fan Y, Gao Y, Zhan Y, Wang L, Xiao B, Qiu W, Gu X, Sun K, Yu Y, Xu N
Eur J Hum Genet 2023 Jan;31(1):112-121. Epub 2022 Nov 14 doi: 10.1038/s41431-022-01217-4. PMID: 36376392Free PMC Article
Reijnders MRF, Janowski R, Alvi M, Self JE, van Essen TJ, Vreeburg M, Rouhl RPW, Stevens SJC, Stegmann APA, Schieving J, Pfundt R, van Dijk K, Smeets E, Stumpel CTRM, Bok LA, Cobben JM, Engelen M, Mansour S, Whiteford M, Chandler KE, Douzgou S, Cooper NS, Tan EC, Foo R, Lai AHM, Rankin J, Green A, Lönnqvist T, Isohanni P, Williams S, Ruhoy I, Carvalho KS, Dowling JJ, Lev DL, Sterbova K, Lassuthova P, Neupauerová J, Waugh JL, Keros S, Clayton-Smith J, Smithson SF, Brunner HG, van Hoeckel C, Anderson M, Clowes VE, Siu VM, Ddd Study T, Selber P, Leventer RJ, Nellaker C, Niessing D, Hunt D, Baralle D
J Med Genet 2018 Feb;55(2):104-113. Epub 2017 Nov 2 doi: 10.1136/jmedgenet-2017-104946. PMID: 29097605Free PMC Article

Recent clinical studies

Etiology

Kofoed AWS, Kristiansen SS, Miranda MJ, Rubboli G, Johannesen KM
Clin Genet 2024 Oct;106(4):386-393. Epub 2024 Jun 24 doi: 10.1111/cge.14581. PMID: 38923490
Dai W, Sun Y, Fan Y, Gao Y, Zhan Y, Wang L, Xiao B, Qiu W, Gu X, Sun K, Yu Y, Xu N
Eur J Hum Genet 2023 Jan;31(1):112-121. Epub 2022 Nov 14 doi: 10.1038/s41431-022-01217-4. PMID: 36376392Free PMC Article
Choi SA, Lee HS, Park TJ, Park S, Ko YJ, Kim SY, Lim BC, Kim KJ, Chae JH
Brain Dev 2021 Oct;43(9):912-918. Epub 2021 Jun 8 doi: 10.1016/j.braindev.2021.05.009. PMID: 34116881

Diagnosis

Proske M, Janowski R, Bacher S, Kang HS, Monecke T, Koehler T, Hutten S, Tretter J, Crois A, Molitor L, Varela-Rial A, Fino R, Donati E, De Fabritiis G, Dormann D, Sattler M, Niessing D
Elife 2024 Apr 24;13 doi: 10.7554/eLife.93561. PMID: 38655849Free PMC Article
Solazzi R, Fiorini E, Parrini E, Guerrini R, Bernardina BD, Nardocci N, Cantalupo G
Epileptic Disord 2021 Oct 1;23(5):745-748. doi: 10.1684/epd.2021.1328. PMID: 34583915
Choi SA, Lee HS, Park TJ, Park S, Ko YJ, Kim SY, Lim BC, Kim KJ, Chae JH
Brain Dev 2021 Oct;43(9):912-918. Epub 2021 Jun 8 doi: 10.1016/j.braindev.2021.05.009. PMID: 34116881
Lee BH, Reijnders MRF, Abubakare O, Tuttle E, Lape B, Minks KQ, Stodgell C, Bennetto L, Kwon J, Fong CT, Gripp KW, Marsh ED, Smith WE, Huq AM, Coury SA, Tan WH, Solis O, Mehta RI, Leventer RJ, Baralle D, Hunt D, Paciorkowski AR
Am J Med Genet A 2018 Jan;176(1):56-67. Epub 2017 Nov 17 doi: 10.1002/ajmg.a.38521. PMID: 29150892Free PMC Article
Reijnders MRF, Janowski R, Alvi M, Self JE, van Essen TJ, Vreeburg M, Rouhl RPW, Stevens SJC, Stegmann APA, Schieving J, Pfundt R, van Dijk K, Smeets E, Stumpel CTRM, Bok LA, Cobben JM, Engelen M, Mansour S, Whiteford M, Chandler KE, Douzgou S, Cooper NS, Tan EC, Foo R, Lai AHM, Rankin J, Green A, Lönnqvist T, Isohanni P, Williams S, Ruhoy I, Carvalho KS, Dowling JJ, Lev DL, Sterbova K, Lassuthova P, Neupauerová J, Waugh JL, Keros S, Clayton-Smith J, Smithson SF, Brunner HG, van Hoeckel C, Anderson M, Clowes VE, Siu VM, Ddd Study T, Selber P, Leventer RJ, Nellaker C, Niessing D, Hunt D, Baralle D
J Med Genet 2018 Feb;55(2):104-113. Epub 2017 Nov 2 doi: 10.1136/jmedgenet-2017-104946. PMID: 29097605Free PMC Article

Therapy

Zhang D, Gao J
Int J Gynaecol Obstet 2023 Dec;163(3):1033-1035. Epub 2023 Sep 19 doi: 10.1002/ijgo.15094. PMID: 37724818
Wyrebek R, DiBartolomeo M, Brooks S, Geller T, Crenshaw M, Iyadurai S
Neuromuscul Disord 2022 Feb;32(2):166-169. Epub 2022 Jan 16 doi: 10.1016/j.nmd.2022.01.005. PMID: 35094889

Prognosis

Proske M, Janowski R, Bacher S, Kang HS, Monecke T, Koehler T, Hutten S, Tretter J, Crois A, Molitor L, Varela-Rial A, Fino R, Donati E, De Fabritiis G, Dormann D, Sattler M, Niessing D
Elife 2024 Apr 24;13 doi: 10.7554/eLife.93561. PMID: 38655849Free PMC Article
Wyrebek R, DiBartolomeo M, Brooks S, Geller T, Crenshaw M, Iyadurai S
Neuromuscul Disord 2022 Feb;32(2):166-169. Epub 2022 Jan 16 doi: 10.1016/j.nmd.2022.01.005. PMID: 35094889
Cinquina V, Ciaccio C, Venturini M, Masson R, Ritelli M, Colombi M
Mol Genet Genomic Med 2021 Jan;9(1):e1562. Epub 2020 Dec 4 doi: 10.1002/mgg3.1562. PMID: 33275834Free PMC Article
Reijnders MRF, Janowski R, Alvi M, Self JE, van Essen TJ, Vreeburg M, Rouhl RPW, Stevens SJC, Stegmann APA, Schieving J, Pfundt R, van Dijk K, Smeets E, Stumpel CTRM, Bok LA, Cobben JM, Engelen M, Mansour S, Whiteford M, Chandler KE, Douzgou S, Cooper NS, Tan EC, Foo R, Lai AHM, Rankin J, Green A, Lönnqvist T, Isohanni P, Williams S, Ruhoy I, Carvalho KS, Dowling JJ, Lev DL, Sterbova K, Lassuthova P, Neupauerová J, Waugh JL, Keros S, Clayton-Smith J, Smithson SF, Brunner HG, van Hoeckel C, Anderson M, Clowes VE, Siu VM, Ddd Study T, Selber P, Leventer RJ, Nellaker C, Niessing D, Hunt D, Baralle D
J Med Genet 2018 Feb;55(2):104-113. Epub 2017 Nov 2 doi: 10.1136/jmedgenet-2017-104946. PMID: 29097605Free PMC Article

Clinical prediction guides

Proske M, Janowski R, Bacher S, Kang HS, Monecke T, Koehler T, Hutten S, Tretter J, Crois A, Molitor L, Varela-Rial A, Fino R, Donati E, De Fabritiis G, Dormann D, Sattler M, Niessing D
Elife 2024 Apr 24;13 doi: 10.7554/eLife.93561. PMID: 38655849Free PMC Article
Dai W, Sun Y, Fan Y, Gao Y, Zhan Y, Wang L, Xiao B, Qiu W, Gu X, Sun K, Yu Y, Xu N
Eur J Hum Genet 2023 Jan;31(1):112-121. Epub 2022 Nov 14 doi: 10.1038/s41431-022-01217-4. PMID: 36376392Free PMC Article
Cinquina V, Ciaccio C, Venturini M, Masson R, Ritelli M, Colombi M
Mol Genet Genomic Med 2021 Jan;9(1):e1562. Epub 2020 Dec 4 doi: 10.1002/mgg3.1562. PMID: 33275834Free PMC Article
Reijnders MRF, Janowski R, Alvi M, Self JE, van Essen TJ, Vreeburg M, Rouhl RPW, Stevens SJC, Stegmann APA, Schieving J, Pfundt R, van Dijk K, Smeets E, Stumpel CTRM, Bok LA, Cobben JM, Engelen M, Mansour S, Whiteford M, Chandler KE, Douzgou S, Cooper NS, Tan EC, Foo R, Lai AHM, Rankin J, Green A, Lönnqvist T, Isohanni P, Williams S, Ruhoy I, Carvalho KS, Dowling JJ, Lev DL, Sterbova K, Lassuthova P, Neupauerová J, Waugh JL, Keros S, Clayton-Smith J, Smithson SF, Brunner HG, van Hoeckel C, Anderson M, Clowes VE, Siu VM, Ddd Study T, Selber P, Leventer RJ, Nellaker C, Niessing D, Hunt D, Baralle D
J Med Genet 2018 Feb;55(2):104-113. Epub 2017 Nov 2 doi: 10.1136/jmedgenet-2017-104946. PMID: 29097605Free PMC Article

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