Congenital Myasthenic Syndrome: Spectrum of Mutations in an Indian Cohort

J Clin Neuromuscul Dis. 2018 Sep;20(1):14-27. doi: 10.1097/CND.0000000000000222.

Abstract

Objectives: To investigate the mutational spectrum and genotype-phenotype correlation in Indian patients with congenital myasthenic syndrome (CMS), using next-generation sequencing of 5 genes.

Methods: CHRNE, COLQ, DOK7, RAPSN, and GFPT1 were sequenced in 25 affected patients.

Results: We found clinically significant variants in 18 patients, of which variants in CHRNE were the most common, and 9 were novel. A common pathogenic COLQ variant was also detected in 4 patients with isolated limb-girdle congenital myasthenia.

Conclusions: Targeted screening of 5 genes is an effective alternate test for CMS, and an affordable one even in a developing country such as India. In addition, we recommend that patients with isolated limb-girdle congenital myasthenia be screened initially for the common COLQ pathogenic variant. This study throws the first light on the genetic landscape of CMSs in India.

MeSH terms

  • Acetylcholinesterase / genetics
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cohort Studies
  • Collagen / genetics
  • Female
  • Genetic Association Studies
  • Glutamine-Fructose-6-Phosphate Transaminase (Isomerizing) / metabolism
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Muscle Proteins / genetics*
  • Mutation / genetics*
  • Myasthenic Syndromes, Congenital / epidemiology*
  • Myasthenic Syndromes, Congenital / genetics*
  • Receptors, Nicotinic / genetics
  • Severity of Illness Index
  • Young Adult

Substances

  • CHRNE protein, human
  • DOK7 protein, human
  • Muscle Proteins
  • Receptors, Nicotinic
  • peripheral membrane protein 43K
  • Collagen
  • GFPT1 protein, human
  • Glutamine-Fructose-6-Phosphate Transaminase (Isomerizing)
  • Acetylcholinesterase
  • COLQ protein, human