Report on three additional patients and genotype-phenotype correlation in SLC25A22-related disorders group

Eur J Hum Genet. 2019 Nov;27(11):1692-1700. doi: 10.1038/s41431-019-0433-2. Epub 2019 Jul 8.

Abstract

Early infantile epileptic encephalopathy (EIEE) is a heterogeneous group of severe forms of age-related developmental and epileptic encephalopathies with onset during the first weeks or months of life. The interictal electroencephalogram (EEG) shows a "suppression burst" (SB) pattern. The prognosis is usually poor and most children die within the first two years or survive with very severe intellectual disabilities. EIEE type 3 is caused by variants affecting function, in SLC25A22, which is also responsible for epilepsy of infancy with migrating focal seizures (EIMFS). We report a family with a less severe phenotype of EIEE type 3. We performed exome sequencing and identified two unreported variants in SLC25A22 in the compound heterozygous state: NM_024698.4: c.[813_814delTG];[818 G>A] (p.[Ala272Glnfs*144];[Arg273Lys]). Functional studies in cultured skin fibroblasts from a patient showed that glutamate oxidation was strongly defective, based on a literature review. We clustered the 18 published patients (including those from this family) into three groups according to the severity of the SLC25A22-related disorders. In an attempt to identify genotype-phenotype correlations, we compared the variants according to the location depending on the protein domains. We observed that patients with two variants located in helical transmembrane domains presented a severe phenotype, whereas patients with at least one variant outside helical transmembrane domains presented a milder phenotype. These data are suggestive of a continuum of disorders related to SLC25A22 that could be called SLC25A22-related disorders. This might be a first clue to enable geneticists to outline a prognosis based on genetic molecular data regarding the SLC25A22 gene.

MeSH terms

  • Adolescent
  • Base Sequence
  • Child
  • Child, Preschool
  • Electroencephalography
  • Exome
  • Female
  • Fibroblasts
  • Genetic Association Studies / methods*
  • Genetic Predisposition to Disease / genetics*
  • Humans
  • Male
  • Mitochondrial Membrane Transport Proteins / genetics*
  • Pedigree
  • Phenotype
  • Skin
  • Spasms, Infantile / genetics*

Substances

  • Mitochondrial Membrane Transport Proteins
  • SLC25A22 protein, human

Supplementary concepts

  • Infantile Epileptic-Dyskinetic Encephalopathy