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Congenital myasthenic syndrome in Turkey: clinical and genetic features in the long-term follow-up of patients

  • Gülen Gül MertEmail author
  • Neslihan Özcan
  • Özlem Hergüner
  • Şakir Altunbaşak
  • Faruk Incecik
  • Atıl Bişgin
  • Serdar Ceylaner
Original article

Abstract

Congenital Myasthenic Syndromes (CMS) are rare disorders that occur as a result of defects in the structure and in the function of neuromuscular junctions. Molecular genetic diagnosis is important to select the most suitable therapeutic option and treatment. Eight patients with congenital myasthenic syndromes who presented to the Çukurova University Pediatric Neurology Department Outpatient Clinic between June 2015 and May 2018 were reviewed. Mutations in the acetylcholine receptor (subunits in epsilon) (CHRNE) in three and mutations in the collagenic tail of endplate acetylcholinesterase (COLQ) gene in five patients were identified; p.W148 mutation was detected to be homozygous in four, c.1169A > G novel mutation in COLQ gene was homozygous in one, c452_454delAGG mutation was homozygous in the other patient, IVS7 + 2T > C(c.802 + 2T > C) mutation was homozygous in a patient and compound heterozygous mutations of c.865C > T(p.Leu289Phe) and c.872C > G(p.A2916)(p.Arg291Gly) in the CHRNE gene in the last patient. The parents of all the evaluated patients were consanguineous. Ptosis, ophthalmoplegia, generalized hypotonia, bulbar weakness, and respiratory crisis were the main findings at the time of presentation. Pyridostigmine is the first-line drug therapy in primary AChR deficiency. Beta adrenergic agonists, ephedrine, and albuterol are the other treatment options for CMS subtypes caused by mutations in COLQ. This study points out the genetic and phenotypic features of CMS patients in the Turkish population and it also reports previously unreported mutations in the literature. CHRNE and COLQ gene mutations are common in the Turkish population. Patients can get serious benefits and recover after the treatment. The treatment should be planned according to genetic tests and clinical findings.

Keywords

Congenital myasthenic syndromes CHRNE COLQ Neuromuscular junction 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the parents or legal guardians of each participant included in the study.

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Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  • Gülen Gül Mert
    • 1
    Email author
  • Neslihan Özcan
    • 1
  • Özlem Hergüner
    • 1
  • Şakir Altunbaşak
    • 1
  • Faruk Incecik
    • 1
  • Atıl Bişgin
    • 2
  • Serdar Ceylaner
    • 3
  1. 1.Department of Pediatrics, Division of Pediatric NeurologyCukurova UniversityAdanaTurkey
  2. 2.Department of Medical GeneticsCukurova University Faculty of MedicineAdanaTurkey
  3. 3.Intergen Genetic LaboratoryAnkaraTurkey

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