Epilepsy Combined With Multiple Gene Heterozygous Mutation

He Qiuju; Zhuang Jianlong; Wen Qi; Li Zhifa; Wang Ding; Sun Xiaofang; Xie Yingjun

doi:10.3389/fped.2022.763642

Epilepsy Combined With Multiple Gene Heterozygous Mutation

Front Pediatr. 2022 Mar 1:10:763642. doi: 10.3389/fped.2022.763642. eCollection 2022.

Authors

He Qiuju^{1

2

3}, Zhuang Jianlong⁴, Wen Qi^{1

2

3}, Li Zhifa⁵, Wang Ding^{1

2}, Sun Xiaofang^{1

2}, Xie Yingjun^{1

2}

Affiliations

¹ Department of Obstetrics and Gynaecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
³ Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China.
⁴ Prenatal Diagnosis Center, Quanzhou Women's and Children's Hospital, Quanzhou, China.
⁵ Gastrointestinal Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Abstract

The fast pace of gene discovery has resulted in groundbreaking advances in the field of epilepsy genetics. Clinical testing using comprehensive gene panels, exomes, or genomes is now increasingly available and has significantly increased the diagnostic yield for early-onset epilepsies and enabled precision medicine approaches. In this paper, we report a case of epilepsy in a pedigree. The proband had heterozygous mutations in KCNC1 (NM_001112741.1:c.959G>A, p. Arg320His), CAPN3 (NM_000070.2:c.526G>A, p. Val176Met), and NEFH (NM_021076.3:c. 2595 delC, p. Lys866Argfs^*51). Sanger sequencing verification was consistent with the results of whole-exome sequencing. The KCNC1 mutation was a de novo mutation, and the CAPN3 and NEFH mutations were inherited from their father and mother, respectively. Based on the American College of Medical Genetics and Genomics (ACMG) guidelines, a heterozygous mutation was found for APOB (NM_000384.2: c.10579C > T, p. Arg3527Trp). The heterozygous mutation at this site was inherent in the pedigree. Coexpression analysis indicated that heterozygous mutations of KCNC1, CAPN3, NEFH, and APOB were closely related to the clinical phenotypes of the patient, and the clinical phenotypic heterogeneity of the disease may be the result of the interaction of multiple genes.

Keywords: Sanger sequencing; coexpression analysis; epilepsy; heterozygous mutations; whole exome sequencing.