Infection-triggered familial or recurrent cases of acute necrotizing encephalopathy caused by mutations in a component of the nuclear pore, RANBP2 by Neilson Derek E, Adams Mark D, Orr Caitlin M D, Schelling Deborah K, Eiben Robert M, Kerr Douglas S, Anderson Jane, Bassuk Alexander G, Bye Ann M, Childs Anne-Marie, Clarke Antonia, Crow Yanick J, Di Rocco Maja, Dohna-Schwake Christian, Dueckers Gregor, Fasano Alfonso E, Gika Artemis D, Gionnis Dimitris, Gorman Mark P, Grattan-Smith Padraic J, Hackenberg Annette, Kuster Alice, Lentschig Markus G, Lopez-Laso Eduardo, Marco Elysa J, Mastroyianni Sotiria, Perrier Julie, Schmitt-Mechelke Thomas, Servidei Serenella, Skardoutsou Angeliki, Uldall Peter, van der Knaap Marjo S, Goglin Karrie C, Tefft David L, Aubin Cristin, de Jager Philip, Hafler David, Warman Matthew L in American journal of human genetics (2009).

[PMID: 19118815] PubMed


Acute necrotizing encephalopathy (ANE) is a rapidly progressive encephalopathy that can occur in otherwise healthy children after common viral infections such as influenza and parainfluenza. Most ANE is sporadic and nonrecurrent (isolated ANE). However, we identified a 7 Mb interval containing a susceptibility locus (ANE1) in a family segregating recurrent ANE as an incompletely penetrant, autosomal-dominant trait. We now report that all affected individuals and obligate carriers in this family are heterozygous for a missense mutation (c.1880C-->T, p.Thr585Met) in the gene encoding the nuclear pore protein Ran Binding Protein 2 (RANBP2). To determine whether this mutation is the susceptibility allele, we screened controls and other patients with ANE who are unrelated to the index family. Patients from 9 of 15 additional kindreds with familial or recurrent ANE had the identical mutation. It arose de novo in two families and independently in several other families. Two other patients with familial ANE had different RANBP2 missense mutations that altered conserved residues. None of the three RANBP2 missense mutations were found in 19 patients with isolated ANE or in unaffected controls. We conclude that missense mutations in RANBP2 are susceptibility alleles for familial and recurrent cases of ANE.

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