A Patient with a Novel < b > < i > RARS2 < /i > < /b > Variant Exhibiting Liver Involvement as a New Clinical Feature and Review of the Literature

We report here on 2 siblings who presented with neonatal lactic acidosis, microcephaly, growth retardation, persistent seizures, and cholestasis with a previously undefinedRARS2 pathogenic variant. In our literature review, we evaluated the clinical features and pathogenic variants of 34 patients reported in 16 publications since the initial identification ofRARS2 pathogenic variants in PCH6 in 2007. Both siblings were detected with c.1564G#x3e;A (p.Val522Ile), a novel homozygous pathogenic variant of theRARS2 gene. Imaging revealed advanced cerebral atrophy and cerebellar hypoplasia, while the basal ganglia and pons were preserved. At follow-up, the elevations in liver function test results and cholestasis had regressed while the LDH and GGT elevations persisted. Both siblings showed microcephaly on follow-up and started to suffer seizures. Severe developmental delay and nutritional problems were observed, and both died in infancy.RARS2 pathogenic variant is a mitochondrial disease that causes severe mental, motor, and developmental retardation, as well as short life expectancy. Our patients are the first cases with liver involvement in PCH6 and a novel homozygousRARS2 pathogenic variant to be reported in the literature. This additional phenotype can be considered as making a valid contribution to the literature.Mol Syndromol
Source: Molecular Syndromology - Category: Molecular Biology Source Type: research