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Teaching NeuroImage: Glutaredoxin-5-Associated Variant Nonketotic Hyperglycinemia.

Sayoni Roy Chowdhury1, Rekha Mittal1, Richa Yadav1

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A novel genetic mutation in the Glutaredoxin-5 (GLRX5) gene caused a rare leukoencephalopathy in a young boy. This condition led to severe motor regression and neurological deficits.

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Area of Science:

  • Neurogenetics
  • Mitochondrial Biology
  • Neurodegenerative Diseases

Background:

  • Mitochondrial dysfunction is implicated in various neurological disorders.
  • Glutaredoxin-5 (GLRX5) plays a role in iron homeostasis and oxidative stress response.
  • Leukoencephalopathies are a group of white matter disorders affecting the brain.

Observation:

  • A 5-year-old boy presented with subacute motor regression, spasticity, generalized dystonia, and pseudobulbar palsy.
  • Elevated plasma lactate levels and neuroimaging revealed cavitating leukoencephalopathy affecting long tracts.
  • No sideroblastic anemia was detected, differentiating from other GLRX5-related conditions.

Findings:

  • A novel homozygous missense variant (c.171C > A, p.Phe57Leu) in the GLRX5 gene was identified via next-generation sequencing.
  • This genetic finding provides a molecular basis for the observed leukoencephalopathy.
  • The variant is located in exon 1 of the GLRX5 gene.

Implications:

  • This case expands the spectrum of GLRX5-associated disorders.
  • Understanding this novel variant's impact on GLRX5 function is crucial for potential therapeutic strategies.
  • Highlights the importance of genetic testing in diagnosing complex pediatric neurological conditions.