A patient with Beta-Propeller Protein-Associated Neurodegeneration: a new missense mutation of the WDR45 gene

Abstract

Summary Introduction Beta-propeller protein-associated neurodegeneration (BPAN) is a neurodegenerative disorder; its estimated prevalence is 2 to 3 per million individuals. All published cases of BPAN have been sporadic, with a clear female predominance and mutations in various exons of the WDR45 gene. Case presentation The study aimed to confirm the diagnosis of BPAN in a 9-year-old girl with a developmental delay since early childhood complicated with intellectual disability, lack of speech and febrile and non-febrile tonic-clonic seizures. The patient also had autistic symptoms as well as some Rett-like symptoms: stereotypical movements of the hands–twisting objects, putting hands in the mouth. Discussion Clinical exome analysis and Sanger sequencing of the proband have been performed to confirm the diagnosis. The novel heterozygous missense mutation c.755T>C of the WDR45 «autophagy» gene was revealed. Sanger sequencing of the trio (proband and parents) proved the de novo nature of mutation; its clinical significance has been defined as probably pathogenic. Thus, we report a new missense variant of the WDR45 gene in a girl with a clinical picture of BPAN. The use of NGS made it possible to get a correct diagnosis during rather a short period before the second debilitating phase of the disease started so that the physicians and the family would have time to prepare and hopefully choose the way to resist.