©istock.com/Andrea Obzerova
Interdisciplinary CompetenceMolecular Diagnostics
Know how in the analysis of genetic material.
For the benefit of patients.

IllnessDystonia, Dopa-responsive; differential diagnosis

Summary

Short information

Comprehensive differential diagnostic panel for Dystonia, DOPA-responsive comprising 5 guideline-curated genes and altogether 7 curated genes according to the clinical signs

ID
DP0190
Number of genes
7 Accredited laboratory test
Examined sequence length
13,8 kb (Core-/Core-canditate-Genes)
15,6 kb (Extended panel: incl. additional genes)
Analysis Duration
on request
Material
  • EDTA-anticoagulated blood (3-5 ml)
Diagnostic indications

NGS +

[Sanger]

 

Gene panel

Selected genes

NameExon Length (bp)OMIM-GReferenz-Seq.Heredity
GCH1753NM_000161.3AD, AR
KMT2B8232NM_014727.3AD
PRKN1398NM_004562.3AR
SPR786NM_003124.5AR
TH1587NM_199292.3AR
TOR1A999NM_000113.3AD
PINK11746NM_032409.3AR, digenisch

Informations about the disease

Clinical Comment

In Dopa-Responsive dystonia (DRD), mild to severe involuntary muscle contractions, tremor and especially dystonia occur. Symptoms of DRD usually begin in childhood, often by age 6. The first signs are typically clubfeet and dystonia in the lower limbs. DRD spreads to the upper limbs, and by adolescence, virtually the entire body is affected. Affected individuals sometimes have unusual limb positions and lack of coordination when walking and running. Some patients have sleep problems or depressive episodes, often parkinsonism. The movement disorder worsens with age, but it stabilizes around age 30. Characteristic is diurnal fluctuation, i.e., worsening of problems during the day and morning betterment after waking. In rare cases, movement problems do not appear until adulthood. GCH1 mutations are the most common cause of DRD, less commonly mutated TH or SPR genes. In some cases, the genetic cause remains unclear. When DRD is caused by mutations in the GCH1 gene, it is inherited in an autosomal dominant manner. Some GCH1 mutation carriers never develop symptoms, but women are 2-4 times more likely to be affected than men. When TH gene mutations are responsible, DRD is inherited in an autosomal recessive manner; when caused by SPR mutations, DRD can be inherited either in an autosomal recessive manner or, less commonly, in a dominant manner. A negative DNA test result does not exclude the clinical diagnosis.

References: https://www.ncbi.nlm.nih.gov/books/NBK1508/

https://www.ncbi.nlm.nih.gov/books/NBK1437/

https://www.ncbi.nlm.nih.gov/books/NBK304122/

 

Synonyms
  • Allelic: Adenocarcinoma of lung, somatic (PRKN)
  • Allelic: Arthrogryposis multiplex congenita 5 (TOR1A)
  • Allelic: Hyperphenylalaninemia, BH4-deficient, B (GCH1)
  • Allelic: Ovarian cancer, somatic (PRKN)
  • Allelic: Polyneuropathy (GCH1)
  • Dystonia 28, childhood-onset (KMT2B)
  • Dystonia 5 (GCH1)
  • Dystonia [panelapp] (PINK1)
  • Dystonia, DOPA-responsive, AD (GCH1)
  • Dystonia, DOPA-responsive, due to sepiapterin reductase deficiency (SPR)
  • Dystonia, DOPA-responsive, with/-out hyperphenylalaninemia (GCH1)
  • Dystonia, infantile (GCH1)
  • Dystonia, progressive, with diurnal variation/fluctuation (GCH1)
  • Dystonia-1, modifier of (TOR1A)
  • Dystonia-1, torsion (TOR1A)
  • Parkinson disease 6, early onset (PINK1)
  • Parkinson disease, juvenile, type 2 (PRKN)
  • Segawa syndrome, AD (GCH1)
  • Segawa syndrome, AR (TH)
  • Spastic paraplegia (GCH1)
  • Tyrosine hydroxylase-deficient dopa-responsive dystonia (TH)
Heredity, heredity patterns etc.
  • AD
  • AR
  • digenisch
OMIM-Ps
  • Multiple OMIM-Ps
ICD10 Code

Bioinformatics and clinical interpretation

No text defined