Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report
Abstract Background N-methyl-D-aspartate (NMDA) receptors are ligand-gated ion channels that mediate excitatory synaptic transmission in the central nervous system. The functional NMDA receptors are heterotetramers consisting mainly of two GluN1 and two GluN2 subunits. GluN2 is encoded by the GRIN2D...
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2021-01-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-020-02462-6 |
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doaj-944851f9b8714f708185793a6950569c2021-01-10T12:23:09ZengBMCBMC Pediatrics1471-24312021-01-012111410.1186/s12887-020-02462-6Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case reportJiancheng Jiao0Li Li1Min Sun2Junchen Fang3Lingzhi Meng4Yudong Zhang5Chao Jia6Li Ma7Neonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceNeonatology Department, Children’s Hospital of Hebei ProvinceAbstract Background N-methyl-D-aspartate (NMDA) receptors are ligand-gated ion channels that mediate excitatory synaptic transmission in the central nervous system. The functional NMDA receptors are heterotetramers consisting mainly of two GluN1 and two GluN2 subunits. GluN2 is encoded by the GRIN2D gene. A few case series have shown that GRIN2D variants are linked to developmental and epileptic encephalopathy. In this article, we report a novel GRIN2D variant, namely c.2021C > A (p.T674K) in a neonate with intractable epileptic encephalopathy. Case presentation A 12-day-old boy who had stiffness of the lower and upper extremities since birth was transferred from a local hospital to our department. On admission, the patient presented with head tilting backwards, staring, apnea and hypertonia of limbs. Video electroencephalogram showed continuous, generalized or multi-focal spike-wave and spike-and-slow wave discharges and hypsarrhythmia. A treatment regimen composed of phenobarbital, midazolam, levetiracetam and clonazepam was administered, which however led to only partial control of the seizure. Whole-exome sequencing identified c.2021C > A (p.T674K) in GRIN2D in the patient while such a mutation was not detected in the parents. The patient was hospitalized for 1 month and died of sudden cardio-respiratory arrest 2 weeks after discharge. Conclusions A novel variant of GRIN2D was identified in a neonate with epileptic encephalopathy. Epilepsy associated with this GRIN2D mutation is refractory to conventional anti-epileptic medications.https://doi.org/10.1186/s12887-020-02462-6case reportNMDA receptorsGRIN2D variantsde novo mutationepileptic encephalopathyanti-epileptic medications |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Jiancheng Jiao Li Li Min Sun Junchen Fang Lingzhi Meng Yudong Zhang Chao Jia Li Ma |
| spellingShingle |
Jiancheng Jiao Li Li Min Sun Junchen Fang Lingzhi Meng Yudong Zhang Chao Jia Li Ma Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report BMC Pediatrics case report NMDA receptors GRIN2D variants de novo mutation epileptic encephalopathy anti-epileptic medications |
| author_facet |
Jiancheng Jiao Li Li Min Sun Junchen Fang Lingzhi Meng Yudong Zhang Chao Jia Li Ma |
| author_sort |
Jiancheng Jiao |
| title |
Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report |
| title_short |
Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report |
| title_full |
Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report |
| title_fullStr |
Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report |
| title_full_unstemmed |
Identification of a novel GRIN2D variant in a neonate with intractable epileptic encephalopathy-a case report |
| title_sort |
identification of a novel grin2d variant in a neonate with intractable epileptic encephalopathy-a case report |
| publisher |
BMC |
| series |
BMC Pediatrics |
| issn |
1471-2431 |
| publishDate |
2021-01-01 |
| description |
Abstract Background N-methyl-D-aspartate (NMDA) receptors are ligand-gated ion channels that mediate excitatory synaptic transmission in the central nervous system. The functional NMDA receptors are heterotetramers consisting mainly of two GluN1 and two GluN2 subunits. GluN2 is encoded by the GRIN2D gene. A few case series have shown that GRIN2D variants are linked to developmental and epileptic encephalopathy. In this article, we report a novel GRIN2D variant, namely c.2021C > A (p.T674K) in a neonate with intractable epileptic encephalopathy. Case presentation A 12-day-old boy who had stiffness of the lower and upper extremities since birth was transferred from a local hospital to our department. On admission, the patient presented with head tilting backwards, staring, apnea and hypertonia of limbs. Video electroencephalogram showed continuous, generalized or multi-focal spike-wave and spike-and-slow wave discharges and hypsarrhythmia. A treatment regimen composed of phenobarbital, midazolam, levetiracetam and clonazepam was administered, which however led to only partial control of the seizure. Whole-exome sequencing identified c.2021C > A (p.T674K) in GRIN2D in the patient while such a mutation was not detected in the parents. The patient was hospitalized for 1 month and died of sudden cardio-respiratory arrest 2 weeks after discharge. Conclusions A novel variant of GRIN2D was identified in a neonate with epileptic encephalopathy. Epilepsy associated with this GRIN2D mutation is refractory to conventional anti-epileptic medications. |
| topic |
case report NMDA receptors GRIN2D variants de novo mutation epileptic encephalopathy anti-epileptic medications |
| url |
https://doi.org/10.1186/s12887-020-02462-6 |
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