Defects of the glycosylphosphatidylinositol (GPI) biosynthesis pathway constitute an emerging subgroup of congenital disorders of glycosylation with heterogeneous phenotypes. A mutation in the promoter of PIGM, resulting in a syndrome with portal vein thrombosis and persistent absence seizures, was previously described in three patients. We now report four additional patients in two unrelated families, with further clinical, biochemical and molecular delineation of this unique entity. We also describe the first prenatal diagnosis of PIGM deficiency, allowing characterization of the natural history of the disease from birth. The patients described herein expand the phenotypic spectrum of PIGM deficiency to include macrocephaly and infantile-onset cerebrovascular thrombotic events. Finally, we offer insights regarding targeted treatment of this rare disorder with sodium phenylbutyrate.
|Number of pages||11|
|Journal||Molecular Genetics and Metabolism|
|State||Published - 1 Sep 2019|
Bibliographical noteFunding Information:
The authors wish to thank the patients and their families for their kind cooperation. This study was supported in part by funds from the Israel Science Foundation (grant number 2023/14 ) (G.H.); the Talpiot Medical Leadership Program (B.P.S., G.H., N.P.S.); and the Intramural Research Program of the National Human Genome Research Institute of the National Institutes of Health.
- Absence seizures
- Congenital disorders of glycosylation
- Glycosylphosphatidylinositol deficiency
- Portal vein thrombosis