PURA syndrome

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PURA syndrome
Other namesPURA-related neurodevelopmental disorder
Autosomal dominant - en.svg
Specialty Medical genetics
Symptoms Developmental, speech and walking delays with epilepsy and other associated anomalies
CausesMutation in the PURA gene, located on Chromosome 5 at 5q31.
PreventionNone
Prognosis Medium (with treatment)
Frequencyvery rare, with roughly 500 reported in medical literature worldwide
Deaths-

PURA syndrome, also known as PURA-related neurodevelopmental disorder, is a rare novel genetic disorder which is characterized by developmental and speech delay, neo-natal hypotonia, failure to thrive, excessive sleepiness, epilepsy, and other anomalies. [1]

Contents

Description

Patients (usually children, but including adults) with this disorder usually show: [2] [3] [4]

Breathing problems often resolve after the age of one.

Causes

This disorder is caused by mutations in the PURA gene, in chromosome 5. [5] This gene is essential for the formation of pur-alpha, a protein which controls the activity of various genes and is vital for the replication of genes. It is also important for the normal development of the brain by directing the growth and division of neurons, the formation and maturation of myelin, which is a substance that protects nerves and promotes efficient nerve impulse transmission. [6] These mutations are often spontaneous (de novo), which means that they may appear in a baby whose family history is clear of the mutation. It has been shown that the mutations would be inherited in an autosomal dominant fashion. [7]

Etiology

This condition was first discovered in 2014 by Lalani et al. when they described 11 individuals with neonatal-onset hypotonia, encephalopathy which was often (but not always) associated with epilepsy, and severe developmental delay. [8]

Epidemiology

According to OMIM, around 62 cases have been described in medical literature worldwide, making PURA syndrome a very rare disorder. [9] It is estimated that this syndrome is the cause of 1% of all cases of developmental delay.

As would be expected with a disease this rare, patients who were undiagnosed (or misdiagnosed with other disorders, such as the similar-appearing Angelmans Syndrome) are being discovered. As of 2023, PURA Syndrome Foundation has recognized over 500 patients worldwide. [10]

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References

  1. "PURA syndrome: MedlinePlus Genetics". medlineplus.gov. Retrieved 2022-06-01.
  2. S.L.U, 2022 Viguera Editores. "PURA syndrome in a child with severe developmental delay: a challenging diagnosis : Neurología.com". www.neurologia.com. Retrieved 2022-06-01.{{cite web}}: CS1 maint: numeric names: authors list (link)
  3. Reijnders, Margot R. F.; Janowski, Robert; Alvi, Mohsan; Self, Jay E.; Essen, Ton J. van; Vreeburg, Maaike; Rouhl, Rob P. W.; Stevens, Servi J. C.; Stegmann, Alexander P. A.; Schieving, Jolanda; Pfundt, Rolph (2018-02-01). "PURA syndrome: clinical delineation and genotype-phenotype study in 32 individuals with review of published literature". Journal of Medical Genetics. 55 (2): 104–113. doi:10.1136/jmedgenet-2017-104946. ISSN   0022-2593. PMC   5800346 . PMID   29097605.
  4. Trau, Steven; Pizoli, Carolyn (2018-04-10). "PURA Syndrome and Myotonia: A Case Report and Review of the Literature (P3.336)". Neurology. 90 (15 Supplement). ISSN   0028-3878.
  5. Fukuda, Yuya; Kudo, Yoshimasa; Saito, Makoto; Kaname, Tadashi; Oota, Tohru; Shoji, Reikichi (2022-04-19). "Expanding the PURA syndrome phenotype with manifestations in a Japanese female patient". Human Genome Variation. 9 (1): 11. doi:10.1038/s41439-022-00189-7. ISSN   2054-345X. PMC   9019084 . PMID   35440576.
  6. "PURA gene: MedlinePlus Genetics". medlineplus.gov. Retrieved 2022-06-01.
  7. Reijnders, Margot RF; Leventer, Richard J.; Lee, Bo Hoon; Baralle, Diana; Selber, Paulo; Paciorkowski, Alex R.; Hunt, David (1993), Adam, Margaret P.; Ardinger, Holly H.; Pagon, Roberta A.; Wallace, Stephanie E. (eds.), "PURA-Related Neurodevelopmental Disorders", GeneReviews®, Seattle (WA): University of Washington, Seattle, PMID   28448108 , retrieved 2022-06-01
  8. Lalani, Seema R.; Zhang, Jing; Schaaf, Christian P.; Brown, Chester W.; Magoulas, Pilar; Tsai, Anne Chun-Hui; El-Gharbawy, Areeg; Wierenga, Klaas J.; Bartholomew, Dennis; Fong, Chin-To; Barbaro-Dieber, Tina (2014-11-06). "Mutations in PURA cause profound neonatal hypotonia, seizures, and encephalopathy in 5q31.3 microdeletion syndrome". American Journal of Human Genetics. 95 (5): 579–583. doi:10.1016/j.ajhg.2014.09.014. ISSN   1537-6605. PMC   4225583 . PMID   25439098.
  9. Lalani, Seema R.; Zhang, Jing; Schaaf, Christian P.; Brown, Chester W.; Magoulas, Pilar; Tsai, Anne Chun-Hui; El-Gharbawy, Areeg; Wierenga, Klaas J.; Bartholomew, Dennis; Fong, Chin-To; Barbaro-Dieber, Tina (2014-11-06). "Mutations in PURA cause profound neonatal hypotonia, seizures, and encephalopathy in 5q31.3 microdeletion syndrome". American Journal of Human Genetics. 95 (5): 579–583. doi:10.1016/j.ajhg.2014.09.014. ISSN   1537-6605. PMC   4225583 . PMID   25439098.
  10. "PURA 101 | PURA Syndrome Foundation". purasyndrome.org. Retrieved 2023-02-28.