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Yıl:2019; Cilt: 56; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2019;56(2):106-109
Sakarya İli Herediter Ataksi Hastalarının Fenotipik ve Genotipik İncelenmesi
S Sayan, D Kotan, AG Eken, I Şahbaz, C Koçoğlu, AN Başak
Sakarya Universitesi, Sakarya
Amaç: Herediter ataksiler, klinik ve genetik özellikleriyle heterojen bir grup hastalıktır. Yavaş progresyon gösteren ataksi ile karakterize olan kliniğe piramidal ve ekstrapiramidal bulgular, artikülasyon bozuklukları, oftalmik hareket bozuklukları, nöropatik yakınmalar, kognitif ve davranışsal bozukluklar ve epilepsi eşlik edebilir. Herediter ataksilerde kesin tanı moleküler çalışmalara dayanır. Anamnez, klinik muayene, laboratuvar ve nörogörüntüleme çalışmaları tanıya yardımcıdır. Çalışmamızda, Sakarya ili herediter ataksi şüphesi taşıyan 37 olgunun fenotipik ve genotipik özellikleri incelendi ve bu hastalarda saptanan mutasyonların klinik bulgularla ilişkisi belirlenip sonuçlar literatürdeki bilgiler ile karşılaştırıldı. Yöntem: Çalışmamıza 2010–2016 yılları arasında merkezimize başvuran, aile öyküsü ve fenotipik özellikleriyle herediter ataksi düşündüren 22 aileden 37 olgu dâhil edildi. Olgular klinik, aile ağacı, nörogörüntüleme ve laboratuvar özellikleri açısından incelendi. İleri genetik araştırma için periferik venöz kan örnekleri alındı. Bulgular: 37 olgunun 21’i kadın, 16’sı erkekti. Genetik incelemeler sonucu; dört ailede (10 hasta) spinoserebellar ataksi (SCA), üç ailede (sekiz hasta) Friedrich ataksisi (FRDA), bir ailede (iki hasta) ise MRE-11 geninin nokta mutasyonuna bağlı otozomal resesif ataksi saptandı. SCA olgularının alt tiplemesi SCA 1, 2, 6 ve 8 şeklindeydi. Kalan 16 hastanın genetik incelemesi devam etmektedir. Sonuç: Herediter ataksiler nadir görülen nörodejeneratif hastalıklardandır. Genetik havuzunun geniş olması yanı sıra etnik ve bölgesel farklılıklar göstermesi, tanı konulmasını zorlaştırmaktadır. Çalışmamızın, ilimiz herediter SCA hastalarının fenotipik ve genotipik özelliklerini ve nadir görülen herediter ataksi genotipleri yansıtması ile literatüre katkı sağladığını düşünmekteyiz.
Phenotypic and Genotypic Analysis of Hereditary Ataxia Patients inSakarya City, Turkey
Introduction: Hereditary ataxias are a group of heterogeneous diseases in regard to their clinical and genetic characteristics. Ataxia that progresses slowly may be accompanied by pyramidal and extrapyramidal findings, articulation disorders, ophthalmic movement disorders, neuropathic complaints, cognitive and behavioral abnormalies, and epilepsy. Definitive diagnosis in hereditary ataxias is based on molecular assays. History, clinical examination, laboratory and neuroimaging assist diagnosis. In our study, thirty-seven patients of suspected hereditary ataxia were examined with their clinical and genetic aspects, and the results compared with literature. Method: Our study included 37 patients in 22 families who presented to our center between 2010–2016, and whose familial history and phenotypic features indicated hereditary ataxia. The patients were studied for clinical findings, family tree, neuroimaging, and laboratory findings. Advanced genetic investigations were performed on peripheral venous blood samples for hereditary ataxia. Results: Of the 37 patients included in our study, 21 were females and 16 were males. Genetic analyses resulted in spinocerebellar ataxia (SCA) in four families (10 patients), Friedrich ataxia (FA) in three families (eight patients), and recessive ataxia due to point mutation in one family (two patients). SCA subtyping revealed SCA 1, 2, 6 and 8 in our patients. The remaining 16 patients included in our study could not be solved so far and are under investigation. Conclusion: Hereditary ataxias are rare neurodegenerative disorders. Large genetic pool, ethnic and local differences complicate diagnosing even further. Our study contributes to the literature by reflecting phenotypic and genotypic characteristics of hereditary SCA patients in our region and reporting rare hereditary ataxia genotypes.

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