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Published 2 February 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.08.2008.0711]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Rare disease

De novo seven extra repeat expanded mutation in the PRNP gene in an Italian patient with early onset dementia

M Cannella1, Tiziana Martino1, Maria Simonelli1, Andrea Ciammola2, Roberto Gradini3, Andrea Ciarmiello4, Fernando Gianfrancesco5, Ferdinando Squitieri1

1 IRCCS Neuromed, Neurogenetics, Localita’ Camerelle, Pozzilli, 86077, Italy
2 IRCCS Auxologico, Via Zucchi, 18, Milan, 20095, Italy
3 University Sapienza of Rome, Viale Regina Magherita, 1, Rome, 00198, Italy
4 Sant’Andrea Hospital, Nuclear Medicine, via Vittorio Veneto, 197, La Spezia, 19124, Italy
5 CNR, Via P. Castellino, Naples, 80100, Italy

Correspondence to:
genetics{at}neuromed.it

SUMMARY

Point and octapeptide repeat (24 bp) insertional mutations in the prion protein gene (PRNP) cause a dominantly transmitted dementia, associated with spongiform degeneration of the brain, astrocytic gliosis and neuronal loss due to cell accumulation of mutated protease resistant prion protein. The octapeptide repeat region lies between codon 51 and 91, and comprises a nonapeptide followed by a tandem repeat containing four copies of an octapeptide. The normal tandem length in healthy individuals is five repeats R1-R2-R2-R3-R4, but mutations can contain up to nine additional extra repeats. Some insight into this genetic mechanism comes from the de novo meiotic insertional extra repeat mutation in PRNP we detected in a patient whose parents had a normal phenotype and a wild-type sequence in the same gene. To our knowledge, this is the first time this condition has been described.


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