Clinical, radiological and possible pathological overlap of cystic leukoencephalopathy without megalencephaly and Aicardi-Goutières syndrome

Davide Tonduti, Simona Orcesi, Emma M. Jenkinson, Imen Dorboz, Florence Renaldo, Celeste Panteghini, Gillian I. Rice, Marco Henneke, John H. Livingston, Monique Elmaleh, Lydie Burglen, Michèl A A P Willemsen, Luisa Chiapparini, Barbara Garavaglia, Diana Rodriguez, Odile Boespflug-Tanguy, Isabella Moroni, Yanick J. Crow

Research output: Contribution to journalArticle

Abstract

Background: Cystic leukoencephalopathy without megalencephaly is a disorder related in some cases to RNASET2 mutations and characterized by bilateral anterior temporal subcortical cysts and multifocal lobar white matter lesions with sparing of central white matter structures. This phenotype significantly overlaps with the sequelae of in utero cytomegalovirus (CMV) infection, including the presence of intracranial calcification in some cases. Aicardi-Goutières syndrome (AGS) is another inherited leukodystrophy with cerebral calcification mimicking congenital infection. Clinical, radiological and biochemical criteria for the diagnosis of AGS have been established, although the breadth of phenotype associated with mutations in the AGS-related genes is much greater than previously envisaged. Patients and Methods: We describe the clinical, biochemical and radiological findings of five patients demonstrating a phenotype reminiscent of AGS. Results: All patients were found to carry biallelic mutations of RNASET2. Conclusions: Our patients illustrate the clinical and radiological overlap that can be seen between RNASET2-related leukodystrophy and AGS in some cases. Our data highlight the need to include both disorders in the same differential diagnosis, and hint at possible shared pathomechanisms related to auto-inflammation which are worthy of further investigation.

Original languageEnglish
JournalEuropean Journal of Paediatric Neurology
DOIs
Publication statusAccepted/In press - Oct 12 2015

Keywords

  • Aicardi-Goutières syndrome
  • Calcification
  • Interferonopathy
  • Leukodystrophy
  • RNASET2

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health

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    Tonduti, D., Orcesi, S., Jenkinson, E. M., Dorboz, I., Renaldo, F., Panteghini, C., Rice, G. I., Henneke, M., Livingston, J. H., Elmaleh, M., Burglen, L., Willemsen, M. A. A. P., Chiapparini, L., Garavaglia, B., Rodriguez, D., Boespflug-Tanguy, O., Moroni, I., & Crow, Y. J. (Accepted/In press). Clinical, radiological and possible pathological overlap of cystic leukoencephalopathy without megalencephaly and Aicardi-Goutières syndrome. European Journal of Paediatric Neurology. https://doi.org/10.1016/j.ejpn.2016.03.009