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 journalArticlepeer-review

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
Pages (from-to)604-10
Number of pages7
JournalEuropean Journal of Paediatric Neurology
Volume20
Issue number4
DOIs
Publication statusPublished - Jul 2016

Keywords

  • Adolescent
  • Autoimmune Diseases of the Nervous System
  • Brain
  • Calcinosis
  • Child
  • Child, Preschool
  • Cysts
  • Cytomegalovirus Infections
  • Diagnosis, Differential
  • Female
  • Humans
  • Infant
  • Leukoencephalopathies
  • Magnetic Resonance Imaging
  • Male
  • Mutation
  • Nervous System Malformations
  • Phenotype
  • Ribonucleases
  • Tomography, X-Ray Computed
  • Tumor Suppressor Proteins
  • Young Adult
  • Case Reports
  • Journal Article

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