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2018 ; 19
(ä): 374-381
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Atypical Presentation of Gelsolin Amyloidosis in a Man of African Descent with a
Novel Mutation in the Gelsolin Gene
#MMPMID29599423
Oregel KZ
; Shouse GP
; Oster C
; Martinez F
; Wang J
; Rosenzweig M
; Deisch JK
; Chen CS
; Nagaraj G
Am J Case Rep
2018[Mar]; 19
(ä): 374-381
PMID29599423
show ga
BACKGROUND Gelsolin amyloidosis is a very rare systemic disease presenting with a
pathognomonic triad of corneal lattice dystrophy, cutis laxa, and polyneuropathy.
The disease is mostly restricted to a Finnish population with known mutations
(G654A, G654T) in exon 4 of the gelsolin gene. The mutations lead to errors in
protein processing and folding, and ultimately leads to deposition of an
amyloidogenic fragment in the extracellular space, causing the symptoms of
disease. CASE REPORT We present a case of gelsolin amyloidosis in a male of
African descent with an atypical clinical presentation including fevers, skin
rash, polyneuropathy, and anemia. Gelsolin amyloidosis was diagnosed based on
mass spectrometry of tissue samples. Importantly, a novel mutation in the
gelsolin gene (C1375G) in exon 10 was found in this patient. His atypical
presentation can possibly be attributed to the presence of a novel mutation in
the gelsolin gene as the likely underlying cause of the syndrome. PCR primers
were used to amplify the gelsolin gene from genomic DNA. Purified PCR products
were then shipped to Eton Biosciences (San Diego, CA) for sequencing. CONCLUSIONS
This study carries several important lessons relevant to the practice of
medicine. First, the differential diagnosis for multisystem disease presentations
should always include amyloidosis. Second, despite what has been uncovered about
the molecular biology of disease, there is always more that can be discovered.
Finally, further work to verify the link between this mutation and the clinical
syndrome is still needed, as are effective treatments for this disease.