Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report

Objective To report one case of chronic cerebral venous thrombosis (CVT) caused by compound heterozygous mutation in MTHFR gene, and to investigate the association between compound heterozygous mutation in MTHFR gene and chronic CVT as well as its pathophysiology mechanism. Methods and Results A 27-...

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Main Authors: YU Xuan-yue, LIU Ke-xin, FAN Tie-ping, LI Shu-min, LIANG Xin-tian, LIU Yi
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2025-06-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
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Online Access:http://www.cjcnn.org/index.php/cjcnn/article/view/3050
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author YU Xuan-yue
LIU Ke-xin
FAN Tie-ping
LI Shu-min
LIANG Xin-tian
LIU Yi
author_facet YU Xuan-yue
LIU Ke-xin
FAN Tie-ping
LI Shu-min
LIANG Xin-tian
LIU Yi
author_sort YU Xuan-yue
collection DOAJ
description Objective To report one case of chronic cerebral venous thrombosis (CVT) caused by compound heterozygous mutation in MTHFR gene, and to investigate the association between compound heterozygous mutation in MTHFR gene and chronic CVT as well as its pathophysiology mechanism. Methods and Results A 27-year-old male patient presented to the hospital with sudden onset headache. Imaging findings showed chronic thrombosis of the left superior sagittal sinus, inferior sagittal sinus, straight sinus, transverse sinus and confluence of sinus, and laboratory tests revealed hyperhomocysteinemia (homocysteine > 100 μmol/L). Genetic testing showed that the patient had a compound heterozygous mutation of MTHFR gene c.325C > G (p.Arg109Gly) and c.277C > T (p.Arg93Ter), and the mother also carried the c.277C > T (p.Arg93Ter) heterozygous mutation, suggesting a familial predisposition. The clinical diagnosis was chronic CVT caused by a compound heterozygous mutation in MTHFR gene. Following anticoagulation therapy combined with folate acid and vitamin B supplementation, symptoms improved, but homocysteine level remained elevated. Conclusions This paper first reports the association of MTHFR gene c.325C > G (p.Arg109Gly) and c.277C > T (p.Arg93Ter) compound heterozygous mutation with CVT. Compound heterozygous mutation in MTHFR gene play an important role in the chronicity of thrombosis, and the necessity of genetic testing and individualized therapy for patients with hereditary thrombophilia should be emphasized.
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spelling doaj-art-58d04e54d0604a4abecb9d583e6606ed2025-08-20T03:29:52ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312025-06-0125651752210.3969/j.issn.1672⁃6731.2025.06.010Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case reportYU Xuan-yue0LIU Ke-xin1FAN Tie-ping2LI Shu-min3LIANG Xin-tian4LIU Yi5Department of Neurology, Central Hospital of Dalian University of Technology, Dalian 116033, Liaoning, ChinaGrade 2023, The First Clinical College of China Medical University, Shenyang 110122, Liaoning, ChinaDepartment of Neurology, Central Hospital of Dalian University of Technology, Dalian 116033, Liaoning, ChinaDepartment of Neurology, Central Hospital of Dalian University of Technology, Dalian 116033, Liaoning, ChinaGrade 2022, Graduate School of Dalian Medical University, Dalian 116044, Liaoning, ChinaDepartment of Neurology, Central Hospital of Dalian University of Technology, Dalian 116033, Liaoning, ChinaObjective To report one case of chronic cerebral venous thrombosis (CVT) caused by compound heterozygous mutation in MTHFR gene, and to investigate the association between compound heterozygous mutation in MTHFR gene and chronic CVT as well as its pathophysiology mechanism. Methods and Results A 27-year-old male patient presented to the hospital with sudden onset headache. Imaging findings showed chronic thrombosis of the left superior sagittal sinus, inferior sagittal sinus, straight sinus, transverse sinus and confluence of sinus, and laboratory tests revealed hyperhomocysteinemia (homocysteine > 100 μmol/L). Genetic testing showed that the patient had a compound heterozygous mutation of MTHFR gene c.325C > G (p.Arg109Gly) and c.277C > T (p.Arg93Ter), and the mother also carried the c.277C > T (p.Arg93Ter) heterozygous mutation, suggesting a familial predisposition. The clinical diagnosis was chronic CVT caused by a compound heterozygous mutation in MTHFR gene. Following anticoagulation therapy combined with folate acid and vitamin B supplementation, symptoms improved, but homocysteine level remained elevated. Conclusions This paper first reports the association of MTHFR gene c.325C > G (p.Arg109Gly) and c.277C > T (p.Arg93Ter) compound heterozygous mutation with CVT. Compound heterozygous mutation in MTHFR gene play an important role in the chronicity of thrombosis, and the necessity of genetic testing and individualized therapy for patients with hereditary thrombophilia should be emphasized.http://www.cjcnn.org/index.php/cjcnn/article/view/3050venous thrombosiscerebral veinschronic diseasemethylenetetrahydrofolate reductase (nadph2)genesmutationheterozygotehyperhomocysteinemia
spellingShingle YU Xuan-yue
LIU Ke-xin
FAN Tie-ping
LI Shu-min
LIANG Xin-tian
LIU Yi
Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report
Chinese Journal of Contemporary Neurology and Neurosurgery
venous thrombosis
cerebral veins
chronic disease
methylenetetrahydrofolate reductase (nadph2)
genes
mutation
heterozygote
hyperhomocysteinemia
title Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report
title_full Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report
title_fullStr Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report
title_full_unstemmed Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report
title_short Compound heterozygous mutation in MTHFR gene lead to chronic cerebral venous thrombosis: one case report
title_sort compound heterozygous mutation in mthfr gene lead to chronic cerebral venous thrombosis one case report
topic venous thrombosis
cerebral veins
chronic disease
methylenetetrahydrofolate reductase (nadph2)
genes
mutation
heterozygote
hyperhomocysteinemia
url http://www.cjcnn.org/index.php/cjcnn/article/view/3050
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