The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia

Glycine encephalopathy, also known as nonketotic hyperglycinemia (NHK), is a rare inherited disease caused by an inborn error of glycine metabolism, resulting in elevated glycine concentration in plasma and cerebrospinal fluid. Clinical manifestations mainly include varying degrees of hypotonia, apn...

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Main Authors: Fang Yuan, Xiaozhen Song, Rongrong Yin, Xiaoping Lan, Jingjing Sun, Xiaojun Tang, Wuhen Xu, Shaohua Hu, Man Xiao, Hong Zhang, Wenhao Weng, Yuanfeng Zhang, Shengnan Wu
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Molecular Genetics and Metabolism Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214426925000242
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author Fang Yuan
Xiaozhen Song
Rongrong Yin
Xiaoping Lan
Jingjing Sun
Xiaojun Tang
Wuhen Xu
Shaohua Hu
Man Xiao
Hong Zhang
Wenhao Weng
Yuanfeng Zhang
Shengnan Wu
author_facet Fang Yuan
Xiaozhen Song
Rongrong Yin
Xiaoping Lan
Jingjing Sun
Xiaojun Tang
Wuhen Xu
Shaohua Hu
Man Xiao
Hong Zhang
Wenhao Weng
Yuanfeng Zhang
Shengnan Wu
author_sort Fang Yuan
collection DOAJ
description Glycine encephalopathy, also known as nonketotic hyperglycinemia (NHK), is a rare inherited disease caused by an inborn error of glycine metabolism, resulting in elevated glycine concentration in plasma and cerebrospinal fluid. Clinical manifestations mainly include varying degrees of hypotonia, apneic episodes, epilepsy, psychomotor delay during the neonatal period or early infancy. Biallelic variants in GLDC account for up to 80 % of classical NKH cases. Here we describe the clinical, biochemical, and molecular characteristics of two Chinese siblings with severe NHK. Their phenotypes included severe symptoms in neonatal period, seizures, and psychomotor delay. The siblings carry novel compound heterozygous variants in GLDC, c.1740C > G (p.His580Gln) and c.1023G > A (p.Val341=). Based on previous literature reports and pathogenicity prediction, the c.1740C > G (p.His580Gln) variant is classified as likely pathogenic. By minigene analysis, we confirmed the synonymous mutation c.1023G > A (p.Val341=) led to abnormal splicing, with 38 bp missing in exon 7 in the GLDC gene. These findings highlight the pathogenic nature of a novel synonymous mutation c.1023G > A, expand the genetic spectrum of GLDC and provide crucial guidance for both the patient's clinical management and family's reproductive genetic counseling.
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spelling doaj-art-8aed382b1fb848a9b87cbc027c7d47142025-08-20T02:35:51ZengElsevierMolecular Genetics and Metabolism Reports2214-42692025-06-014310120910.1016/j.ymgmr.2025.101209The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemiaFang Yuan0Xiaozhen Song1Rongrong Yin2Xiaoping Lan3Jingjing Sun4Xiaojun Tang5Wuhen Xu6Shaohua Hu7Man Xiao8Hong Zhang9Wenhao Weng10Yuanfeng Zhang11Shengnan Wu12Department of Neurology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Neurology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Neurology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Corresponding author.Department of Clinical Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Pediatric Infection, Immunity, and Critical Care Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Faculty of Medical Laboratory Science, College of Health Science and Technology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Corresponding author.Glycine encephalopathy, also known as nonketotic hyperglycinemia (NHK), is a rare inherited disease caused by an inborn error of glycine metabolism, resulting in elevated glycine concentration in plasma and cerebrospinal fluid. Clinical manifestations mainly include varying degrees of hypotonia, apneic episodes, epilepsy, psychomotor delay during the neonatal period or early infancy. Biallelic variants in GLDC account for up to 80 % of classical NKH cases. Here we describe the clinical, biochemical, and molecular characteristics of two Chinese siblings with severe NHK. Their phenotypes included severe symptoms in neonatal period, seizures, and psychomotor delay. The siblings carry novel compound heterozygous variants in GLDC, c.1740C > G (p.His580Gln) and c.1023G > A (p.Val341=). Based on previous literature reports and pathogenicity prediction, the c.1740C > G (p.His580Gln) variant is classified as likely pathogenic. By minigene analysis, we confirmed the synonymous mutation c.1023G > A (p.Val341=) led to abnormal splicing, with 38 bp missing in exon 7 in the GLDC gene. These findings highlight the pathogenic nature of a novel synonymous mutation c.1023G > A, expand the genetic spectrum of GLDC and provide crucial guidance for both the patient's clinical management and family's reproductive genetic counseling.http://www.sciencedirect.com/science/article/pii/S2214426925000242GLDCGlycine cleavage enzyme systemNonketotic hyperglycinemiaSeizureSynonymous mutation
spellingShingle Fang Yuan
Xiaozhen Song
Rongrong Yin
Xiaoping Lan
Jingjing Sun
Xiaojun Tang
Wuhen Xu
Shaohua Hu
Man Xiao
Hong Zhang
Wenhao Weng
Yuanfeng Zhang
Shengnan Wu
The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia
Molecular Genetics and Metabolism Reports
GLDC
Glycine cleavage enzyme system
Nonketotic hyperglycinemia
Seizure
Synonymous mutation
title The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia
title_full The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia
title_fullStr The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia
title_full_unstemmed The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia
title_short The precise molecular diagnosis of novel GLDC compound heterozygous variants highlights the benefits for a Chinese family with nonketotic hyperglycinemia
title_sort precise molecular diagnosis of novel gldc compound heterozygous variants highlights the benefits for a chinese family with nonketotic hyperglycinemia
topic GLDC
Glycine cleavage enzyme system
Nonketotic hyperglycinemia
Seizure
Synonymous mutation
url http://www.sciencedirect.com/science/article/pii/S2214426925000242
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