Skip to main content
Top
Published in: BMC Neurology 1/2024

Open Access 01-12-2024 | CADASIL | Case Report

First report of a p.Cys484Tyr Notch3 mutation in a CADASIL patient with acute bilateral multiple subcortical infarcts—case report and brief review

Authors: Weili Liu, Jie Zhang, Jian Li, Shuai Jia, Yanqiang Wang, Jianhong Geng, Yaozhen Wang

Published in: BMC Neurology | Issue 1/2024

Login to get access

Abstract

Background

CADASIL(Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy)is an inherited small vessel disease caused by mutations in NOTCH3 gene. Although NOTCH3 has numerous hotspots of gene mutations, mutations in exons 9 are rare. The p.C484T gene mutation type associated with it has not been reported in any relevant cases yet. Furthermore, CADASIL patients rarely present with acute bilateral multiple subcortical infarcts.

Case presentation

We report the case of a Chinese female patient with CADASIL who experienced “an acute bilateral subcortical infarction” because of“hemodynamic changes and hypercoagulability”. In genetic testing, we discovered a new Cys484Tyr mutation in exon 9, which has also been found in the patient’s two daughters.

Conclusions

It is important to note that this discovery not only expands the mutation spectrum of Notch3 mutations in CADASIL patients, but also examines the mechanism behind acute bilateral subcortical infarction in CADASIL patients via case reviews and literature reviews, in order to provide some clinical recommendations for early intervention, diagnosis, and treatment in similar cases in the future.
Literature
1.
go back to reference Gobron C, Viswanathan A, Bousser M-G, Chabriat H. Multiple simultaneous cerebral infarctions in cerebral autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy. Cerebrovasc Dis. 2006;22(5–6):445–6.CrossRefPubMed Gobron C, Viswanathan A, Bousser M-G, Chabriat H. Multiple simultaneous cerebral infarctions in cerebral autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy. Cerebrovasc Dis. 2006;22(5–6):445–6.CrossRefPubMed
2.
go back to reference Gravesteijn G, Dauwerse JG, Overzier M, Brouwer G, Hegeman I, Mulder AA, Baas F, Kruit MC, Terwindt GM, van Duinen SG, et al. Naturally occurring NOTCH3 exon skipping attenuates NOTCH3 protein aggregation and disease severity in CADASIL patients. Hum Mol Genet. 2020;29(11):1853–63.CrossRefPubMedPubMedCentral Gravesteijn G, Dauwerse JG, Overzier M, Brouwer G, Hegeman I, Mulder AA, Baas F, Kruit MC, Terwindt GM, van Duinen SG, et al. Naturally occurring NOTCH3 exon skipping attenuates NOTCH3 protein aggregation and disease severity in CADASIL patients. Hum Mol Genet. 2020;29(11):1853–63.CrossRefPubMedPubMedCentral
3.
go back to reference Rutten JW, Dauwerse HG, Gravesteijn G, van Belzen MJ, van der Grond J, Polke JM, Bernal-Quiros M, Lesnik Oberstein SAJ. Archetypal NOTCH3 mutations frequent in public exome: implications for CADASIL. Ann Clin Transl Neurol. 2016;3(11):844–53.CrossRefPubMedPubMedCentral Rutten JW, Dauwerse HG, Gravesteijn G, van Belzen MJ, van der Grond J, Polke JM, Bernal-Quiros M, Lesnik Oberstein SAJ. Archetypal NOTCH3 mutations frequent in public exome: implications for CADASIL. Ann Clin Transl Neurol. 2016;3(11):844–53.CrossRefPubMedPubMedCentral
4.
go back to reference Ni W, Zhang Y, Zhang L, Xie JJ, Li HF, Wu ZY. Genetic spectrum of NOTCH3 and clinical phenotype of CADASIL patients in different populations. CNS Neurosci Ther. 2022;28(11):1779–89.CrossRefPubMedPubMedCentral Ni W, Zhang Y, Zhang L, Xie JJ, Li HF, Wu ZY. Genetic spectrum of NOTCH3 and clinical phenotype of CADASIL patients in different populations. CNS Neurosci Ther. 2022;28(11):1779–89.CrossRefPubMedPubMedCentral
5.
go back to reference Wang T, Baron M, Trump D. An overview of Notch3 function in vascular smooth muscle cells. Prog Biophys Mol Biol. 2008;96(1–3):499–509.CrossRefPubMed Wang T, Baron M, Trump D. An overview of Notch3 function in vascular smooth muscle cells. Prog Biophys Mol Biol. 2008;96(1–3):499–509.CrossRefPubMed
6.
go back to reference Mizuno T, Mizuta I, Watanabe-Hosomi A, Mukai M, Koizumi T. Clinical and genetic aspects of CADASIL. Front Aging Neurosci 2020, 12. Mizuno T, Mizuta I, Watanabe-Hosomi A, Mukai M, Koizumi T. Clinical and genetic aspects of CADASIL. Front Aging Neurosci 2020, 12.
7.
go back to reference Schoemaker D, Quiroz YT, Torrico-Teave H, Arboleda-Velasquez JF. Clinical and research applications of magnetic resonance imaging in the study of CADASIL. Neurosci Lett. 2019;698:173–9.CrossRefPubMedPubMedCentral Schoemaker D, Quiroz YT, Torrico-Teave H, Arboleda-Velasquez JF. Clinical and research applications of magnetic resonance imaging in the study of CADASIL. Neurosci Lett. 2019;698:173–9.CrossRefPubMedPubMedCentral
8.
go back to reference Arboix A. Clinical study of 39 patients with atypical lacunar syndrome. J Neurol Neurosurg Psychiatry. 2005;77(3):381–4.CrossRef Arboix A. Clinical study of 39 patients with atypical lacunar syndrome. J Neurol Neurosurg Psychiatry. 2005;77(3):381–4.CrossRef
9.
go back to reference Locatelli M, Padovani A, Pezzini A. Pathophysiological mechanisms and potential therapeutic targets in cerebral autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy (CADASIL). Front Pharmacol 2020, 11. Locatelli M, Padovani A, Pezzini A. Pathophysiological mechanisms and potential therapeutic targets in cerebral autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy (CADASIL). Front Pharmacol 2020, 11.
10.
11.
go back to reference Cruciani A, Pilato F, Rossi M, Motolese F, Di Lazzaro V, Capone F. Ischemic stroke in a patient with stable CADASIL during COVID-19: a Case Report. Brain Sci 2021, 11(12). Cruciani A, Pilato F, Rossi M, Motolese F, Di Lazzaro V, Capone F. Ischemic stroke in a patient with stable CADASIL during COVID-19: a Case Report. Brain Sci 2021, 11(12).
12.
go back to reference Muiño E, Fernández-Cadenas I, Arboix A. Contribution of Omic studies to the understanding of Cadasil. A systematic review. Int J Mol Sci 2021, 22(14). Muiño E, Fernández-Cadenas I, Arboix A. Contribution of Omic studies to the understanding of Cadasil. A systematic review. Int J Mol Sci 2021, 22(14).
Metadata
Title
First report of a p.Cys484Tyr Notch3 mutation in a CADASIL patient with acute bilateral multiple subcortical infarcts—case report and brief review
Authors
Weili Liu
Jie Zhang
Jian Li
Shuai Jia
Yanqiang Wang
Jianhong Geng
Yaozhen Wang
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
CADASIL
Published in
BMC Neurology / Issue 1/2024
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-024-03573-8

Other articles of this Issue 1/2024

BMC Neurology 1/2024 Go to the issue