A novel mutation in PNPLA2 leading to neutral lipid storage disease with myopathy

Abstract

Background: Mutations in PNPLA2, a gene encoding adipose triglyceride lipase, lead to neutral lipid storage disease with myopathy.

Objective: To report the clinical and molecular features of a case of neutral lipid storage disease with myopathy resulting from a novel mutation in PNPLA2.

Design: Case report.

Setting: University hospital.

Patient: A 65-year-old man with progressive muscle weakness and high serum creatine kinase levels.

Intervention: Direct sequencing of the PNPLA2 gene.

Results: Identification of a novel homozygous mutation in the patient's PNPLA2 gene confirmed the suspected diagnosis of neutral lipid storage disease with myopathy.

Conclusion: Screening of the PNPLA2 gene should be considered for patients presenting with high levels of creatine kinase, progressive muscle weakness, and systemic lipid accumulation. The presence of Jordans anomaly can be a strong diagnostic clue.

Figure 1

Vacuolization of granulocytes (Jordans anomaly) in a peripheral blood smear from the patient.

Figure 2

Electropherogram showing the patient’s homozygous c.1081G>T mutation in exon 9 of the PNPLA2 gene.

Figure 3

Pedigree of the family based on molecular data. Half-filled symbols are PNPLA2 mutation carriers, and the black symbol denotes homozygous mutation status of the proband (P). U indicates untested.