期刊
JOURNAL OF MOVEMENT DISORDERS
卷 15, 期 2, 页码 171-174出版社
KOREAN MOVEMENT DISORDERS SOC
DOI: 10.14802/jmd.21143
关键词
Chelation therapy; Manganese metabolism disorder; Neurodegenerative disorder; SLC39A14
资金
- Basic Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education, Science, and Technology [2019R1F1A1059873]
- Pusan National University Yangsan Hospital
- National Research Foundation of Korea [2019R1F1A1059873] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
This study reports the first identified case of SLC39A14-associated manganism in Korea and the response to a 5-year chelation therapy. The treatment successfully reduced serum manganese levels and imaging abnormalities, but the dystonia symptoms showed insignificant improvement. Early diagnosis and treatment are crucial for this genetic disorder.
Mutations in the manganese transporter gene SLC39A14 lead to inherited disorders of manganese metabolism. Chelation therapy with edetate calcium disodium (CaNa2EDTA) is known to effectively reduce manganese deposition. We describe the first identified Korean case of SLC39A14-associated manganism and the treatment response to a 5-year chelation therapy. An 18-year-old female presented with childhood-onset dystonia. Magnetic resonance imaging showed T1 hyperintensity throughout the basal ganglia, brainstem, cerebellum, cerebral and cerebellar white matter, and pituitary gland. Blood manganese levels were elevated, and whole-exome sequencing revealed compound heterozygous mutations in SLC39A14. Treatment with intravenous CaNa(2)EDTA led to a significant reduction in serum manganese levels and T1 hyperintensities. However, her dystonia improved insignificantly. Hence, early diagnosis of this genetic disorder is essential because it is potentially treatable. Even though our treatment did not significantly reverse the establish deficits, chelation therapy could have been more effective if it was started at an earlier stage of the disease.
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