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Sensory ataxic neuropathy with dysarthria and ophthalmoparesis (SANDO) in late life due to compound heterozygous POLG mutations
Authors:Michael D Weiss MD  Russell P Saneto DO  PhD
Institution:1. Department of Neurology, University of Washington Medical Center, Box 356115, 1959 NE Pacific Street, Seattle, Washington 98195, USA;2. Division of Pediatric Neurology, Seattle Children's Hospital, Seattle, Washington, USA
Abstract:Missense mutations in the gene for polymerase γ 1 (POLG1) cause a number of phenotypically heterogeneous mitochondrial diseases, most commonly progressive external ophthalmoplegia, and are characterized by the accumulation of multiple, large‐scale deletions of mitochondrial DNA. The triad of sensory ataxic neuropathy, dysarthria, and ophthalmoparesis (SANDO) has been demonstrated in a small subset of patients with POLG1 mutations. We report a sporadic case of an 80‐year‐old compound heterozygote man who presented with SANDO and was found to have three known pathogenic mutations in the POLG1 gene (p.T251I/p.P587L/p.G848S). To our knowledge, none of these mutations have been demonstrated previously in SANDO. This patient's late presentation illustrates that a mitochondrial disorder should be considered regardless of age if the clinical symptoms warrant. Muscle Nerve, 2010
Keywords:dysarthria  polymerase γ    mitochondrial myopathy  progressive external ophthalmoplegia  sensory ataxic neuropathy
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