Published on:
    Journal of Cardiovascular Disease Research, 2012; 3(2):67-75
    ORIGINAL ARTICLE | doi:10.4103/0975-3583.95357

    Genotype-phenotype analysis of three Chinese families with Jervell and Lange-Nielsen syndrome

    Authors:

    Yuanfeng Gao, Cuilan Li, Wenling Liu, Robby Wu1, Xiaoliang Qiu, Ruijuan Liang, Lei Li, Li Zhang2, Dayi Hu

    Heart Center, Peking University People’s Hospital, Beijing – 100 044, P. R. China,

    1Philadelphia College of Osteopathic Medicine,

    2ankenau Medical Center, Lankenau Institute for Medical Research, Jefferson Medical College, Philadelphia, U.S.A.

    Abstract:

    Background: Long QT syndrome (LQTS) is characterized by QT prolongation, syncope and sudden death. This study aims to explore the causes, clinical manifestations and therapeutic outcomes of Jervell and Lange-Nielsen syndrome (JLNS), a rare form of LQTS with congenital sensorineural deafness, in Chinese individuals. Materials and Methods: Three JLNS kindreds from the Chinese National LQTS Registry were investigated. Mutational screening of KCNQ1 and KCNE1 genes was performed by polymerase chain reaction and direct DNA sequence analysis. LQTS phenotype and therapeutic outcomes were evaluated for all probands and family members. Results: We identified 7 KCNQ1 mutations. c.1032_1117dup (p.Ser373TrpfsX10) and c.1319delT (p.Val440AlafsX26) were novel, causing JLNS in a 16-year-old boy with a QTc (QT interval corrected for heart rate) of 620 ms and recurrent syncope. c.605-2A>G and c.815G>A (p.Gly272Asp) caused JLNS in a 12-year-old girl and her 5-year-old brother, showing QTc of 590 to 600 ms and recurrent syncope. The fourth JLNS case, a 46-year-old man carrying c.1032G>A (p.Ala344Alasp) and c.569G>A (p.Arg190Gln) and with QTc of 460 ms, has been syncope-free since age 30. His 16-year-old daughter carries novel missense mutation c.574C>T (p.Arg192Cys) and c.1032G>A(p.Ala344Alasp) and displayed a severe phenotype of Romano-Ward syndrome (RWS) characterized by a QTc of 530 ms and recurrent syncope with normal hearing. Both the father and daughter also carried c.253G>A (p.Asp85Asn; rs1805128), a rare single nucleotide polymorphism (SNP) on KCNE1. Bizarre T waves were seen in 3/4 JLNS patients. Symptoms were improved and T wave abnormalities became less abnormal after appropriate treatment. Conclusion: This study broadens the mutation and phenotype spectrums of JLNS. Compound heterozygous KCNQ1 mutations can result in both JLNS and severe forms of RWS in Chinese individuals.

    Key words: Compound heterozygous mutation, frameshift mutation, Jervell and Lange-Nielsen syndrome, KCNQ1, KCNE1, long QT syndrome, Romano-Ward syndrome, single nucleotide polymorphism.