Hyperhidrosis as the initial symptom in FUS mutation-associated amyotrophic lateral sclerosis: a case report and comprehensive literature review

Neurol Sci. 2024 Apr;45(4):1523-1527. doi: 10.1007/s10072-023-07141-9. Epub 2023 Oct 31.

Abstract

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that is now recognized to involve autonomic dysfunction. The burden of autonomic dysfunction is an important factor in the quality of life and prognosis of ALS patients. This article presents the clinical characteristics of a young female ALS patient with a fused in sarcoma (FUS) gene mutation and notable hyperhidrosis.

Method: Detailed clinical characteristics of the patients were collected, and comprehensive examinations such as electrophysiological assessment, neuro-ultrasound, genetic testing, and relevant blood tests were conducted.

Result: A 24-year-old female experienced progressive weakness in both lower limbs for over 5 months, along with excessive sweating on both palms and feet. A positive skin iodine-starch test was observed. Electromyography revealed extensive neurogenic damage and prolonged sympathetic skin response (SSR) latency in both lower limbs. Full exon gene sequencing showed a heterozygous mutation c.1574C>T (p.Pro525Leu) in the FUS gene.

Conclusion: The pathogenesis of ALS remains unclear at present. This case underscores the presence of autonomic nervous symptoms in ALS associated with FUS mutation and highlights the importance of early diagnosis and timely treatment intervention to enhance patient prognosis.

Keywords: Amyotrophic lateral sclerosis; Autonomic nervous dysfunction; FUS gene mutation; Hyperhidrosis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Amyotrophic Lateral Sclerosis* / complications
  • Amyotrophic Lateral Sclerosis* / diagnosis
  • Amyotrophic Lateral Sclerosis* / genetics
  • Female
  • Humans
  • Hyperhidrosis* / genetics
  • Mutation
  • Neurodegenerative Diseases*
  • Quality of Life
  • RNA-Binding Protein FUS / genetics
  • Young Adult

Substances

  • FUS protein, human
  • RNA-Binding Protein FUS