Compound heterozygous mutations in KCNJ2 and KCNH2 in a patient with severe Andersen-Tawil syndrome

BMJ Case Rep. 2020 Aug 25;13(8):e235703. doi: 10.1136/bcr-2020-235703.

Abstract

Andersen-Tawil syndrome (ATS) is a rare channelopathy, sometimes referred to as long QT syndrome type 7. ATS is an autosomal dominant disease predominantly caused by mutations in the KCNJ2 gene. Patients with ATS present with episodes of muscle weakness, arrythmias, including prolonged QT intervals, and various skeletal abnormalities. Unlike other channelopathies, ATS has a relatively mild clinical course and low risk of sudden cardiac death. In this study, we describe a female patient with typical symptoms of ATS with the addition of unusually severe arrhythmias. Extensive DNA testing was performed to find the possible cause of this unique presentation. In addition to a known mutation in KCNJ2, the patient carried a variant in KCNH2 The combination of genetic variants may lead to the severe clinical manifestation of ATS. Additional genetic information allowed accurate genetic counselling to be provided to the patient.

Keywords: arrhythmias; cardiovascular system; genetic screening / counselling.

Publication types

  • Case Reports

MeSH terms

  • Andersen Syndrome / genetics*
  • ERG1 Potassium Channel / genetics*
  • Female
  • Heterozygote
  • Humans
  • Mutation*
  • Pedigree
  • Potassium Channels, Inwardly Rectifying / genetics*
  • Severity of Illness Index
  • Young Adult

Substances

  • ERG1 Potassium Channel
  • KCNH2 protein, human
  • KCNJ2 protein, human
  • Potassium Channels, Inwardly Rectifying