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Article

Compound Heterozygous RYR1 Variants in a Patient with Severe Congenital Myopathy: Case Report and Comparison with Additional Cases of Recessive RYR1-Related Myopathy

by
Sören Janßen
1,†,
Leoni S. Sabrina Erbe
2,†,
Moritz Kneifel
3,
Matthias Vorgerd
3,
Kristina Döring
2,
Krzysztof P. Lubieniecki
2,
Joanna M. Lubieniecka
2,
Wanda M. Maria Gerding
2,
Nicolas Casadei
4,5,
Anne-Katrin Güttsches
3,
Christoph Heyer
6,
Thomas Lücke
1,7,
Hoa Huu Phuc Nguyen
2,7,
Cornelia Köhler
1,7,‡ and
Sabine Hoffjan
2,7,*,‡
1
Department of Neuropediatrics, University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
2
Department of Human Genetics, Ruhr-University Bochum, 44801 Bochum, Germany
3
Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
4
Institute of Medical Genetics and Applied Genomics, University Tübingen, 72074 Tübingen, Germany
5
NGS Competence Center Tübingen, 72076 Tübingen, Germany
6
Institute for Pediatric Radiology, Katholisches Klinikum Bochum, Ruhr-University Bochum, 44791 Bochum, Germany
7
Center for Rare Diseases Ruhr (CeSER), 44791 Bochum, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
These authors contributed equally to this work.
Int. J. Mol. Sci. 2024, 25(19), 10867; https://doi.org/10.3390/ijms251910867
Submission received: 31 July 2024 / Revised: 16 September 2024 / Accepted: 2 October 2024 / Published: 9 October 2024
(This article belongs to the Special Issue Molecular and Neuromuscular Mechanisms in Skeletal Muscle Aging)

Abstract

Pathogenic variants in the ryanodine receptor 1 (RYR1) gene are causative for a wide spectrum of muscular phenotypes, ranging from malignant hyperthermia over mild, non-progressive to severe congenital myopathy. Both autosomal dominant and recessive inheritance can occur, with the more severe forms usually showing recessive inheritance. However, genotype–phenotype correlations are complicated due to the large size of the gene and heterogeneous phenotypes. We present a 6-year-old patient with severe congenital myopathy, carrying a heterozygous pathogenic RYR1 variant inherited from the healthy mother. Through whole genome sequencing we identified a second, deep intronic RYR1 variant that has recently been described in another patient with severe congenital myopathy and shown to affect splicing. Segregation analyses confirmed the variants to be compound heterozygous. We compared our patient’s phenotype to that of the patient from the literature as well as five additional patients with compound heterozygous RYR1 variants from our center. The main overlapping features comprised congenital onset, predominant muscular hypotonia, and normal creatine kinase (CK) levels, while overall clinical expression varied substantially. Interestingly, both patients carrying the new intronic splice variant showed a very severe disease course. More widespread use of genome sequencing will open the way for better genotype–phenotype correlations.
Keywords: ryanodine receptor 1 (RYR1); whole genome sequencing (WGS); congenital myopathy; splice variant; RYR1-related myopathies ryanodine receptor 1 (RYR1); whole genome sequencing (WGS); congenital myopathy; splice variant; RYR1-related myopathies

Share and Cite

MDPI and ACS Style

Janßen, S.; Erbe, L.S.S.; Kneifel, M.; Vorgerd, M.; Döring, K.; Lubieniecki, K.P.; Lubieniecka, J.M.; Gerding, W.M.M.; Casadei, N.; Güttsches, A.-K.; et al. Compound Heterozygous RYR1 Variants in a Patient with Severe Congenital Myopathy: Case Report and Comparison with Additional Cases of Recessive RYR1-Related Myopathy. Int. J. Mol. Sci. 2024, 25, 10867. https://doi.org/10.3390/ijms251910867

AMA Style

Janßen S, Erbe LSS, Kneifel M, Vorgerd M, Döring K, Lubieniecki KP, Lubieniecka JM, Gerding WMM, Casadei N, Güttsches A-K, et al. Compound Heterozygous RYR1 Variants in a Patient with Severe Congenital Myopathy: Case Report and Comparison with Additional Cases of Recessive RYR1-Related Myopathy. International Journal of Molecular Sciences. 2024; 25(19):10867. https://doi.org/10.3390/ijms251910867

Chicago/Turabian Style

Janßen, Sören, Leoni S. Sabrina Erbe, Moritz Kneifel, Matthias Vorgerd, Kristina Döring, Krzysztof P. Lubieniecki, Joanna M. Lubieniecka, Wanda M. Maria Gerding, Nicolas Casadei, Anne-Katrin Güttsches, and et al. 2024. "Compound Heterozygous RYR1 Variants in a Patient with Severe Congenital Myopathy: Case Report and Comparison with Additional Cases of Recessive RYR1-Related Myopathy" International Journal of Molecular Sciences 25, no. 19: 10867. https://doi.org/10.3390/ijms251910867

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