Andersen-Tawil syndrome: report of 3 novel mutations and high risk of symptomatic cardiac involvement

Muscle Nerve. 2015 Feb;51(2):192-6. doi: 10.1002/mus.24293. Epub 2014 Nov 19.

Abstract

Introduction: Andersen-Tawil syndrome (ATS) is a potassium channelopathy affecting cardiac and skeletal muscle. Periodic paralysis is a presenting symptom in some patients, whereas, in others, symptomatic arrhythmias or prolongation of QT in echocardiographic recordings will lead to diagnosis of ATS. Striking intrafamilial variability of expression of KCNJ2 mutations and rarity of the syndrome may lead to misdiagnosis.

Methods: We report 15 patients from 8 Polish families with ATS, including 3 with novel KCNJ2 mutations.

Results: All patients had dysmorphic features; periodic paralysis affected males more frequently than females (80% vs. 20%), and most attacks were normokalemic. Two patients (with T75M and T309I mutations) had aborted sudden cardiac death. An implantable cardioverter-defibrillator was utilized in 40% of cases.

Conclusions: KCNJ2 mutations cause a variable phenotype, with dysmorphic features seen in all patients studied, a high penetrance of periodic paralysis in males and ventricular arrhythmia with a risk of sudden cardiac death.

Keywords: KCNJ2; channelopathy; long QT; periodic paralysis; ventricular arrhythmia.

MeSH terms

  • Adolescent
  • Adult
  • Andersen Syndrome / complications*
  • Andersen Syndrome / genetics*
  • Andersen Syndrome / surgery
  • Child
  • DNA Mutational Analysis
  • Defibrillators, Implantable
  • Echocardiography
  • Female
  • Genetic Predisposition to Disease / genetics*
  • Heart Diseases / etiology*
  • Heart Diseases / genetics
  • Heart Diseases / surgery
  • Humans
  • Longitudinal Studies
  • Male
  • Mutation / genetics*
  • Paralyses, Familial Periodic / etiology
  • Paralyses, Familial Periodic / genetics
  • Poland
  • Potassium Channels, Inwardly Rectifying / genetics*
  • Retrospective Studies
  • Young Adult

Substances

  • KCNJ2 protein, human
  • Potassium Channels, Inwardly Rectifying