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Clinical manifestations and AR gene mutations in Kennedy’s disease

  • Xiaomin LiuEmail author
  • Meijia Zhu
  • Xiuhua Li
  • Jiyou TangEmail author
Original Article
  • 35 Downloads

Abstract

Kennedy’s disease, resulted from the expansion of a CAG repeat in exon 1 of androgen receptor (AR) gene, is a motor neuron degenerative disease in the brainstem and spinal cord with the slow development of facial, bulbar, and limb muscle degeneration. To investigate the clinical manifestations and gene mutations in Han Chinese patients with Kennedy’s disease. The clinical manifestations of 5 male Han Chinese patients including 2 probands and their relatives from 2 families and 1 sporadic case were retrospectively studied. The CAG repeats in the first exon of AR were screened in 5 Han Chinese people including 2 probands and their healthy relatives from 2 families and 1 sporadic case by polymerase chain reaction (PCR) and direct sequencing. The average age at onset of Kennedy’s disease was 48.20 ± 8.70 (mean ± SD) years and the average duration was 7.60 ± 5.32 years. All the patients showed slow onset and progressive weakness, wasting, and fasciculations of the whole body. Four patients demonstrated decreased fertility and 1 patient showed mild gynecomastia. Serum creatine kinase and testosterone levels were elevated mildly in 2 and 1 patients, respectively. The electromyogram showed neurogenic abnormalities. Muscle magnetic resonance demonstrated reduced muscle volume and fatty infiltration. Three different enlarged CAG domains were discovered in the 2 families and 1 sporadic patient with Kennedy’s disease, and the CAG repeat number was 48, 43, and 44, respectively. The clinical manifestations of Kennedy’s disease in Han Chinese middle-aged men were progressive weakness and atrophy in the bulbar and spinal muscles, occasionally demonstrating incomplete androgen insensitivity syndrome. These patients were also characterized with enlarged CAG repeat number in the first exon of AR, indicating that CAG number could be used in the diagnosis of Han Chinese patients with Kennedy’s disease.

Keywords

Kennedy’s disease Clinical features Androgen receptor gene CAG repeat sequence 

Notes

Acknowledgments

We thank the family members for participating in the study and the referring physicians of the patients.

Funding

This study was supported by grant ZR2013HQ016 from the Natural Scientific Foundation of Shandong Province and grant 2015GGH318011 from the Key Research and Development Project of Shandong Province.

Compliance with ethical standards

This retrospective study was approved and supported by the ethical committee of Shandong University, Shandong province, China.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurology, Qianfoshan HospitalShandong UniversityJinanPeople’s Republic of China

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