Neurological symptoms in Schimke immuno-osseous dysplasia in a 11-year-old girl: a case report

Abstract

Background: Schimke immuno-osseous dysplasia (SIOD, OMIM 242900) is a rare, autosomal recessive, pleiotropic disease caused by mutations in the SMARCAL1 gene. SIOD is characterized by a triad of symptoms, i.e., progressive kidney disease due to focal segmen- tal glomerulosclerosis (FSGS), spondyloepiphyseal dysplasia and T-cell immunodeficiency. Additionally, heterogeneous neurological symptoms are often observed in the course of the syndrome. Case: The authors describe the case of a 14-year-old girl with SIOD, who presented with recurrent neurological symptoms, such as migraine-like headaches, diplopia and seizures. She was born at 34 weeks of pregnancy with hypotrophy (1280 g) and short stature (44 cm). Nephrotic-range proteinuria, the first symptom of the disease, was detected at the age of 4 and a half years. Significant immunodeficiency was also observed. She was finally diagnosed with Schimke immuno-osseous dysplasia on account of two pat- hogenic variants, c.836T>C (p.F279S) and c.2542G>T (p.E848X) identified in the SMARCAL1 gene. Conclusions: This report describes the clinical features and neuroimaging findings of a patient with SIOD. It also presents a possible correlation between neurological events and the Schimke disease, which should be considered during the diagnostic process.