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Neurology

University of Vermont

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2022

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A Family With Neuropathies And An Mfn2 Variant, Leah Miller Jan 2022

A Family With Neuropathies And An Mfn2 Variant, Leah Miller

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

BACKGROUND: The axonal subtype of Charcot-Marie-Tooth (CMT2A) is commonly caused by dominant mutations in MFN2, which encodes a protein involved in mitochondrial dynamics and axonal transport. Over 100 variants in MFN2 are reportedly pathogenic. MFN2 dysfunction yields heterogenous neuropathies which can include optic atrophy, dysautonomia and diaphragmatic/airway dysfunction.

CASE REPORT: A 52-year-old man presented with a 10-year history of burning forefoot dysthesias and orthostasis. His examination revealed reduced sensation to light touch and pinprick distally with preserved strength and reflexes. NCS/EMG demonstrated mild, symmetric axonal polyneuropathy. Autonomic testing revealed orthostatic tachycardia and postganglionic sudomotor dysfunction. Laboratory evaluation for common causes …