PRMT7-related syndrome imitating mitochondrial disorder: A case report

Protein arginine methyltransferase 7 (PRMT7) is an enzyme that methylates arginine residues within protein substrates, influencing biological processes such as gene expression regulation, stress response, neuromuscular development, and adipogenesis. PRMT7-related syndrome is a neurodevelopmental disorder characterized by growth impairment, skeletal and endocrine abnormalities, hypotonia, digital and craniofacial malformations, seizures, and obesity. In murine models, PRMT7 has been shown to positively regulate mitochondrial dynamics, suggesting a potential role in mitochondrial function, particularly under stress conditions. Herein, we describe a child presenting with encephalopathy, recurrent seizures, myopathy, cerebral ischemia, and dysmorphic features. The child’s seizures worsened with sodium valproate, prompting suspicion of a mitochondrial disorder. Sodium valproate was discontinued, and anti-seizure medications were adjusted alongside the initiation of supportive treatment for mitochondrial disorder. Following these interventions, the child’s condition improved significantly. Genetic analysis identified a novel homozygous c.82C>T variant in the PRMT7 gene. This case underscores the role of PRMT7 in mitochondrial bioenergetics in humans.
- Kernohan KD, McBride A, Xi Y, et al. Loss of the arginine methyltranserase PRMT7 causes syndromic intellectual disability with microcephaly and brachydactyly. Clin Genet. 2017;91(5):708-716. doi: 10.1111/cge.12884
- Miranda TB, Miranda M, Frankel A, Clarke S. PRMT7 is a member of the protein arginine methyltransferase family with a distinct substrate specificity. J Biol Chem. 2004;279(22):22902-22907. doi: 10.1074/jbc.M312904200
- Jeong HJ, Lee HJ, Vuong TA, et al. Prmt7 deficiency causes reduced skeletal muscle oxidative metabolism and age-related obesity. Diabetes. 2016;65(7):1868-1882. doi: 10.2337/db15-1500
- Hwang JW, Cho Y, Bae GU, Kim SN, Kim YK. Protein arginine methyltransferases: Promising targets for cancer therapy. Exp Mol Med. 2021;53(5):788-808. doi: 10.1038/s12276-021-00613-y
- Pham HQ, Tao X, Yang Y. Protein arginine methylation in transcription and epigenetic regulation. Front Epigenetics Epigenomics. 2023;1:1-20. doi: 10.3389/freae.2023.12458320
- Halabelian L, Barsyte-Lovejoy D. Structure and function of protein arginine methyltransferase PRMT7. Life (Basel). 2021;11(8):768. doi: 10.3390/life11080768
- Cali E, Suri M, Scala M, et al. Biallelic PRMT7 pathogenic variants are associated with a recognizable syndromic neurodevelopmental disorder with short stature, obesity, and craniofacial and digital abnormalities. Genet Med. 2023;25(1):135-142. doi: 10.1016/j.gim.2022.09.016
- Lee SY, Vuong TA, So HK, et al. PRMT7 deficiency causes dysregulation of the HCN channels in the CA1 pyramidal cells and impairment of social behaviors. Exp Mol Med. 2020;52(4):604-614. doi: 10.1038/s12276-020-0417-x
- Acosta CH, Clemons GA, Citadin CT, et al. PRMT7 can prevent neurovascular uncoupling, blood-brain barrier permeability, and mitochondrial dysfunction in repetitive and mild traumatic brain injury. Exp Neurol. 2023;366:114445. doi: 10.1016/j.expneurol.2023.114445
- Song Y, Li T, Liu Z, et al. Inhibition of drp1 after traumatic brain injury provides brain protection and improves behavioral performance in rats. Chem Biol Interact. 2019;304:173-185. doi: 10.1016/j.cbi.2019.03.013
- Gao J, Wang L, Liu J, Xie F, Su B, Wang X. Abnormalities of mitochondrial dynamics in neurodegenerative diseases. Antioxidants (Basel). 2017;6(2):25. doi: 10.3390/antiox6020025
- Fischer TD, Hylin MJ, Zhao J, Moore AN, Waxham MN, Dash PK. Altered mitochondrial dynamics and TBI pathophysiology. Front Syst Neurosci. 2016;10:29. doi: 10.3389/fnsys.2016.00029
- Kim S, Han SC, Gallan AJ, Hayes JP. Neurometabolic indicators of mitochondrial dysfunction in repetitive mild traumatic brain injury. Concussion. 2017;2(3):CNC48. doi: 10.2217/cnc-2017-0013
- Chaudhry N, Patidar Y, Puri V. Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes unveiled by valproate. J Pediatr Neurosci. 2013;8(2):135-137. doi: 10.4103/1817-1745.117847