Case report

Familial exploration: A novel association of Thr 60Pro mutations in the Transthyretin gene with familial amyloidosis polyneuropathy

  • Published: 22 May 2025
  • In this study, we present a rare case of familial amyloidosis polyneuropathy (FAP) caused by a novel mutation in the transthyretin protein (TTR) gene. A 40-year-old female patient presented with a complaint of numbness and weakness in both lower limbs that had persisted for a period of 18 months, accompanied by intermittent diarrhea. An analysis of her family history revealed that her father had succumbed to an instance of unexplained heart failure, while one of her siblings exhibited neurological symptoms of a comparable nature. A physical examination was conducted, which revealed sensory loss of distal symmetry, diminished tendon reflexes, and significant autonomic dysfunction. The skin biopsy revealed the presence of amyloid material deposits. Whole-exome sequencing revealed a novel mutation (c.179A>C, p.Thr60Pro), which replaces threonine with a proline at position 60 in the TTR gene. Subsequent screening revealed that other relatives carrying the same mutation also exhibited similar symptoms, thereby supporting the association between this mutation and FAP. This case underscores the significance of identifying novel TTR gene mutations, offers a novel perspective on the understanding of FAP, and posits that an early diagnosis and intervention are pivotal to enhance the prognosis.

    Citation: Guoyan Chen, Jing Gao, Ziyao Li, Jine He. Familial exploration: A novel association of Thr 60Pro mutations in the Transthyretin gene with familial amyloidosis polyneuropathy[J]. AIMS Allergy and Immunology, 2025, 9(2): 89-97. doi: 10.3934/Allergy.2025006

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  • In this study, we present a rare case of familial amyloidosis polyneuropathy (FAP) caused by a novel mutation in the transthyretin protein (TTR) gene. A 40-year-old female patient presented with a complaint of numbness and weakness in both lower limbs that had persisted for a period of 18 months, accompanied by intermittent diarrhea. An analysis of her family history revealed that her father had succumbed to an instance of unexplained heart failure, while one of her siblings exhibited neurological symptoms of a comparable nature. A physical examination was conducted, which revealed sensory loss of distal symmetry, diminished tendon reflexes, and significant autonomic dysfunction. The skin biopsy revealed the presence of amyloid material deposits. Whole-exome sequencing revealed a novel mutation (c.179A>C, p.Thr60Pro), which replaces threonine with a proline at position 60 in the TTR gene. Subsequent screening revealed that other relatives carrying the same mutation also exhibited similar symptoms, thereby supporting the association between this mutation and FAP. This case underscores the significance of identifying novel TTR gene mutations, offers a novel perspective on the understanding of FAP, and posits that an early diagnosis and intervention are pivotal to enhance the prognosis.



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    Conflicts of interest



    The authors declare that they have no conflicts of interest.

    Author contributions



    Guoyan Chen conducted patient admission, medical history collection, physical examinations, and auxiliary examinations; drafted the initial manuscript. Jing Gao organized clinical data and analyzed case characteristics. Ziyao Li performed data analysis and interpretation of results; assisted in data organization. Jine He designed the research framework, reviewed the full manuscript, coordinated the submission process, and ensured the integrity of the study.

    Ethics approval of research



    This research has received ethical approval by the Ethics Commision of Yanan University Affiliated Hospital (IIT-R-20250066). A Written informed consent was obtained from the patient.

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