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Heat shock protein 27 R127W mutation: evidence of a continuum between axonal Charcot–Marie–Tooth and distal hereditary motor neuropathy
  1. Paolo Solla1,
  2. Alessandro Vannelli1,
  3. Alessandra Bolino2,
  4. Giovanni Marrosu1,
  5. Silvia Coviello2,
  6. Maria Rita Murru1,
  7. Stefania Tranquilli1,
  8. Daniela Corongiu1,
  9. Sara Benedetti3,
  10. Maria Giovanna Marrosu1
  1. 1Centro Sclerosi Multipla, Ospedale Binaghi, University of Cagliari, Cagliari, Italy
  2. 2San Raffaele Scientific Institute, Milan, Italy
  3. 3Laboratory of Clinical Molecular Biology DIBIT 2, Diagnostic and Research San Raffaele, Milan, Italy
  1. Correspondence toPaolo Solla, Maria Giovanna Marrosu, Centro Sclerosi Multipla, Ospedale Binaghi, University of Cagliari, Via Is Guadazzonis 2, Cagliari 09126, Italy; paosol29{at}, gmarrosu{at}


Background Heat shock protein 27 (HSP27) mutations have been reported to cause both Charcot-Marie-Tooth disease (CMT) type 2F and distal hereditary motor neuropathy (dHMN) although never previously in a single family.

Objective To analyse clinical and electrophysiological findings obtained in a single large Sardinian family bearing the HSP27 R127W mutation.

Methods Twenty-one members of a five generation Sardinian family have been studied, including thirteen members affected by peroneal muscular atrophy and proved heterozygous for the known HSP27 R127W mutation. Twelve patients and eight unaffected relatives were subjected to clinical examination. A standardised electrophysiological study was performed in eleven patients and six unaffected relatives.

Results Mean age at onset (±SD) was 31.2±7.2 years. Mean age at investigation was 45.2±12.9 years and mean disease duration at the time of investigation was 14±12.9 years. According to current criteria for CMT2 and dHMN, of the 10 patients who had undergone both clinical and neurophysiological examination, five were diagnosed as CMT2, two as dHMN and a further two patients were labelled as an intermediate type. Finally, due to the presence of spastic paraplegia, the index patient did not meet established criteria for the diagnosis of CMT or dHMN.

Discussion Findings obtained in the present study, broadening the spectrum of clinical manifestations of disorders associated with HSP27 mutations, support the hypothesis of a continuum between CMT2 and dHMN forms and suggest a possible common spectrum between these entities and several forms of CMT plus pyramidal features (HMSN V), providing important implications for molecular genetic testing.

  • genetics
  • hmsn (charcot-marie-tooth)
  • neuropathy
  • neurophysiol, clinical

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the university ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.