J Am Acad Audiol 2017; 28(01): 080-090
DOI: 10.3766/jaaa.15112
Case Reports
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Detailed Audiological Evaluation of a Patient with Xeroderma Pigmentosum with Neural Degeneration

Danielle Mercer
*   Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA
,
Annette Hurley
†   Department of Communication Disorders, Louisiana State University Health Sciences Center, New Orleans, LA
,
Fern Tsien
*   Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA
› Author Affiliations
Further Information

Publication History

Publication Date:
26 June 2020 (online)

Abstract

Background:

Xeroderma pigmentosum (XP) is a rare autosomal recessive condition characterized by extreme sensitivity to ultraviolet light. Individuals with XP lack the ability to repair DNA (deoxyribonucleic acid) damage caused by ultraviolet radiation, leading to sunburn and increased susceptibility to skin cancers. Approximately 25% of patients also exhibit neural degeneration, which includes progressive mental deterioration, cortical thinning, and sensorineural hearing loss.

Purpose:

Herein, we describe the audiological and genetic findings in a patient with XP subtype D with neural degeneration and hearing loss.

Research Design:

This is a case report of a patient with XP subtype D, type 1 diabetes, and some clinical features typical of Charcot-Marie-Tooth disease.

Data Collection and Analysis:

We obtained audiological evaluations over a course of 11 yr, including serial audiograms, auditory processing disorders evaluations, and electrophysiological testing.

Results:

Hearing sensitivity has progressed from a unilateral mild high-frequency sensorineural hearing loss to a bilateral sloping moderate to severe/profound sensorineural hearing loss. In addition to the dramatic decline in hearing sensitivity, the patient demonstrates global auditory processing deficits, indicating a central component to his hearing loss.

Conclusion:

These findings emphasize the importance of the contribution of audiological evaluations to the diagnosis of a genetic disorder. Periodic evaluations of hearing sensitivity and auditory processing can provide information on disease progression in patients with XP with neural degeneration.

This study was presented as a poster at the American Society of Human Genetics conference in Boston, MA, October 24, 2013; and the American Academy of Audiology conference in Orlando, FL, March 28, 2014.


 
  • REFERENCES

  • Angeli S, Lin X, Liu XZ. 2012; Genetics of hearing and deafness. Anat Rec (Hoboken) 295 (11) 1812-1829
  • Balfour PB, Pillion JP, Gaskin AE. 1998; Distortion product otoacoustic emission and auditory brain stem response measures of pediatric sensorineural hearing loss with islands of normal sensitivity. Ear Hear 19 (06) 463-472
  • Barch M, Knutsen T, Spurbeck JL. 1997. The AGT Cytogenetics Laboratory Manual. 3rd ed. Philadelphia, PA: Lippincott-Raven;
  • Bellis T. 2003. Assessment and Management of Central Auditory Processing Disorders in the Educational Setting: From Science to Practice. 2nd ed. Clifton Park, NY: Delmar Learning;
  • Bowden NA, Beveridge NJ, Ashton KA, Baines KJ, Scott RJ. 2015; Understanding xeroderma pigmentosum complementation groups using gene expression profiling after UV-light exposure. Int J Mol Sci 16 (07) 15985-15996
  • Bradford PT, Goldstein AM, Tamura D, Khan SG, Ueda T, Boyle J, Oh KS, Imoto K, Inui H, Moriwaki S, Emmert S, Pike KM, Raziuddin A, Plona TM, DiGiovanna JJ, Tucker MA, Kraemer KH.. 2011; Cancer and neurologic degeneration in xeroderma pigmentosum: long term follow-up characterises the role of DNA repair. J Med Genet 48 (03) 168-176
  • Butinar D, Starr A, Zidar J, Koutsou P, Christodoulou K. 2008; Auditory nerve is affected in one of two different point mutations of the neurofilament light gene. Clin Neurophysiol 119 (02) 367-375
  • Butinar D, Zidar J, Leonardis L, Popovic M, Kalaydjieva L, Angelicheva D, Sininger Y, Keats B, Starr A.. 1999; Hereditary auditory, vestibular, motor, and sensory neuropathy in a Slovenian Roma (Gypsy) kindred. Ann Neurol 46 (01) 36-44
  • Halkud R, Shenoy AM, Naik SM, Chavan P, Sidappa KT, Biswas S. 2014; Xeroderma pigmentosum: clinicopathological review of the multiple oculocutaneous malignancies and complications. Indian J Surg Oncol 5 (02) 120-124
  • Hirai Y, Kodama Y, Moriwaki S, Noda A, Cullings HM, Macphee DG, Kodama K, Mabuchi K, Kraemer KH, Land CE, Nakamura N.. 2006; Heterozygous individuals bearing a founder mutation in the XPA DNA repair gene comprise nearly 1% of the Japanese population. Mutat Res 601 1–2 171-178
  • Howe B, Umrigar A, Tsien F. 2014; Chromosome preparation from cultured cells. J Vis Exp 83 (83) e50203
  • Jani-Acsadi A, Ounpuu S, Pierz K, Acsadi G. 2015; Pediatric Charcot-Marie-Tooth disease. Pediatr Clin North Am 62 (03) 767-786
  • Jerger J, Johnson K. 1988; Interactions of age, gender, and sensorineural hearing loss on ABR latency. Ear Hear 9 (04) 168-176
  • Keith RW. 2009 SCAN-3:C Tests for Auditory Processing Disorders for Children. San Antonio, TX: Pearson Clinical Assessment Group
  • Kharroubi AT, Darwish HM. 2015; Diabetes mellitus: the epidemic of the century. World J Diabetes 6 (06) 850-867
  • Kleijer WJ, Laugel V, Berneburg M, Nardo T, Fawcett H, Gratchev A, Jaspers NG, Sarasin A, Stefanini M, Lehmann AR. 2008; Incidence of DNA repair deficiency disorders in western Europe: xeroderma pigmentosum, Cockayne syndrome and trichothiodystrophy. DNA Repair (Amst) 7 (05) 744-750
  • Kovach MJ, Campbell KC, Herman K, Waggoner B, Gelber D, Hughes LF, Kimonis VE.. 2002; Anticipation in a unique family with Charcot-Marie-Tooth syndrome and deafness: delineation of the clinical features and review of the literature. Am J Med Genet 108 (04) 295-303
  • Kraemer KH, DiGiovanna JJ. 2014. Xeroderma pigmentosum. In: GeneReviews (Internet) Seattle, WA: University of Washington; http://www.ncbi.nlm.nih.gov/books/NBK1397/ . Accessed September 21, 2015
  • Lai JP, Liu YC, Alimchandani M, Liu Q, Aung PP, Matsuda K, Lee CC, Tsokos M, Hewitt S, Rushing EJ, Tamura D, Levens DL, Digiovanna JJ, Fine HA, Patronas N, Khan SG, Kleiner DE, Oberholtzer JC, Quezado MM, Kraemer KH.. 2013; The influence of DNA repair on neurological degeneration, cachexia, skin cancer and internal neoplasms: autopsy report of four xeroderma pigmentosum patients (XP-A, XP-C and XP-D). Acta Neuropathol Commun 1: 4-20
  • Lehmann AR, McGibbon D, Stefanini M. 2011; Xeroderma pigmentosum. Orphanet J Rare Dis 6: 70-75
  • Liu Z, Zhao W, Zhang Q, Lai L, Jiang S, Zhang J, Xu S.. 2015; Increased oxidative damage and reduced DNA repair enzyme XPD involvement in high glucose-mediated enhancement of levobupivacaine-induced neurotoxicity. Neurochem Res 40 (09) 1919-1928
  • Mareddy S, Reddy J, Babu S, Balan P. 2013; Xeroderma pigmentosum: man deprived of his right to light. ScientificWorldJournal 2013: 534752
  • Mercer D. 2015; Guidelines for audiologists on the benefits and limitations of genetic testing. Am J Audiol 24 (04) 451-461
  • National Institute of Neurological Disorders and Stroke (NINDS). 2015 Charcot-Marie-Tooth disease fact sheet. http://www.ninds.nih.gov/disorders/charcot_marie_tooth/detail_charcot_marie_tooth.htm . Accessed September 13, 2015
  • Patzkó A, Shy ME. 2011; Update on Charcot-Marie-Tooth disease. Curr Neurol Neurosci Rep 11 (01) 78-88
  • Rance G, Ryan MM, Bayliss K, Gill K, O’Sullivan C, Whitechurch M. 2012; Auditory function in children with Charcot-Marie-Tooth disease. Brain 135 (05) 1412-1422
  • Robbins JH, Kraemer KH, Lutzner MA, Festoff BW, Coon HG. 1974; Xeroderma pigmentosum: an inherited diseases with sun sensitivity, multiple cutaneous neoplasms, and abnormal DNA repair. Ann Intern Med 80 (02) 221-248
  • Saporta ASD, Sottile SL, Miller LJ, Feely SME, Siskind CE, Shy ME. 2011; Charcot-Marie-Tooth disease subtypes and genetic testing strategies. Ann Neurol 69 (01) 22-33
  • Satya-Murti S, Cacace AT, Hanson PA. 1979; Abnormal auditory evoked potentials in hereditary motor-sensory neuropathy. Ann Neurol 5 (05) 445-448
  • Siskind CE, Panchal S, Smith CO, Feely SM, Dalton JC, Schindler AB, Krajewski KM.. 2013; A review of genetic counseling for Charcot Marie Tooth disease (CMT). J Genet Couns 22 (04) 422-436
  • Starr A, Michalewski HJ, Zeng FG, Fujikawa-Brooks S, Linthicum F, Kim CS, Winnier D, Keats B.. 2003; Pathology and physiology of auditory neuropathy with a novel mutation in the MPZ gene (Tyr145→Ser). Brain 126 (07) 1604-1619
  • Starr A, Picton TW, Sininger Y, Hood LJ, Berlin CI. 1996; Auditory neuropathy. Brain 119 (03) 741-753
  • Sugimoto J, Kohyama J, Shimohira M, Iwakawa Y. 1999; Auditory brainstem responses in group A xeroderma pigmentosum. No To Hattatsu 31 (03) 276-279
  • Totonchy MB, Tamura D, Pantell MS, Zalewski C, Bradford PT, Merchant SN, Nadol J, Khan SG, Schiffmann R, Pierson TM, Wiggs E, Griffith AJ, DiGiovanna JJ, Kraemer KH, Brewer CC.. 2013; Auditory analysis of xeroderma pigmentosum 1971–2012: hearing function, sun sensitivity and DNA repair predict neurological degeneration. Brain 136 (01) 194-208
  • Viana LM, Seyyedi M, Brewer CC, Zalewski C, DiGiovanna JJ, Tamura D, Totonchy M, Kraemer KH, Nadol Jr JB. 2013; Histopathology of the inner ear in patients with xeroderma pigmentosum and neurologic degeneration. Otol Neurotol 34 (07) 1230-1236