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From the Departments of Neurology (Drs. Gamez and Cervera), Gastroenterology (Drs. Accarino and Guarner), Neurophysiology (Dr. Raguer), and CIBBM (Dr. Andreu), Hospital Gral, Vall dHebron, Barcelona, Spain; and Department of Neurology (Drs. Martí and Hirano, and C. Ferreiro and S. Tadesse), Columbia University College of Physicians and Surgeons, New York, NY.
Address correspondence and reprint requests to Dr. M. Hirano, Department of Neurology, Columbia University College of Physicians and Surgeons, 630 W. 168th St., P & S 4-443, New York, NY 10032; e-mail: mh29{at}Columbia.edu
Clinical, biochemical, and genetic features of a Spanish family with mitochondrial neurogastrointestinal encephalomyopathy are reported. The proband presented with severe gastrointestinal dysmotility and the affected sister had extraocular muscle weakness. In both affected individuals, biochemical defects of thymidine phosphorylase and a pathogenic G-to-A transition mutation at nucleotide 435 in the thymidine phosphorylase gene were identified. The first thymidine phosphorylase mutation identified in Spain showed phenotypic variability at onset.
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