Identification of two novel compound heterozygous CLCN1 mutations associated with autosomal recessive myotonia congenita.

Objectives: Myotonia congenita (MC) is a rare genetic muscular disorder caused by CLCN1 mutations, which codes for skeletal muscle chloride channel CLC1. MC is characterized by impaired muscle relaxation after contraction resulting in muscle stiffness. This study aimed to identify the genetic etiology of a Chinese family affected with recessive MC. Methods: Whole exome sequencing was performed to identify the disease-associated variants. The candidate causal genes discovered by WES were then confirmed by Sanger sequencing and co-segregation analyses were also conducted. Results: Two novel compound heterozygous mutations in CLCN1 gene, p.D94Y (paternal allele) and p.Y206* (maternal allele), were successfully identified as the pathogenic mutations by whole-exome sequencing (WES). The mutations were confirmed with Sanger sequencing in the family members and cosegregated with the MC phenotype. The two mutations have not been reported in the HGMD, dbSNP, 1000 Genomes project, ClinVar database, ExAC, and gnomAD previously. Mutation p.D94Y is predicted to be deleterious by using in silico tools and p.Y206* is a nonsense mutation, causing protein synthesis termination. Conclusions: Molecular genetics analysis offers an accurate method for diagnosing MC. Our results expand the mutational spectrum of recessive MC.