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7/27/2019 Ataxia-Telangiectasia Factsheet
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Ataxia-Telangiectasia Factsheet
Published October 2013 NCHPEGAll rights reserved
Clinical featuresAtaxia Telangiectasia (AT) is a rare inherited disorder that affects the nervous, immune, and other body systems. Individuals with AT
have progressive difficulty with coordinating movements (ataxia) beginning in early childhood, usually before age 5. Affected
children typically develop difficulty walking, problems with balance and hand coordination, chorea, myoclonus, and neuropathy.
Most children require a wheelchair by adolescence. People with AT also have slurred speech and oculomotor apraxia.
Telangiectasias often occur in the eyes and on the surface of the skin and are often present in early childhood.
People with AT often have a weakened immune system, and many develop chronic lung infections. They are also at an increased risk
of developing cancer, particularly leukemia and lymphoma. Affected individuals are very sensitive to the effects of radiation
exposure, including medical x-rays. Although people with AT usually live into adulthood, their life expectancy is reduced.
Diagnosis
Diagnosis of AT can be made through immunoblotting of the ATM protein or molecular genetic analysis. Generally, immunoblotting
is used for diagnosis, because of high sensitivity and specificity and lower cost than other testing modalities.
Genetics
AT is caused by variants in the ATM gene, which is normally involved in DNA repair.
Inheritance
AT inherited in an autosomal recessive pattern. Parents of an affected individual are obligate carriers of a single mutation. Siblings of
an affected individual have a 25%, or 1 in 4 chance to have AT, and a 50% chance to be carriers.
Carriers of an ATM mutation are not at risk to develop neurologic manifestations. However, carriers have 4 times the general
population risk for breast cancer, and an increased risk for leukemia. The mechanism of cancer susceptibility in carriers isincompletely understood, but is thought to be related to impaired DNA repair by the ATM protein.
Clinical testing
Immunoblotting for the ATM protein is the most sensitive and specific clinical test for establishing the diagnosis of A-T. Nearly 100%
of individuals with AT will have significantly reduced (usually absent) or non-functional ATM protein. Immunoblotting is also less
expensive than molecular genetic analysis.
Sequencing of the ATM gene identifies a variant in about 90% of affected individuals. Deletion and duplication analysis can identify
variants in an additional 1-2%. However, the effects of a given variant may be difficult to predict, and variants of uncertain clinical
significance are common. Genetic testing fails to identify both disease-causing mutations in about 5-10%. When both ATM variants
have been identified in an affected individual, testing for carrier status is available for relatives. Prenatal testing may also be
available.
Additional clinical testing such as serum AFP assessment and peripheral blood chromosome analysis may show elevated serum AFP
and peripheral blood 7;14 chromosome translocation, respectively. Such findings support the diagnosis of AT.
7/27/2019 Ataxia-Telangiectasia Factsheet
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Published October 2013 NCHPEGAll rights reserved
Management
Management of AT focuses on treating presenting symptoms, and prevention and surveillance of future manifestations. Treatment
may include intravenous immunoglobulin therapy, physical therapy, and medications to manage neurologic symptoms. Individuals
with AT are monitored for malignancy and should avoid ionizing radiation.
References
GeneReviews: Ataxia-Telangiectasia athttp://www.ncbi.nlm.nih.gov/books/NBK26468/
Genetics Home Reference: Ataxia-Telangiectasia athttp://ghr.nlm.nih.gov/condition/ataxia-telangiectasia
National Institute of Neurological Disorders and Stroke: NINDS Ataxia Telangiectasia Information Page athttp://www.ninds.nih.gov/disorders/a_t/a-t.htm
A-T Childrens Project athttp://www.atcp.org/
http://www.ncbi.nlm.nih.gov/books/NBK26468/http://www.ncbi.nlm.nih.gov/books/NBK26468/http://www.ncbi.nlm.nih.gov/books/NBK26468/http://ghr.nlm.nih.gov/condition/ataxia-telangiectasiahttp://ghr.nlm.nih.gov/condition/ataxia-telangiectasiahttp://ghr.nlm.nih.gov/condition/ataxia-telangiectasiahttp://www.ninds.nih.gov/disorders/a_t/a-t.htmhttp://www.ninds.nih.gov/disorders/a_t/a-t.htmhttp://www.atcp.org/http://www.atcp.org/http://www.atcp.org/http://www.atcp.org/http://www.ninds.nih.gov/disorders/a_t/a-t.htmhttp://ghr.nlm.nih.gov/condition/ataxia-telangiectasiahttp://www.ncbi.nlm.nih.gov/books/NBK26468/