A Síndrome de Kufor-Rakeb (SKR) é uma doença genética rara que afeta o sistema nervoso e piora com o tempo. Ela se manifesta por sintomas parecidos com os do Parkinson que surgem na juventude, problemas nos movimentos como a distonia (contrações musculares involuntárias que causam torções e posturas anormais), dificuldade para controlar os movimentos dos olhos e problemas de memória e raciocínio.
Introdução
O que você precisa saber de cara
A Síndrome de Kufor-Rakeb (SKR) é uma doença genética rara que afeta o sistema nervoso e piora com o tempo. Ela se manifesta por sintomas parecidos com os do Parkinson que surgem na juventude, problemas nos movimentos como a distonia (contrações musculares involuntárias que causam torções e posturas anormais), dificuldade para controlar os movimentos dos olhos e problemas de memória e raciocínio.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 36 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 78 características clínicas mais associadas, ordenadas por frequência.
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.
ATPase which acts as a lysosomal polyamine exporter with high affinity for spermine (PubMed:31996848). Also stimulates cellular uptake of polyamines and protects against polyamine toxicity (PubMed:31996848). Plays a role in intracellular cation homeostasis and the maintenance of neuronal integrity (PubMed:22186024). Contributes to cellular zinc homeostasis (PubMed:24603074). Confers cellular protection against Mn(2+) and Zn(2+) toxicity and mitochondrial stress (PubMed:26134396). Required for pr
Lysosome membraneLate endosome membraneEndosome, multivesicular body membraneCytoplasmic vesicle, autophagosome membrane
Kufor-Rakeb syndrome
A rare form of autosomal recessive juvenile or early-onset, levodopa-responsive parkinsonism. In addition to typical parkinsonian signs, clinical manifestations of Kufor-Rakeb syndrome include behavioral problems, facial tremor, pyramidal tract dysfunction, supranuclear gaze palsy, and dementia.
Variantes genéticas (ClinVar)
190 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 1,002 variantes classificadas pelo ClinVar.
Vias biológicas (Reactome)
1 via biológica associada aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Síndrome de Kufor-Rakeb
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Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
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Publicações mais relevantes
Kufor-Rakeb syndrome: a cohort-based clinical, imaging and genetic profile.
Lysosomal polyamine storage upon ATP13A2 loss impairs β-glucocerebrosidase via altered lysosomal pH and electrostatic hydrolase-lipid interactions.
ATP13A2 is an endolysosomal polyamine transporter mutated in several neurodegenerative conditions involving lysosomal defects, including Parkinson's disease (PD). While polyamines are polybasic and polycationic molecules that play pleiotropic cellular roles, their specific impact on lysosomal health is unknown. Here, we demonstrate lysosomal polyamine accumulation in ATP13A2 knockout (KO) cell lines and human induced pluripotent stem cell (iPSC)-derived neurons. Primary polyamine storage caused secondary storage of lysosomal anionic phospholipid bis(monoacylglycero)phosphate (BMP) and an age-dependent increase in the β-glucocerebrosidase (GCase) substrate glucosylsphingosine in Atp13a2 KO brains. Polyamine accumulation inhibited lysosomal GCase activity in cells, and this was reversed by lysosome reacidification or BMP supplementation. A liposome-based GCase assay utilizing physiological substrates demonstrated dose-dependent inhibition of BMP-stimulated GCase activity by polyamines, in part via a pH-independent, electrostatics-based mechanism. Therefore, excess polyamine compromises lysosomes by disrupting pH and electrostatic interactions between GCase and BMP that enable efficient substrate hydrolysis, potentially clarifying pathogenic mechanisms and suggesting convergence on PD-relevant pathways.
Quantitative Iron Measurements in the Basal Ganglia of NBIA Patients Using QSM: Insights From a Tertiary Center.
Neurodegeneration with brain iron accumulation (NBIA) comprises rare genetic disorders characterized by predominantly extrapyramidal symptoms and iron deposition in the basal ganglia. Conventional magnetic resonance imaging (MRI) detects qualitative changes but cannot accurately quantify iron accumulation. Quantitative susceptibility mapping (QSM) allows precise in vivo quantification of iron, providing insight into the pathophysiology of the disease. We studied 27 genetically confirmed NBIA patients and 11 age-matched healthy controls using susceptibility-weighted imaging (SWI) on a 3 Tesla MRI scanner. Basal ganglia regions of interest (ROIs) were manually delineated and QSM values were extracted. Sixteen NBIA patients and 11 controls were analyzed. QSM showed significantly higher iron in the globus pallidus (GP) (p = 0.008), with PKAN patients showing a 2.5-fold increase in GP iron (p = 0.001). MPAN patients showed 2.5 times higher iron in both GP and substantia nigra (SN). A GP iron level > 0.1133 ppm increased the likelihood of PKAN 18-fold. Atypical PKAN cases had 2.5 times higher SN iron levels compared to classic cases. QSM is a sensitive and noninvasive tool for detecting and quantifying iron accumulation in NBIA. The GP consistently showed the highest susceptibility values across subtypes, emphasizing its significant role in disease pathology. Distinct patterns of iron deposition in different NBIA subtypes may reflect subtype-specific mechanisms with diagnostic and therapeutic relevance. Age-related susceptibility changes were found to be significant, reinforcing the need to account for age when interpreting QSM data. More importantly, QSM may serve as a candidate biomarker for longitudinal disease monitoring in future clinical trials targeting disease-modifying therapies in NBIA.
Kufor-Rakeb Syndrome in a Guatemalan Patient With an ATP13A2 Gene Pathogenic Variant: A Case Report.
Parkinson's disease (PD) is a neurodegenerative condition characterized by progressive loss of dopaminergic neurons and by heterogeneous etiologies and clinical manifestations. Juvenile-onset forms are rare and can be caused by biallelic mutations in several genes. Kufor-Rakeb syndrome (KRS) is an autosomal-recessive form of early-onset parkinsonism caused by pathogenic variants in the ATP13A2 (PARK9) gene. This P5B-ATPase dysfunction impairs lysosomal processing, leading to the accumulation of α-synuclein. Here, we present the first documented Guatemalan case of KRS, a young woman with progressive motor and cognitive decline. Genetic testing identified a homozygous pathogenic variant in ATP13A2. This report underscores the importance of recognizing KRS in diverse populations and of using gene-based testing to guide diagnosis, counseling, and multidisciplinary supportive care.
C-Myc Indirectly Controls ATP13A2 Levels via HIF-1α Activation.
c-Myc is an essential transcription factor controlling an extensive range of intracellular processes, and the abnormal activity of c-Myc is associated with many different complex diseases, such as different types of cancer and neurodegenerative diseases. Understanding the regulatory functions of c-Myc has been challenging due to its intricate and multifaceted roles in cellular processes. The ATP13A2 (PARK9) gene encodes the ATP13A2 protein, which has important roles in lysosomal functions and metal ion transport. The association of ATP13A2 with Kufor-Rakeb Syndrome (KRS), as well as its role in Parkinson's disease, highlights its significance in maintaining cellular homeostasis. While our previous study indicated that c-Myc might play a role in the regulation of the ATP13A2 gene and its mutation linked to KRS, very little is known about the transcriptional regulation of the ATP13A2 gene. In this study, we identified potential c-Myc transcription factor binding sites on the ATP13A2 promoter and showed in vivo c-Myc binding using ChIP assay. qPCR and luciferase analyses revealed that the ATP13A2 transcription level was decreased upon 36 h of c-Myc overexpression. In contrast, western blot analysis revealed an increased ATP13A2 protein level under the same conditions. We further analyzed this discrepancy in a time-dependent manner, and results indicated that after c-Myc overexpression, ATP13A2 expression was markedly upregulated for the first 24 h, but this impact gradually decreased, returning to baseline levels by 72 h. Both HIF1α and p53 exhibited transient upregulation followed by a time-dependent decrease, suggesting that the initial increase in ATP13A2 may be regulated by c-Myc-driven HIF1α stabilization, which was supported by the elevated ATP13A2 expression and HIF1α stabilization by CoCl2 treatment. Prussian blue analysis indicated corresponding changes in intracellular iron accumulation with the temporal alterations in ATP13A2 expression. Our findings indicate that c-Myc indirectly causes an increased ATP13A2 expression by increasing HIF1α accumulation.
Publicações recentes
Clinical Evaluation of Three KRS Families and Cellular Analysis of Distinct ATP13A2 Mutations Reveal Different Levels of Iron Accumulation.
Progress in modelling ATP13A2-linked neurodegeneration.
Kufor-Rakeb syndrome: a cohort-based clinical, imaging and genetic profile.
Kufor-Rakeb Syndrome in a Guatemalan Patient With an ATP13A2 Gene Pathogenic Variant: A Case Report.
C-Myc Indirectly Controls ATP13A2 Levels via HIF-1α Activation.
📚 EuropePMC26 artigos no totalmostrando 81
Kufor-Rakeb syndrome: a cohort-based clinical, imaging and genetic profile.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyKufor-Rakeb Syndrome in a Guatemalan Patient With an ATP13A2 Gene Pathogenic Variant: A Case Report.
Case reports in geneticsC-Myc Indirectly Controls ATP13A2 Levels via HIF-1α Activation.
Journal of neurochemistryPhenotypic characterization of an Atp13a2 knockout rat model of Parkinson's disease.
NPJ Parkinson's diseaseLysosomal polyamine storage upon ATP13A2 loss impairs β-glucocerebrosidase via altered lysosomal pH and electrostatic hydrolase-lipid interactions.
Cell reportsQuantitative Iron Measurements in the Basal Ganglia of NBIA Patients Using QSM: Insights From a Tertiary Center.
Annals of clinical and translational neurologyCase Report: Novel ATP13A2 pathogenic variants associated with early-onset parkinsonism and a mini-review.
Frontiers in geneticsMotor Neuron Involvement in Two ATP13A2-Related Families: ALS And HSP-Like Phenotypes.
Movement disorders clinical practiceNigral ATP13A2 depletion induces Parkinson's disease-related neurodegeneration in a pilot study in non-human primates.
NPJ Parkinson's diseaseAdult-onset deletion of ATP13A2 in mice induces progressive nigrostriatal pathway dopaminergic degeneration and lysosomal abnormalities.
NPJ Parkinson's diseaseKufor-Rakeb syndrome-associated psychosis: a novel loss-of-function ATP13A2 variant and response to antipsychotic therapy.
NeurogeneticsEstimation of Ambulation and Survival in Neurodegeneration with Brain Iron Accumulation Disorders.
Movement disorders clinical practiceA novel ATP13A2 variant causing complicated hereditary spastic paraplegia.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyATP13A2 (PARK9) and basal ganglia function.
Frontiers in neurologyNeurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure.
Movement disorders : official journal of the Movement Disorder SocietyOlfactory status in neurodegeneration with brain iron accumulation disorders.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyDystonic Opisthotonus in Kufor-Rakeb Syndrome: Expanding the Phenotypic and Genotypic Spectrum.
Journal of movement disordersKufor Rakeb syndrome without gaze palsy and pyramidal signs due to novel ATP13A2 mutations.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical NeurophysiologyParkinson's disease-associated ATP13A2/PARK9 functions as a lysosomal H+,K+-ATPase.
Nature communicationsP5-ATPases: Structure, substrate specificities, and transport mechanisms.
Current opinion in structural biologyATP13A2 Gene Silencing in Drosophila Affects Autophagic Degradation of A53T Mutant α-Synuclein.
International journal of molecular sciencesATP13A2 modifies mitochondrial localization of overexpressed TOM20 to autolysosomal pathway.
PloS oneKufor Rakeb Syndrome with Novel Mutation and the Role of Deep Brain Stimulation.
Movement disorders clinical practiceTeaching Video NeuroImage: Facial-Faucial-Finger Myoclonus in Kufor-Rakeb Syndrome.
NeurologyStructural mechanisms for gating and ion selectivity of the human polyamine transporter ATP13A2.
Molecular cellNeuropathologic Findings in a Patient With Juvenile-Onset Levodopa-Responsive Parkinsonism Due to ATP13A2 Mutation.
NeurologyPallidal degenerations and related disorders: an update.
Journal of neural transmission (Vienna, Austria : 1996)Neurodegeneration with brain iron accumulation: Characterization of clinical, radiological, and genetic features of pediatric patients from Southern India.
Brain & developmentATP13A2 Regulates Cellular α-Synuclein Multimerization, Membrane Association, and Externalization.
International journal of molecular sciencesIdentification of a novel mutation in ATP13A2 associated with a complicated form of hereditary spastic paraplegia.
Neurology. GeneticsNovel mutations in ATP13A2 associated with mixed neurological presentations and iron toxicity due to nonsense-mediated decay.
Brain researchIntermediate phenotype of ATP13A2 mutation in two Chilean siblings: Towards a continuum between parkinsonism and hereditary spastic paraplegia.
Parkinsonism & related disordersAstrocytes Protect Human Dopaminergic Neurons from α-Synuclein Accumulation and Propagation.
The Journal of neuroscience : the official journal of the Society for NeurosciencePhenotypic assays in yeast and zebrafish reveal drugs that rescue ATP13A2 deficiency.
Brain communicationsAtaxia-myoclonus syndrome due to a novel homozygous ATP13A2 mutation.
Parkinsonism & related disordersDegeneration of dopaminergic neurons and impaired intracellular trafficking in Atp13a2 deficient zebrafish.
IBRO reportsDysregulated iron metabolism in C. elegans catp-6/ATP13A2 mutant impairs mitochondrial function.
Neurobiology of diseaseATP13A2 deficiency disrupts lysosomal polyamine export.
NatureClinical and genetic analysis of ATP13A2 in hereditary spastic paraplegia expands the phenotype.
Molecular genetics & genomic medicineKufor-Rakeb Syndrome/ Parkinson Disease Type 9.
Indian journal of pediatricsClinical and ultrastructural findings in an ataxic variant of Kufor-Rakeb syndrome.
Folia neuropathologicaOverexpression of human Atp13a2Isoform-1 protein protects cells against manganese and starvation-induced toxicity.
PloS oneYeast as a Tool for Deeper Understanding of Human Manganese-Related Diseases.
GenesSuccessful treatment of psychosis in a patient with Kufor-Rakeb syndrome with low dose aripiprazole: a case report.
NeurocaseFrom PARK9 to SPG78: The clinical spectrum of ATP13A2 mutations.
Parkinsonism & related disordersThe Parkinson-associated human P5B-ATPase ATP13A2 modifies lipid homeostasis.
Biochimica et biophysica acta. BiomembranesIncreased Lysosomal Exocytosis Induced by Lysosomal Ca2+ Channel Agonists Protects Human Dopaminergic Neurons from α-Synuclein Toxicity.
The Journal of neuroscience : the official journal of the Society for NeuroscienceMutations in ATP13A2 (PARK9) are associated with an amyotrophic lateral sclerosis-like phenotype, implicating this locus in further phenotypic expansion.
Human genomicsATP13A2 missense variant in Australian Cattle Dogs with late onset neuronal ceroid lipofuscinosis.
Molecular genetics and metabolismEmerging links between pediatric lysosomal storage diseases and adult parkinsonism.
Movement disorders : official journal of the Movement Disorder SocietyATP13A2 facilitates HDAC6 recruitment to lysosome to promote autophagosome-lysosome fusion.
The Journal of cell biologyKufor-Rakeb Syndrome/PARK9: One Novel and One Possible Recurring Ashkenazi ATP13A2 Mutation.
Journal of Parkinson's diseasePartial loss of ATP13A2 causes selective gliosis independent of robust lipofuscinosis.
Molecular and cellular neurosciencesSiblings with unusual presentation of early onset Parkinson's disease with dual heterozygous PARK2 and PARK 9 mutation.
Parkinsonism & related disordersOverlapping expression patterns and functions of three paralogous P5B ATPases in Caenorhabditis elegans.
PloS oneExacerbation of sensorimotor dysfunction in mice deficient in Atp13a2 and overexpressing human wildtype alpha-synuclein.
Behavioural brain researchAction Myoclonus and Seizure in Kufor-Rakeb Syndrome.
Movement disorders clinical practiceKufor-Rakeb Syndrome Due to a Novel ATP13A2 Mutation in 2 Chinese-American Brothers.
Movement disorders clinical practiceThe strategic function of the P5-ATPase ATP13A2 in toxic waste disposal.
Neurochemistry internationalLysosomal defects in ATP13A2 and GBA associated familial Parkinson's disease.
Journal of neural transmission (Vienna, Austria : 1996)The effect of manganese exposure in Atp13a2-deficient mice.
NeurotoxicologyATP13A2/PARK9 regulates endo-/lysosomal cargo sorting and proteostasis through a novel PI(3, 5)P2-mediated scaffolding function.
Human molecular geneticsLoss-of-function mutations in the ATP13A2/PARK9 gene cause complicated hereditary spastic paraplegia (SPG78).
Brain : a journal of neurologyLysosomal Storage of Subunit c of Mitochondrial ATP Synthase in Brain-Specific Atp13a2-Deficient Mice.
The American journal of pathologyPoster 298 Ataxia and Dysarthria in Two Siblings with Kufor-Rakeb Syndrome: A Case Report.
PM & R : the journal of injury, function, and rehabilitationEndolysosomal dysfunction in Parkinson's disease: Recent developments and future challenges.
Movement disorders : official journal of the Movement Disorder SocietyA diagnostic approach for neurodegeneration with brain iron accumulation: clinical features, genetics and brain imaging.
Arquivos de neuro-psiquiatria[GENETICALLY DETERMINED DISEASES ASSOCIATED WITH PATHOLOGICAL BRAIN IRON ACCUMULATION AND NEURODEGENERATION].
Ideggyogyaszati szemleExome Sequencing Identifies a Novel Homozygous Missense ATP13A2 Mutation.
Movement disorders clinical practiceProtection against Mitochondrial and Metal Toxicity Depends on Functional Lipid Binding Sites in ATP13A2.
Parkinson's diseaseLoss of ATP13A2 impairs glycolytic function in Kufor-Rakeb syndrome patient-derived cell models.
Parkinsonism & related disordersHereditary Parkinsonism-Associated Genetic Variations in PARK9 Locus Lead to Functional Impairment of ATPase Type 13A2.
Current protein & peptide scienceRegulation of ATP13A2 via PHD2-HIF1α Signaling Is Critical for Cellular Iron Homeostasis: Implications for Parkinson's Disease.
The Journal of neuroscience : the official journal of the Society for NeurosciencePathogenic LRRK2 mutations, through increased kinase activity, produce enlarged lysosomes with reduced degradative capacity and increase ATP13A2 expression.
Human molecular geneticsA lipid switch unlocks Parkinson's disease-associated ATP13A2.
Proceedings of the National Academy of Sciences of the United States of AmericaNeurodegeneration with Brain Iron Accumulation: Genetic Diversity and Pathophysiological Mechanisms.
Annual review of genomics and human geneticsFirst Report of Kufor-Rakeb Syndrome (PARK 9) from India, and a Novel Nonsense Mutation in ATP13A2 Gene.
Movement disorders clinical practiceThe Parkinson-associated human P5B-ATPase ATP13A2 protects against the iron-induced cytotoxicity.
Biochimica et biophysica actaThe role of ATP13A2 in Parkinson's disease: Clinical phenotypes and molecular mechanisms.
Movement disorders : official journal of the Movement Disorder Societyα-Synuclein-independent histopathological and motor deficits in mice lacking the endolysosomal Parkinsonism protein Atp13a2.
The Journal of neuroscience : the official journal of the Society for NeurosciencePeripheral neuropathy and parkinsonism: a large clinical and pathogenic spectrum.
Journal of the peripheral nervous system : JPNSAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Kufor-Rakeb syndrome: a cohort-based clinical, imaging and genetic profile.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology· 2026· PMID 41493629mais citado
- Lysosomal polyamine storage upon ATP13A2 loss impairs β-glucocerebrosidase via altered lysosomal pH and electrostatic hydrolase-lipid interactions.
- Quantitative Iron Measurements in the Basal Ganglia of NBIA Patients Using QSM: Insights From a Tertiary Center.
- Kufor-Rakeb Syndrome in a Guatemalan Patient With an ATP13A2 Gene Pathogenic Variant: A Case Report.
- C-Myc Indirectly Controls ATP13A2 Levels via HIF-1α Activation.
- Clinical Evaluation of Three KRS Families and Cellular Analysis of Distinct ATP13A2 Mutations Reveal Different Levels of Iron Accumulation.
- Progress in modelling ATP13A2-linked neurodegeneration.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:306674(Orphanet)
- OMIM OMIM:606693(OMIM)
- MONDO:0011706(MONDO)
- GARD:9174(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q6441908(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
