POLR3A-related syndrome complicated with cerebral abscesses: a case report and literature review

A review of 60 unrelated probands with <i>POLR3A</i>-related syndrome was conducted based on previously published cases. The analysis revealed no significant sex difference in disease occurrence. The median age of onset was approximately 8 years, with common initial symptoms including gait disturbance and cognitive developmental impairment. Neuroimaging findings indicated cerebral atrophy in 31 cases (66.0%) and white matter hypomyelination in 17 cases (34.7%). Among the reported genetic variants, c.1909 + 22G>A was the most prevalent, identified in 19 families (17.8%), followed by c.1771-6C>G in 9 families (6.4%). Furthermore, patients with different variant sites displayed heterogeneity in initial symptoms, clinical presentations, and imaging characteristics. This comprehensive review enhances the understanding of the phenotypic and genotypic spectrum of <i>POLR3A</i>-related syndrome.