TECPR2 mutation-associated respiratory dysregulation: More than central apnea

Pallavi P. Patwari*, Lisa F. Wolfe, Girish D. Sharma, Elizabeth Berry-Kravis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Children with rare genetic diseases that cause respiratory dysregulation are at particularly high mortality risk due to development of respiratory failure. The tectonin β-propeller-containing protein 2 (TECPR2) mutations are proposed to cause autophagy defect affecting axonal integrity and development of progressive neurodegenerative and neuromuscular disease. Published TECPR2 mutation cases have described a high prevalence of respiratory failure. We review respiratory pathology in previously published cases and a new case of a 5-year-old girl with previously undescribed TECPR2 mutation demonstrating progressive central apnea due to respiratory cycle dysregulation. This is the first TECPR2 mutation case to demonstrate an ataxic (Biot's) breathing pattern with consistently inconsistent inspiratory and expiratory times and with relatively intact chemoreception during sleep. Therefore, we propose that the central apnea index alone may not be the appropriate marker for mortality risk. Rather, the morbidity and mortality associated with TECPR2 mutations are multisystem in nature and this burden complicates the ultimate needs for ventilation support and prognosis.

Original languageEnglish (US)
Pages (from-to)977-982
Number of pages6
JournalJournal of Clinical Sleep Medicine
Issue number6
StatePublished - Jun 15 2020


  • Ataxic breathing
  • Autonomic dysregulation
  • Biot's breathing
  • Central apnea
  • Circadian rhythm disturbance
  • Respiratory

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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