ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (5): 456-458.doi: 10.3969/j.issn.1674-3865.2017.05.031

• 病例报告 • 上一篇    下一篇

以转氨酶升高为主的多种酰基辅酶A脱氢酶缺乏症1例临床表现及基因分析

谭艳芳,欧阳文献,姜涛,唐莲,苏雨霞,李双杰   

  1. 410007 长沙,湖南省儿童医院肝病中心
  • 出版日期:2017-10-25 发布日期:2017-12-18
  • 通讯作者: 李双杰,E-mail:lesjie62@vip.sina.com
  • 作者简介:谭艳芳(1981-),女,医学硕士,主治医师。研究方向:小儿肝胆内科疾病的诊治

Clinical manifestation and gene analysis of multiple acyl-coa dehydrogenase deficiency with transaminase increase

TAN Yangfang, OUYANG Wenxian, JIANG Tao, TANG Lian,SU Yuxia,LI Shuangjie   

  1. Department of Hepatopathy Center, Hunan Children's Hospital, Changsha 410007, China
  • Online:2017-10-25 Published:2017-12-18

摘要:

目的
研究1例以转氨酶升高为主的多种酰基辅酶A脱氢酶缺乏症患者临床表现、实验室检查、肌肉活检及基因突变情况分析,并进行文献复习,为该病的早期诊断及治疗提供依据。
方法
收集1例7岁3月男性患儿的临床资料,采集患儿及父母血标本,采用二代基因测序检测致病基因,腓肠肌穿刺活检明确肌肉病变情况。
结果患儿肌肉活检电镜结果示肌纤维内大量脂滴沉积。基因测序结果显示患儿的ETFDH基因存在c.1773_1774 del AT p.(Cys592※)无义突变和c.389A>T p.(Asp130Val)错义突变,考虑为复合杂合突变,患儿父母分别为携带者。
结论
临床上有转氨酶升高为主伴有心肌酶升高、运动障碍者,应尽早进行分子遗传学检查,有条件者行腓肠肌肌肉活检术,可以为患儿家庭提供准确的遗传咨询和产前诊断。

关键词: 多种酰基辅酶A脱氢酶缺乏症, 脂质沉积性肌病, ETFDH基因, 儿童

Abstract: Objective:To study the clinical manifestations of the patients with multiple acyl-coa dehydrogenase deficiency with transaminase increase, the laboratory tests, muscle biopsy and gene mutations, and to review the literature in order to provide the evidence for the early diagnosis and treatment of the disease.
Methods;Collectthe clinical data of a boy aged 7 years and 3 months, and take the blood samples of the child and his parents. The second-generation gene sequencing was used to detect the pathogenic gene, and gastrocnemius muscle biopsy was used to find out the muscle condition.
Results:The electron microscopic results of the muscle biopsy showed that there was a lot of lipid droplets in the myofiber. The gene sequencing results showed that there were nonsense mutation of c.1773_1774 del AT p.(Cys592※) and missense mutation of c.389A>T p.(Asp130Val) in ETFDH genes of the child, which was considered to be complex heterozygous mutation. The parents were the carriers.
Conclusion:Clinically there are people with transaminase increase complicated with increase of myocardial enzymes and movement disorders, in whom molecular genetic examinations should be performed as soon as possible. The patients with suitable conditions should be given gastrocnemius muscle biopsy, which can provide accurate hereditary consultation and prenatal diagnosis for the family of the patient.

Key words: Multiple acyl-coa dehydrogenase deficiency, Lipid storage myopathy, ETFDH gene, Child