临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (12): 889-.doi: 10.3969/j.issn.1000-3606.2019.12.003

• 遗传、代谢、内分泌疾病专栏 • 上一篇    下一篇

新生儿筛查确诊甲硫氨酸腺苷转移酶Ⅰ / Ⅲ缺陷症5 例临床分析

张志蕾, 孙云, 王彦云, 马定远, 程威, 蒋涛   

  1. 南京医科大学附属妇产医院(南京市妇幼保健院)( 江苏南京 210004)
  • 发布日期:2020-02-03
  • 通讯作者: 蒋涛 电子信箱:jiangtao6310@126.com
  • 基金资助:
    江苏省妇幼健康重点人才项目(No. FRC201747)

Clinical analysis of methionine adenosyltransferase Ⅰ / Ⅲ deficiency in 5 confirmed cases in neonatal screening

ZHANG Zhilei, SUN Yun, Wang Yanyun, MA Dingyuan, CHENG Wei, JIANG Tao   

  1. Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, Jiangsu, China
  • Published:2020-02-03

摘要: 目的 探讨甲硫氨酸腺苷转移酶Ⅰ/Ⅲ缺陷症的临床和基因变异特点。方法 回顾分析串联质谱新生儿筛查 发现的5例甲硫氨酸腺苷转移酶Ⅰ/Ⅲ缺陷患儿的临床资料及基因检测。结果 22万例新生儿筛查中发现甲硫氨酸腺苷 转移酶Ⅰ/Ⅲ缺陷5例,发病率为1/44000。 5例患儿中, 3例血甲硫氨酸在70~150 μmol/L之间。基因检测2例符合常染色 体显性遗传、 1例符合常染色体隐性遗传。 3例随访至今预后良好,另2例血甲硫氨酸持续>500 μmol/L;予以特殊饮食治疗, 1例头颅磁共振成像和肝功能异常, 1例伴有微缺失综合征,发育落后。结论 甲硫氨酸腺苷转移酶Ⅰ/Ⅲ缺陷可通过串联 质谱新生儿筛查结合基因检测而早期诊断,需要长期随访。

关键词: 串联质谱; 甲硫氨酸腺苷转移酶Ⅰ/Ⅲ缺陷; MAT1A基因; 随访

Abstract: Objective To explore the clinical and gene variation characteristics of methionine adenosyltransferase Ⅰ/Ⅲ deficiency. Methods The clinical data and gene detection of methionine adenosyltransferase Ⅰ/Ⅲ deficiency in 5 newborns found by tandem mass spectrometry in neonatal screening were retrospectively analyzed. Results In the 220000 newborns screened, 5 cases of methionine adenosyltransferase Ⅰ/Ⅲ deficiency were found and an incidence rate was 1/44000. In the 5 newborns, the concentrations of methionine were 70~150 μmol/L in 3 newborns, among whom 2 were autosomal dominant inheritance and one was autosomal recessive inheritance and all of them had a good prognosis. The blood methionine concentrations of the other 2 newborns were continuously greater than 500 μmol/L and they were autosomal recessive inheritance. These 2 newborns were treated with special diet. During follow-up, 1 patient had abnormal cranial magnetic resonance and abnormal liver function, and 1 patient had microdeletion syndrome and developmental retardation. Conclusion Methionine adenosyltransferase Ⅰ/Ⅲ deficiency can be diagnosed early by tandem mass spectrometry combined with gene detection and the disease requires long-term follow-up.

Key words:  tandem mass spectrometry; methionine adenosyltransferase Ⅰ/Ⅲ deficiency; MAT1A gene; follow-up