临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (6): 467-.doi: 10.3969/j.issn.1000-3606.2020.06.016

• 综合报道 • 上一篇    下一篇

KMT2D 基因新发变异致Kabuki 综合征1 例报告

杨桂花 1, 孙艳芳 2, 李慧源 2, 龚强 2, 余艳 2, 汪静 2, 张五一 1   

  1. 1.张家界市人民医院儿科(湖南张家界 427000);2.长沙金域医学检验实验室临床基因组中心 (湖南长沙 410006)
  • 出版日期:2020-06-15 发布日期:2020-06-12
  • 通讯作者: 张五一 电子信箱:zjjzwy@126.com

Kabuki syndrome caused by a new mutation of KMT2D gene: a case report

YANG Guihua1, SUN Yanfang2, LI Huiyuan2, GONG Qiang2, YU Yan2, WANG Jing2, ZHANG Wuyi1   

  1. 1. Department of Pediatrics, Zhangjiajie People's Hospital, Zhangjiajie 427000, Hunan , China; 2. Clinical Genome Center of Changsha KingMed Center for Clinical Laboratory, Changsha 410006, Hunan, China
  • Online:2020-06-15 Published:2020-06-12

摘要: 目的 探讨Kabuki综合征基因变异,以及基因型与表型的相关性。方法 收集1例Kabuki综合征先证者的 临床资料,通过高通量基因测序、生物信息分析、数据库筛查等方法对疑似Kabuki综合征进行诊断。结果 患儿,男,10岁, 自出生后即反应低下,耳部反复感染,特殊面容(睑裂向外侧延长、下眼睑外1/3轻度外翻、弓形眉伴外侧1/3眉毛稀疏、 鼻尖扁平、鼻中隔较短、耳大而突出、牙齿萌出和排列异常、小下颌),肾功能异常,并逐渐进行性加重。基因检测分析明确 患儿KMT2D基因存在c.8214dupC(p.Phe2739fs)杂合变异,该变异尚未见文献报道,其父母该位点均未发生变异,为新 发变异;根据美国遗传学和基因组学学会指南(ACMG)综合分析该变异符合“致病”。 结论 高通量测序、生物信息学分 析有助于确诊Kabuki综合征;发现一个未见报道的KMT2D基因新变异。

关键词:  Kabuki综合征; KMT2D 基因; 新发突变

Abstract: Objective To explore the genetic mutation in Kabuki syndrome and the correlation between genotype and phenotype. Methods The clinical data of Kabuki syndrome in one proband were collected, and the suspected Kabuki syndrome was diagnosed by high-throughput gene sequencing, biological information analysis, database screening and other methods. Results A 10-year-old boy had slow response since birth, recurrent otitis media, and special facial features (long palpebral fissure extending laterally, eversion of the lateral third of the lower eyelid, arched eyebrows with lateral 1/3 sparse eyebrows, flat nasal tip, short septum of nose, large and prominent ears, abnormal eruption and arrangement of teeth, and micrognathia). The child had abnormal renal function with progressive aggravation. Genetic analysis confirmed that there was a heterozygous variation of c.8214dupC (p.Phe2739fs) in the KMT2D gene of the child, which has not been reported in the literature. No variation was found in this locus in the parents, and it was a new mutation. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, the comprehensive analysis of this variation revealed that it is consistent with "pathogenic". Conclusions High throughput sequencing and bioinformatics analysis are helpful for the diagnosis of Kabuki syndrome. A new mutation in KMT2D gene was found, which had not been reported before.

Key words:  Kabuki syndrome; KMT2D gene; new mutation