临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (11): 809-.doi: 10.3969/j.issn.1000-3606.2021.11.003

• 遗传代谢疾病专栏 • 上一篇    下一篇

PGK1 基因变异致磷酸甘油酸激酶1 缺乏症1 例临床与遗传学分析

孙明霞, 王艳萍, 华颖, 王健彪, 胡笑月, 张林, 马静波, 陈李兰   

  1. 无锡市儿童医院神经科(江苏无锡 214000)
  • 发布日期:2021-11-19
  • 通讯作者: 王艳萍 电子信箱: ypwang 591 @aliyun.com
  • 基金资助:
    无锡市卫生健康委科研青年项目(No.Q 201930);南京医科大学面上项目(No. 2015 NJMU 150)

Clinical and genetic analysis of a child with phosphoglycerate kinase 1 deficiency by PGK1 gene mutation

SUN Mingxia, WANG Yanping, HUA Ying , WANG Jianbiao, HU Xiaoyue, ZHANG Lin , MA Jingbo, CHEN Lilan   

  1. Department of Neurology, Chirdren’s Hospital of Wuxi, WuXi214000 , Jiangsu, China
  • Published:2021-11-19

摘要: 目的 探讨 PGK1 基因变异致Ⅸ型糖原累积病(磷酸甘油酸激酶 1 缺乏症)的临床特点及诊疗方法。 方法 回顾分析1例磷酸甘油酸激酶1缺乏患儿临床资料,分析其临床特点及实验室检查结果,采用二代测序分析基因变 异筛查结果。结果 患儿男性,3岁11个月首次就诊。患儿每次均以抽搐起病,起病后病情迅速加重,出现反复抽搐发作, 每次病程中均有溶血性贫血,第三次住院期间出现严重的横纹肌溶解症,且发病后有明显的智力、运动发育落后,基因检 测显示患儿PGK 1基因错义变异(c. 150 C>G),该变异导致第 50 号氨基酸由Cys变为Trp,来自于母亲,其母为杂合子,符 合 X 连锁隐性遗传方式,既往文献及数据库未见报道。根据ACMG指南,此变异判定为可能致病性(基因检测时,尚未出 现横纹肌溶解症),后期结合临床表现及基因检测结果,确诊为PGK 1缺乏。结论 磷酸甘油酸激酶缺乏症是一类罕见的 X连锁隐性遗传病,由PGK 1基因变异所致,该变异未见报道,扩充了Ⅸ型糖原累积病基因变异数据库。

关键词: 磷酸甘油酸激酶1缺乏; PGK 1基因; 基因变异

Abstract: Objective To explore the clinical features and diagnosis of the type Ⅸ glycogen accumulation disease (phosphoglyceric acid kinase 1 deficiency) resulted from PGK 1 mutation. Methods Clinical traits, laboratory test results, and gene mutation screening by next-generation sequencing of a pediatric case with phosphoglyceric acid kinase 1 deficiency admitted to our hospital were retrospectively analyzed. Results A 3 years and 11 months old boy firstly came to our hospital for a sudden twitching onset, followed by rapid progression. He was attacked by recurrent twitching along with hemolytic anemia. During the third hospitalization, the boy developed the symptom of severe rhabdomyolysis, accompanied by obvious retardation of intelligence and motor developments. Genetic screening found a novel missense mutation (c.150 C>G, p.Cys 50 Trp) in PGK 1 which was inherited from his mother. According to ACMG guideline, the mutation can be classified as “likely pathogenic”. The boy was diagnosed with PGK 1 deficiency based on the clinical traits and genetic test results. Conclusion The phosphoglycerate kinase deficiency was a kind of rare X-linked recessive genetic disease caused by PGK 1 mutation, which can be confirmed by clinical features combing the result of PGK 1 gene mutation. To our knowledge, this mutation is first reported and meaningful for expanding the genetic mutation spectrum of PGK 1.

Key words: Phosphoglycerate kinase 1 deficiency; PGK 1 gene; gene mutation