临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (8): 614-.doi: 10.3969/j.issn.1000-3606.2016.08.013

• 综合报道 • 上一篇    下一篇

X 染色体连续缺失致慢性肉芽肿病和 Mcleod 综合征 2 例报告并文献复习

贺建新 1, 郭雅洁 2, 冯雪莉 1, 王雷 3, 徐保平 1, 刘秀云 1, 申昆玲 1, 江载芳 1   

  1. 1. 首都医科大学附属北京儿童医院呼吸科(北京 100045);2. 首都医科大学附属北京儿童医院 儿科研究所中心实验室(北京 100045);3. 北京新世纪儿童医院内科(北京 100045)
  • 收稿日期:2016-08-15 出版日期:2016-08-15 发布日期:2016-08-15

Chronic granulomatous disease and Mcleod syndrome caused by continuous X chromosome deletion: a report of two cases and literature review

HE Jianxin1, GUO Yajie2, FENG Xueli1, WANG Lei3, XU Baoping1, LIU Xiuyun1, SHEN Kunling1, JIANG Zaifang1   

  1. 1. Department of Respiratory, Beijing Children’s Hospital, Beijing 100045, China; 2. Center Laboratory, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Beijing 100045, China; 3. Beijing New Century Children’s Hospital, Beijing 100045, China
  • Received:2016-08-15 Online:2016-08-15 Published:2016-08-15

摘要: 目的 探讨X染色体连续缺失所致的与X连锁慢性肉芽肿病(X-CGD)相关的Mcleod综合征的临床特征。方 法 回顾分析2例经基因分析诊断为Mcleod综合征和X连锁慢性肉芽肿病患儿的临床资料。结果 两例男性患儿分别为 4岁1个月及1岁9个月,均以迁延性肺内感染入院,既往有反复重症感染史,均有卡介苗相关淋巴结炎,因呼吸爆发缺陷 和CYBB基因全外显子缺失明确诊断为X连锁慢性肉芽肿病。患儿同时有运动落后,用MLPA方法分别检测到DMD基因 外显子1-44及肌肉特异性启动子区及外显子1-2缺失,诊断为Duchenne型肌营养不良(DMD)。 例1外周血涂片有明显棘 状红细胞,例2 XK基因突变分析为全外显子缺失,诊断为Mcleod综合征。结论 X染色体连续缺失可导致Mcleod综合征 及DMD和X-CGD的组合,使病情复杂化。由于缺乏Kx抗原,反复输普通血会产生相关抗体,出现急骤的输血危象。

Abstract: Objective  To explore the clinical features of chronic granulomatous diseases and Mcleod syndrome caused  by continuous X chromosome deletion. Methods The clinical data of two children diagnosed as chronic granulomatous  disease and Mcleod syndrome by gene detection were retrospectively analyzed. Results Two males, 4 year 1 month and 1  year 9 month old, were both hospitalized due to persistent pulmonary infections. Both of them had a history of repeated severe  infections and BCG vaccine associated lymphadenitis, and were diagnosed as X-linked chronic granulomatous disease for  respiratory burst defects and deletion of all CYBB exons. Both of them had retarded motor development, and were diagnosed  as DMD for detection of DMD gene exons and muscle specific promoter region and exon 1-2 deletion by MLPA. One case  was found with obvious echinocytes, the other case showed whole exons deletion of XK gene. Both of them were diagnosed as  Mcleod syndrome. Conclusion Continuous X chromosome deletion could lead to combination of Mcleod syndrome, DMD,  and X-CGD, which may complicate the condition. Due to the lack of Kx antigen, repeated common blood transfusion can  produce relative antibody, which lead to severe hemolytic crisis.