临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (5): 369-.doi: 10.3969/j.issn.1000-3606.2017.05.012

• 综合报道 • 上一篇    下一篇

先天性肌营养不良1A 型1 例临床与基因分析

江士远, 向娜   

  1. 单县海吉亚医院儿科(山东单县 274300)
  • 收稿日期:2017-05-15 出版日期:2017-05-15 发布日期:2017-05-15

Congenital muscular dystrophy type 1A: a report of one case with literature review

JIANG Shiyuan,XIANG Na   

  1. Department of Paediatrics,Shanxian Hygeia Hospital,Shanxian 274300,Shandong, China
  • Received:2017-05-15 Online:2017-05-15 Published:2017-05-15

摘要: 目的 报道1例LAMA2基因变异导致先天性肌营养不良的临床、实验室检查及遗传学特点。方法 回顾分 析1例先天性肌营养不良1A型患儿的临床资料,并复习相关文献。结果 患儿,男, 5岁2个月,临床表现为运动发育落后, 2岁时可独坐,不能独走;肌力及肌张力低下,早期出现关节挛缩。生化检测发现肌酸激酶(CK)升高(491 U/L),其同工 酶CK-MB升高(41.8 U/L);肌电图提示肌源性损害可能;头颅MRI提示大脑白质异常信号。基因检测发现LAMA2存在 复杂杂合突变,c.2045-2046delAG杂合缺失,来自母亲,为已报道的致病变异;exon5存在杂合缺失,来自父亲,为未报道 的新变异,软件功能预测提示为致病性变异。结论 LAMA2基因变异导致先天性肌营养不良,患儿以运动发育落后起病, CK升高,高通量基因检测有助于明确诊断。

Abstract: Objective To investigate the clinical features and genetic tests of a case with congenital muscular dystrophy type 1A (MDC1A). Methods Clinical data of proband were collected, and genetic change were tested using next generation sequencing, and literatures pertinent to the epidemiology, mechanisms, especially genetic testing of  lisencephaly were reviewed. Results A 5 year and 2 month old boy present with normal intelligence and delayed motor development, he can be sit alone but not walk at two years old. Physical examination showed normal mental reaction, muscular dystrophy, hypotonia, and joint contracture at early age. From biochemical tests, we found creatine kinase (CK) and CK-MB were increased (491U/L, 41.8U/L). EMG test suggested possible muscle-derived damage. Brain MRI showed white matter abnormality. And a heterozygous mutation (c.2045-2046delAG) inherited from his mother in LAMA2 gene, and another novel heterozygous mutation (del Exon5) inherited from his father were identified by genetic test. Conclusions LAMA2 gene deficiency can lead to MDC1A, and gene testing can help diagnosis.