临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (8): 620-.doi: 10.3969/j.issn.1000-3606.2017.08.015

• 综合报道 • 上一篇    下一篇

先天性鱼鳞病样皮肤病变IPEX 1 例报告并文献复习

何庭艳, 夏宇, 梁芳芳, 罗颖, 贾实磊, 杨军   

  1. 深圳市儿童医院肾脏免疫科(广东深圳 518026)
  • 收稿日期:2017-08-15 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: 杨军 E-mail:rogasansz@163 .com
  • 基金资助:
    国家卫生部公益性行业科研专项(No. 20140212);深圳市科技创新项目(No.JCYJ 20160429174400950)

IPEX with congenital ichthyosiform skin lesions: a case report and literature review

HE Tingyan, XIA Yu, LIANG Fangfang, LUO Ying, JIA Shilei,YANG Jun   

  1. Kidney and Immunology Department, Children’s Hospital in Shenzhen, 518026, Guangdong, China
  • Received:2017-08-15 Online:2017-08-15 Published:2017-08-15

摘要: 目的 探讨X-连锁多内分泌腺病肠病伴免疫失调综合征(IPEX)的临床表型、治疗及预后。方法 回顾分 析1例以先天性鱼鳞病样皮肤病变起病的IPEX患儿临床资料,并复习相关文献。结果 患儿,男, 2个月11天,因鱼鳞样 皮疹伴头部渗血、双足渗液就诊,合并重症感染及消化道穿孔,最终死于多器官功能障碍综合征。住院期间行全基因组 外显子DNA检测,结果示FOXP3基因11号外显子c.1150G>A,p.A384>T半合子突变,其母亲为携带者,父亲无异常。 结论 早发顽固性腹泻、多发内分泌病及生长落后临床表型的婴儿需警惕IPEX,小婴儿出现鱼鳞样皮疹合并严重感染 时,亦需排查IPEX,基因测序有助于确诊此病。

Abstract: Objective To explore the clinical phenotype, treatment and prognosis of immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome, and to improve pediatricians' knowledge of this disease. Methods Clinical data of a case of IPEX with congenital ichthyosiform skin lesions were retrospectively analyzed, and related literatures China were reviewed. Results The 2-month-11-day old boy came to our hospital due to ichthyosiform skin lesions accompanied by blood oozing in the head and feet exudatation, with severe sepsis and gastrointestinal perforation. He was died of multiple organ failure. DNA sequencing of whole-genome exon group showed a hemizygous mutation of c.1150G> A, p.A384> T in FOXP3 gene. His mother was a heterozygous mutation carrier, while his father was normal. Conclusions In addition to typical symptoms including early-onset refractory diarrhea, multiple endocrine disease and growth retardation, IPEX should be considered also in infants with ichthyosiform rash and severe infection. Gene sequencing will help diagnose the disease.