临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (2): 117-.doi: 10.3969/j.issn.1000-3606.2018.02.007

• 综合报道 • 上一篇    下一篇

Omenn 综合征临床表型及分子诊断#br#

袁建涛, 雷婷   

  1. 咸宁市第一人民医院检验科(湖北咸宁 437000)
  • 收稿日期:2018-02-15 出版日期:2018-02-15 发布日期:2018-02-15
  • 通讯作者: 袁建涛 E-mail:yuanjiantao_81@126.com

Analysis of clinical phenotype and genetic diagnosis in patients with Omenn syndrome

YUAN Jiantao, LEI Ting   

  1. Department of Clinincal Lab,The First Hospital of Xianning City, Xianning  437000, Hubei, China
  • Received:2018-02-15 Online:2018-02-15 Published:2018-02-15

摘要: 目的 探讨Omenn综合征的临床特点及其致病基因。方法 回顾分析2例Omenn综合征患儿的临床资料和 基因检测结果。结果 男女患儿各1例,分别为6个月、 8个月;均有反复感染、皮疹病史;免疫球蛋白水平均降低,CD8+ T 淋巴细胞降低,CD19+ B淋巴细胞严重降低,自然杀伤细胞数量升高。利用高通量测序方法对2例患儿及其家庭成员进行 免疫缺陷相关基因检测,并利用Sanger测序法验证,例1 的RAG1基因外显子2存在c.1211G>A(p.R404Q)纯合突变,分 别遗传自其父母,患儿叔叔亦为携带者。例2的 RAG2存在母源c.830A>G(p.Y277C)突变以及父源c.104G>C(p.G35A) 突变, 2个突变位点均未见报道,生物信息学预测2个突变均为可能致病性异常。结论 Omenn综合征患者发病年龄较早, 免疫功能低下。基因检测有利于早期诊断及遗传咨询。确认了2个可引起Omenn综合征的新突变。

Abstract:  Objective To investigate the clinical features and genetic change of Omenn syndrome. Method Clinical data of two sporadic patients with Omenn syndrome and their family members were collected, and next generation sequencing was used to analyze immunodeficiency associated genes. Results Two patients (one boy and one girl) had a history of recurrent infection and skin rash. The level of IgA, IgM and IgG was decreased. Both of them have a lower level of CD8+ T lymphocytes and CD19+ B lymphocytes, but the number of NK cells increased. Sequencing found a homozygous mutation (c.1211G>A) in RAG1 gene in the girl, and both her father and mother were heterogeneous carrier of this mutation. In the boy, we found novel compound heterozygous mutations, c.830A>G and c.104G>C in RAG2R gene, inherited from his mother and father, respectively. Bioinformatics predicts that these two mutations are likely to be pathogenic. Conclusions The age of Omenn syndrome onset was earlier, with compromised immunological function. Gene detection was helpful for early diagnosis. We found that two novel mutations in RAG2R could cause Omenn syndrome.