临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (11): 852-.doi: 10.3969/j.issn.1000-3606.2018.11.012

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儿童遗传性球形红细胞增多症临床及 ANK1 基因突变分析#br#

张秀丽, 赵国柱, 唐家朋   

  1. 单县中心医院儿科(山东菏泽 274300)
  • 收稿日期:2018-11-15 出版日期:2018-11-15 发布日期:2018-11-15
  • 通讯作者: 张秀丽 E-mail:zhangxl258@126.com

Analysis of clinical phenotype and ANK1 gene mutations in patients with hereditary spherocytosis

 ZHANG Xiuli, ZHAO Guozhu, TANG Jiapeng   

  1. Shanxian Central Hospital, Department of Paediatrics,Heze 274300, Shandong, China
  • Received:2018-11-15 Online:2018-11-15 Published:2018-11-15

摘要: 目的 探讨儿童遗传性球形红细胞增多症的临床及遗传特点。方法 回顾分析3例遗传性球形红细胞增多症 患儿的临床资料。结果 男性2例、女性1例,年龄2岁7个月至4岁10个月,均以“贫血、黄疸”入院;临床表现为面色苍 白,皮肤巩膜黄染,肝脾肿大;血红蛋白低下,网织红细胞比例升高,总胆红素水平上升,外周血涂片发现患儿球形红细胞 比例均超过10%,红细胞渗透脆性实验阳性。基因检测发现3例患儿均存在ANK1基因突变,分别为c.830A>G(p.H277R), IVS3+1G>T以及c.955C>T(p.R319X),均是杂合突变,且IVS3+1G>T和c.955C>T突变未见报道。结论 基因检测可协 助明确诊断遗传性球形红细胞增多症,本次发现两个未见报道ANK1基因新突变。

Abstract: Objective To investigate the clinical and genetic features of three patients diagnosed with hereditary spherocytosis. Methods Clinical data of three patients with hereditary spherocytosis were collected, and genetic changes were identified by next generation sequencing, and Sanger sequencing was used to confirm mutations identified by sequencing. Results Three cases of patients (two boys and one girl) with anaemia and jaundice, aged from 2 year and 7 months to 4year and 10 months, were treated in the outpatient department in our hospital. The clinical manifestations included skin pallor, jaundice and hepatosplenomegaly, declined hemoglomin level, increased total bilirubin, and increased reticulocyte ratio. The percentage of spherical erythrocytes in the peripheral blood was more than 10%. Erythrocyte osmotic brittleness test was positive in three patients. Genetic analysis identified two heterogenous missense mutations c.830A>G(p.H277R) and c.955C>T (p.R319X) in the ANK1 gene in two children, and a splice mutation in another patient (IVS3+1G>T). Conclusions patient diagnosed with hereditary spherocytosis often has anemia and jaundice. ANK1 gene mutation is a common cause of the disease. We found two novel mutations that has not been reported.