临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (5): 360-.doi: 10.3969/j.issn.1000-3606.2019.05.009

• 综合报道 • 上一篇    下一篇

高胰岛素血症伴高氨血症综合征1 例报告并文献复习

魏巍1,2,陈瑶1,李娟1,丁宇1,黄晓东1,沈永年1,王剑1,王秀敏1   

  1. 1.上海交通大学医学院附属上海儿童医学中心(上海 200127);2.皖南医学院第一附属医院儿科 (安徽芜湖 241000)
  • 出版日期:2019-05-15 发布日期:2019-05-15
  • 通讯作者: 王秀敏 电子信箱:wangxiumin1019@126.com
  • 基金资助:
    上海交通大学医工交叉课题(No.YG2016QN39)

Hyperinsulinism-hyperammonemia syndrome: a case report and literature review

 WEI Wei1,2, CHEN Yao1, LI Juan1, DING Yu1, HUANG Xiaodong1, SHEN Yongnian1, WANG Jian1, WANG Xiumin1   

  1. 1.Shanghai Chindren’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2.The First Affiliated Hospital of Wannan Medical College, Wuhu 241000, Anhui, China
  • Online:2019-05-15 Published:2019-05-15

摘要:  目的 探讨GLUD1基因变异所致高胰岛素血症伴高氨血症综合征临床表现和致病基因特点。 方法 回顾分 析1例高胰岛素血症伴高氨血症综合征患儿的临床资料,并复习相关文献。结果 女性患儿, 1岁9个月起病,反复出现血 糖偏低 2 年余,并惊厥发作3次,给予升血糖、止惊对症处理后可缓解;伴血胰岛素、血氨水平升高,诊断为高胰岛素血 症伴高氨血症综合征。高通量测序发现患儿GLUD1基因存在错义变异c.965G>A,p.Arg322His(杂合),其父母该位点均 为正常基因型,为新生突变。结论 基因检测有助于明确高胰岛素血症伴高氨血症综合征诊断。

关键词:  高胰岛素血症; 高氨血症; GLUD 1基因; 高通量测序

Abstract:  Objective To investigate the pathogenesis, clinical manifestations and genetic characteristics of hyperinsulinism-hyperammonemia (HI/HA) syndrome caused by GLUD1 gene mutation. Method Clinical data of a case with HI/HA syndrome was retrospectively analyzed, and relevant literature was reviewed. Results The girl began to have repeated hypoglycemia since she was 1 year and nine months old. During the course of more than two years, convulsions had happened for 3 times which was recovered by elevated blood sugar and anticonvulsant therapy each time. Laboratory data showed that the level of blood insulin and ammonia was elevated, which was defined as HI/HA syndrome. High-throughput sequencing analysis revealed a de novo heterogeneous missense mutation (c.965G > A, p.Arg322His) in GLUD1 gene. Conclusion Gene detection could confirm the diagnosis of HI/HA syndrome.

Key words: hyperinsulinism; hyperammonemia; GLUD1 gene; high throughput sequencing technology