临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (5): 385-.doi: 10.3969/j.issn.1000-3606.2019.05.015

• 综合报道 • 上一篇    下一篇

法布里病2 家系临床及遗传学分析

朱晓明,程首超,龚育红,卢思,赵红玲   

  1. 咸宁市中心医院(湖北咸宁 437000)
  • 出版日期:2019-05-15 发布日期:2019-05-15
  • 通讯作者: 朱晓明 电子信箱:zhuxiaoming_09@sina.com

Clinical features and genetic analysis of two cases with Anderson- Fabry syndrome

 ZHU Xiaoming, CHENG Shouchao, GONG Yuhong, LU Si, ZHAO Hongling   

  1. Xianning Central Hospital, Xianning 437000, Hubei, China
  • Online:2019-05-15 Published:2019-05-15

摘要: 目的 探讨法布里病的临床特点及其致病基因α-半乳糖苷酶A(GAL)的突变特点。方法 回顾分析2个 法布里病家系的临床资料及高通量测序结果,同时复习相关文献。结果 2个家系的男性先证者均在青少年期发病,以四 肢末端疼痛、少汗,听力异常起病;蛋白尿,肾功能异常;眼科检查示角膜基质浅层轮辐状浑浊;肾脏穿刺病理示足细胞 肿胀,泡沫样改变,或者局灶增生硬化性肾小球肾炎等改变;头颅MRI未见异常。基因检测发现先证者1的GLA基因存在 IVS6+3A>G剪接位点突变(半合子),突变遗传自母亲,其小姨亦存在同样突变,姐姐未见异常;功能研究显示,突变影 响mRNA加工成熟,导致GLA基因内含子6未被去除。先证者2的GLA基因检测到c.58G>A半合子突变,突变遗传自母亲, 为已知的致病性改变。结论 法布里病患者存在多器官异常,临床症状表现多样;基因检测有利于尽早确诊。

关键词: 法布里病; GLA基因;  临床特点; 基因分析

Abstract: Objective To investigate the clinical features of Anderson- Fabry syndrome and the mutation features of its pathogenic gene, GAL. Method The clinical manifestations and genetic tests of 2 cases with Fabry syndrome were retrospectively analyzed, and the related literatures were reviewed. The mutation analysis of two patients and their family members was conducted by next generation sequencing (NGS). Results Onset age of both patients were on adolescents. The initial symptoms were pain in the extremities, sweating, hearing loss, proteinuria, abnormal renal function and superficial corneal spoon like turbidity of corneal stroma. Pathological changes by renal biopsy showed changes in podocyte swelling, foam like changes, focal hyperplasia and sclerosing glomerulonephritis. Brain MRI was normal. NGS identified a hemizygous mutation IVS6+3A>G in patient 1 inherited from his mother, and the patient's aunt is also a mutation carrier, the old sister of this patient was normal. Functional studies show that this mutation affects mRNA maturity. NGS found a hemizygote mutation c.58G>A in patient 2 that inherited from his mother has been reported elsewhere. Conclusion Fabry disease patients have multiple organ abnormalities with varied manifestations, gene testing is conducive to the early diagnosis.

Key words: Fabry disease; GLA gene; clinical manifestations; genetic testing