临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (5): 388-.doi: 10.3969/j.issn.1000-3606.2019.05.016

• 综合报道 • 上一篇    下一篇

20p12.2 缺失致Alagille 综合征患儿临床和肝脏病理分析

姜涛,欧阳文献,谭艳芳,康桢,李双杰   

  1. 湖南省儿童医院肝病中心(湖南长沙 410007)
  • 出版日期:2019-05-15 发布日期:2019-05-15

Clinical and hepatic pathological analysis of children with Alagille syndrome caused by 20p12.2 deletion

 JIANG Tao, OUYANG Wenxian, TAN Yanfang, Kang Zhen,LI Shuangjie   

  1. Department of Hepatopathy Center, Hunan Children's Hospital, Changsha 410000, Hunan, China
  • Online:2019-05-15 Published:2019-05-15

摘要: 目的 分析20p12缺失致Alagille综合征(ALGS)患儿的临床表现和肝脏病理。 方法 回顾分析1例20p12 微缺失致ALGS患儿的临床资料。 结果 患儿,男, 1月龄起病,以胆汁淤积为首发表现,伴特殊面容,蝶形椎,肾脏和心 脏病变;肝脏穿刺术病理学检测提示肝脏淤胆改变,肝细胞中度损害(G2S3),无胆管减少表现。采集患儿及父母血标本, 采用二代基因测序检测发现chr20p12.2:( 9288462-10654178)处1.36 Mb的杂合缺失,缺失片段中包含JAG1基因,为 新发突变。确诊后予以对症支持治疗,随访半年,患儿生长发育无异常,黄疸仍迁延不退,远期预后有待进一步随访。结 论 ALGS是一种常染色体显性遗传病,临床表现多样,基因检测和肝活检有助于诊断。

关键词: Alagille 综合征; 20p12.2缺失; JAG1基因; 临床表现; 肝脏病理

Abstract: Objective To analyze the clinical manifestations and liver pathology of child with Alagille syndrome (ALGS) caused by 20p12 deletion. Method Clinical data of one child with ALGS was retrospectively analyzed. Result A male patient was 1 month old at onset with cholestasis as the first manifestation, accompanied by special face, butterfly vertebra, kidney and heart disease. Pathological examination of liver biopsy showed liver cholestasis, moderate hepatic cell damage (G2S3) and no sign of bile duct reduction. The blood samples of this child and his parents were collected. The next generation gene sequencing detected a de novo 1.36 MB heterozygous deletion in 20p12.2 (9,288,462-10,654,178) which contained the JAG1 gene. After the diagnosis, he was given supportive treatment. After half a year of follow-up, the growth and development were normal. His jaundice was still prolonged. The long-term prognosis needs further follow-up. Conclusion ALGS is an autosomal dominant disease with diverse clinical manifestations. Genetic test and liver biopsy were helpful for diagnosis.

Key words: Alagille syndrome; 20p12.2 deletion; JAG1 gene; clinical manifestations; liver pathology