临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (7): 534-.doi: 10.3969/j.issn.1000-3606.2019.07.013

• 罕见病 疑难病 • 上一篇    下一篇

佩梅病2 家系临床及蛋白脂蛋白1 基因突变分析

胡恕香,蔡慧强,彭桂兰   

  1. 厦门市妇幼保健院儿童神经康复科(福建厦门 361003)
  • 发布日期:2019-07-18
  • 通讯作者: 胡恕香 电子信箱:husx715@163.com

Clinical manifestations and gene mutation analysis of proteolipid protein 1 in Pelizaeus-Merzbacher disease in two pedigrees

HU Shuxiang, CAI Huiqiang, PENG Guilan   

  1. Department of Pediatric Neurorehabilitation, Xiamen Maternal and Child Health Care Hospital, Xiamen 361003, Fujiang, China
  • Published:2019-07-18

摘要: 目的 探讨佩梅病的临床表现及蛋白脂蛋白1(PLP1)基因突变情况。方法 收集2例佩梅病先证者及其家 系成员的临床资料及基因分析结果。结果 2例先证者均为男性,均自幼发育落后,生后不久发现眼球震颤;先证者1在2 岁时出现阵发性痉挛发作并伴进行性消廋; 2例先证者的头颅磁共振成像(MRI)均显示脑白质发育落后,髓鞘形成不良。 2例先证者各有一兄长,均有类似表现。基因测序结果发现先证者1的PLP1 基因存在第2外显子c. 137T>C(p.Leu46Pro) 半合子突变;先证者2的PLP1 基因存在第2外显子c. 62C>T(p.Ala21Val)半合子突变。 2例先证者母亲的均表型正常, 但均存在与先证者相同的杂合变异; 2例先证者之兄均存在与先证者相同的半合子突变。 2例先证者突变位点未见报道, 且通过ACMG致病性分析,均证实为致病位点。结论 明确2家系PLP1基因突变与遗传特征,ClinVar数据库未收录该变 异位点,丰富了PLP1致病突变谱。

关键词: 佩梅病; 蛋白脂蛋白1基因; 基因突变

Abstract: Objective To explore the clinical manifestation of Pelizaeus-Merzbacher disease (PMD) and the mutation of protein lipoprotein 1 (PLP1) gene. Method Clinical data and genetic analysis of PMD in 2 probands and their family members were collected. Results Both of the two probands were male and had developmental retardation from childhood, and nystagmus was found shortly after birth. Paroxysmal spasm with progressive emaciation was developed in proband 1 at 2 years of age. Brain magnetic resonance imaging (MRI) of both probands showed white matter dysplasia and myelin sheath dysplasia. Each of the 2 probands had an elder brother with similar manifestations. Gene sequencing results showed that proband 1 had a hemizygous mutation, c. 137T > c (p.eu46pro), in exon 2 of the PLP1 gene and the proband 2 had a hemizygous mutation, c. 62C > T (p.ala21val), in exon 2 of the PLP1 gene. The mothers of the two probands had normal phenotype, but both of them had the same heterozygous variation as the probands; and the elder brother of both probands had the same hemizygote mutation as the probands. The mutation sites of 2 probands were not reported and confirmed as pathogenic sites by pathogenicity analysis of ACMG. Conclusion The mutation and genetic characteristics of PLP1 gene in two families were identified. The mutation site was not included in ClinVar database, and the findings enriched the pathogenic mutation spectrum of PLP1.

Key words: Pelizaeus-Merzbacher disease; proteolipid protein 1; gene mutation