临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (10): 791-.doi: 10.3969/j.issn.1000-3606.2019.10.018

• 罕见病 疑难病 • 上一篇    下一篇

婴儿遗传性铁粒幼细胞性贫血1 例报告

武双双,王玥,薛露,马翠, 陈显秋, 李春怀   

  1. 吉林大学第一医院(吉林长春 130021)
  • 发布日期:2020-01-22
  • 通讯作者: 李春怀 电子信箱:lichunhuai@126.com

Congenital sideroblastic anemia in infants: a case report and literature review 

WU Shuangshuang, WANG Yue, XUE Lu, MA Cui, CHEN Xianqiu, LI Chunhuai   

  1. Department of Pediatric Hematology, The First Hospital of Jilin University, Changchun 130021, Jilin, China
  • Published:2020-01-22

摘要:  目的 探讨婴儿遗传性铁粒幼细胞性贫血的基因变化、临床表现、诊断与治疗。方法 回顾分析1例婴儿期 发病的遗传性铁粒幼细胞性贫血患儿的临床资料。结果 男性5月龄婴儿,因面色苍白就诊;实验室检查示小细胞低色素 性贫血,血清铁58.30 μmol/L;骨髓涂片铁染色,外铁+++,内铁76%,其中环铁54%。高通量测序示ALAS2基因半合子突变, c.1565C>A;生物信息学软件预测显示为有害突变,可能影响蛋白质的功能;患儿母亲为杂合变异,属于X连锁隐性遗传; 查阅文献,未见报道。患儿临床确诊为遗传性铁粒幼细胞性贫血后,经维生素B6治疗有效。结论 遗传性铁粒幼细胞性贫 血罕见,新发现ALAS2基因的半合子突变致病基因。

关键词: 贫血; 遗传; 小细胞低色素; 铁粒幼细胞

Abstract: Objective To explore the genetic changes, clinical manifestations, diagnosis and treatment of congenital sideroblastic anemia in infants. Method The clinical data of congenital sideroblastic anemia in a child were retrospectively analyzed. Results A 5-month-old boy visited for pale complexion. Laboratory examination showed microcytic hypochromic anemia with serum iron of 58.30 μmol/L. Iron staining of bone marrow smears showed the outer iron was +++, and the inner iron accounted for 76%, of which the ring iron was 54%. High-throughput sequencing showed that the ALAS2 gene has a hemizygote mutation, C.1565C > A, which was predicted a harmful mutation by bioinformatics software and may affect the function of proteins. The mother of the child had a heterozygous mutation, which belonged to X-linked recessive inheritance. Literature was reviewed and no report was found. The child was clinically diagnosed with congenital sideroblastic anemia and was effectively treated with vitamin B6. Conclusion Congenital sideroblastic anemia is rare, and a novel hemizygous mutation in the ALAS2 gene has been found.

Key words: anemia; hereditary; small cell low pigment; sideroblastic