临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (10): 794-.doi: 10.3969/j.issn.1000-3606.2019.10.019

• 罕见病 疑难病 • 上一篇    下一篇

SLC25A15 基因复合杂合突变致HHH 综合征1 例报告并文献复习

毛莹莹,陈倩,姬辛娜,高志杰   

  1. 首都儿科研究所附属儿童医院神经内科(北京 100020)
  • 发布日期:2020-01-22
  • 通讯作者: 陈倩 电子信箱:chenqianxhl@163.com

HHH syndrome caused by SLC25A15 gene complex heterozygous mutation: a case report

MAO YingYing, CHEN Qian, JI Xinna, GAO Zhijie   

  1. Department of Neurology, Children’s Hospital of Capital Institute of Pediatrics, Beijing 100020, China
  • Published:2020-01-22

摘要:  目的 探讨高鸟氨酸血症-高氨血症-高同型瓜氨酸尿症(HHH综合征)的临床及基因突变特点。方法 回顾 分析1例HHH综合征患儿的临床资料,并复习文献。结果 患儿,女, 2岁2个月,平素厌食高蛋白食物。生后反应弱,独 走后出现共济失调,感染后加重。实验室检查示高氨血症、转氨酶升高及凝血异常。头颅MRI示半卵圆中心白质容积减少。 基因检测示患儿携带SLC25A15基因c.190T>C(p.Y64H)及c.278G>A(p.R93Q)复合杂合突变,分别来自表型正常的父母。 结论 HHH综合征临床表现以神经系统及肝脏受累为主要,需与其他尿素循环障碍及肝脏疾病相鉴别。

关键词:  高鸟氨酸血症-高氨血症-高同型瓜氨酸尿症综合征; 尿素循环障碍; SLC25A15; 共济失调

Abstract:  Objective To explore the clinical and gene mutation characteristics of hyperornithinemia-hyperammoniahyperhomocysteinuria (HHH syndrome). Methods The clinical data of HHH syndrome in a child were retrospectively analyzed and the literature was reviewed. Results A girl, aged 2 years and 2 months, had an aversion to high-protein foods. The child's reaction was weak after birth, and the ataxia occurred when she walked alone and was aggravated after infection. Laboratory tests showed hyperammonia, elevated transaminase and abnormal coagulation. Head MRI showed decreased white matter volume in the semioval center. The genetic test showed that the child carried compound heterozygous mutations of SLC25A15 gene, c.190T>C (p.Y64H) and c.278G>A (p.R93Q), which were derived from her parents with normal phenotype. Conclusion The main clinical manifestations of HHH syndrome are involvement of nervous system and liver, and required to be differentiated from other urea circulatory disorders and liver diseases. The newly discovered SLC25A15 gene locus mutation may be the pathogenic site of HHH syndrome.

Key words:  hyperornithinemia-hyperammonemia-homocitrullinuria syndrome; HHH syndrome; hyperammonemia;  urea cycle disorder; SLC25A15; ataxia