临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (11): 867-.doi: 10.3969/j.issn.1000-3606.2020.11.015

• 综合报道 • 上一篇    下一篇

Williams-Beuren综合征伴肾上腺皮质功能减退1例临床及遗传学分析

常国营1, 李群1, 李娟1, 郭颖2, 章旭2, 王剑3, 王秀敏1   

  1. 上海交通大学医学院附属上海市儿童医学中心1 . 内分泌遗传代谢科, 2 . 心血管内科, 3 . 医学遗传科分子诊断实验室(上海 200127)
  • 出版日期:2020-11-15 发布日期:2020-11-06
  • 通讯作者: 李娟 电子信箱:ljuan_scmc@ 126 .com
  • 基金资助:
    国家自然科学基金青年项目(No.81900722);金磊儿科内分泌中青年医师成长科研基金资助项目(No.PEGRF 201709007)

Clinical and genetic analysis of a child with Williams-Beuren syndrome with adrenal insufficiency

CHANG Guoying1 , LI Qun1 , LI Juan1 , GUO Ying2 , ZHANG Xu2 , WANG Jian3 , WANG Xiumin3   

  1. 1 .Department of Endocrinology and Metabolism, 2 . Department of Cardiovascular Medicine, 3 . Department of Medical Genetics and Molecular Diagnostic Laboratory, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127 , China
  • Online:2020-11-15 Published:2020-11-06

摘要: 目的 分析Williams-Beuren综合征伴肾上腺皮质功能减退的临床特点及分子机制。方法 回顾分析1例 Williams-Beuren综合征伴肾上腺皮质功能减退患儿的临床资料,并复习相关文献。结果 男性患儿,1个月20天,呈精灵 样貌,全身色素沉着,皮纹褶皱处及口唇明显,心前区可及3/6级收缩期杂音,脐疝,外阴色素沉着,左侧阴囊内可及肿物 突出。血生化检查示高钾、高乳酸,皮质醇水平低,促肾上腺皮质激素高。彩色多普勒超声心动图示主动脉瓣上狭窄、肺动 脉分支狭窄、房间隔缺损II。超声示双侧腹股沟疝气,肾上腺超声及CT平扫未见明显异常。全外显子基因检测显示患儿染 色体7q11.23区域(chr 7:73,442,119 - 74,175,022)存在0 . 73 Mb的杂合缺失,该缺失部位包含15个基因。结论 患儿 具有Williams-Beuren综合征典型临床表现,同时存在肾上腺皮质功能减退,染色体7 q 11 . 23区域 0 .73 Mb杂合缺失是其 致病原因。

关键词: Williams-Beuren综合征; 肾上腺皮质功能减退; 染色体缺失

Abstract: Objective To analyze the clinical phenotypes and the genetic cause for a child with Williams-Beuren syndrome, and to explore its molecular mechanism. Methods The clinical data and genetic sequencing results of a child with Williams-Beuren syndrome who referred to our hospital with adrenal insufficiency were analyzed. Results The patient, one month and 20 days old boy, visted our clinic because of pigmentation in his whole body. He had a little elve face, pigmentation, which is especially evident in skin crease and his lip, 3 /6 cardiac murmur, umbilical hernia, pigmentation in vulva, and a mass in the left scrotum. The lab examination showed that hyperkalaemia, high level lactic acid, Endocrine hormone displayed a lowlevel cortisol and adrenocor ticotropic hormore was in a high level on feedback. The ultra sound of heart showed supravalvular aortic stenosis, pulmonary artery stenosis and atrial septal defect (II). Perineum Ultrasonography showed bilateral inguinal hernia, and the ultrasound and CT of adrenal gland was normal. Next generation sequencing revealed a 0 . 73 Mb deletion on the 7 q 11 . 23 (chr7 :73 , 442 , 119 - 74 , 175 , 022 ) region of the child. The region included 15 protein-coding genes. Conclusion A child with characteristic manifestation of Williams-Beuren syndrome and adrenal insufficiency was diagnosed using next generation sequencing, and his adrenal insufficiency was rare. The deletion on 7 q 11 . 23 underlied the disease in this boy.

Key words: Williams-Beuren syndrome; adrenal insufficiency; chromosome deletion