临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (3): 178-.doi: 10.3969/j.issn.1000-3606.2021.03.004

• 新生儿疾病专栏 • 上一篇    下一篇

新生儿瓜氨酸血症Ⅰ型一家系基因分析

彭薇, 杨晓, 陈雨晗, 闫磊, 张万巧   

  1. 中国人民解放军总医院第七医学中心 出生缺陷防控关键技术国家工程实验室 儿童器官功能 衰竭北京市重点实验室(北京 100700)
  • 出版日期:2021-03-15 发布日期:2021-03-12
  • 通讯作者: 张万巧 电子信箱:zwqiao 23 @163 .com
  • 基金资助:
    国家自然科学基金青年科学基金项目(No. 81901518);国家重点研发计划课题(No. 2018 YFC 1002701)

Genetic analysis of citrullinemia type Ι in a neonate family

y PENG Wei, YANG Xiao, CHEN Yuhan, YAN Lei, ZHANG Wanqiao   

  1. Seventh Medical Center of PLA General Hospital, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing Key Laboratory of Pediatric Organ Failure, Beijing 100700, China
  • Online:2021-03-15 Published:2021-03-12

摘要: 目的 分析新生儿瓜氨酸血症Ⅰ型家系的基因变异特征。方法 回顾分析1例新生儿瓜氨酸血症Ⅰ型患儿 的临床资料,提取患儿及其父母外周血基因组DNA,采用二代测序技术进行基因检测,Sanger测序、生物信息学分析和定 量PCR进一步验证测序结果。结果 女性患儿,出生后反应差、四肢不规则抖动、肌张力增高,逐渐出现呼吸衰竭;血氨、 血乳酸升高,血糖降低。血串联质谱检查提示瓜氨酸显著增高,尿气相色谱质谱检查提示尿乳清酸显著增高。基因检测发 现患儿ASS 1基因c. 1194 - 2 A>G和3号外显子缺失复合杂合变异,其中c. 1194 - 2 A>G遗传自父亲,3号外显子缺失遗传 自母亲,两种变异在HGMD数据库中均未报道,根据ACMG指南划分为可能致病性变异。结论 ASS1基因c.1194-2A>G 杂合变异和3号外显子杂合缺失是该新生儿瓜氨酸血症Ⅰ型的遗传学病因,丰富了中国人新生儿ASS1基因变异谱。

关键词: 瓜氨酸血症Ⅰ型; ASS1基因; 变异; 生物信息学分析

Abstract: Objective To explore the genetic variation characteristics of citrullinemia type Ⅰ in a neonate family. Methods The clinical data of citrullinemia type Ⅰ in a neonate were retrospectively analyzed. Genomic DNA was extracted from the peripheral blood of the child and her parents. Gene detection was performed by second-generation sequencing technology. Sanger sequencing, bioinformatics analysis and quantitative PCR were used to further verify the sequencing results. Results One female neonate had poor reaction, irregular shaking of limbs, increased muscle tension and gradually developed respiratory failure after birth. At the same time, the blood ammonia and lactic acid increased and the blood glucose decreased. Blood mass spectrometry showed a significant increase in citrulline, and urine gas chromatography-mass spectrometry showed a significant increase in urinary whey acid. Gene detection revealed that the neonate's ASS1 gene had c.1194 - 2 A>G heterozygous variant which was inherited from the father and heterozygous deletion of exon 3 which c. 1194 - 2 A>G was inherited from the mother. These two variants were not reported in HGMD database. According to ACMG guidelines, they were classified as possible pathogenic variants. Conclusion ASS1 gene c.1194 - 2 A>G heterozygous variant and exon 3 heterozygous deletion are the genetic causes of the neonatal citrullinemia typeⅠ, which enriches the ASS1 gene variant spectrum in Chinese neonates.

Key words: citrullinemia typeⅠ; ASS1 gene; mutation; bioinformatics analysis