临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (9): 656-.doi: 10.3969/j.issn.1000-3606.2021.09.004

• 新生儿疾病专栏 • 上一篇    下一篇

CRLF1 复合杂合变异致Crisponi 综合征1 例临床特征

刘银芝, 廖镇宇, 杨慧, 杨志明, 叶红球, 占彩霞, 黄瑞文   

  1. 湖南省儿童医院新生儿科(湖南长沙 410007)
  • 出版日期:2021-09-15 发布日期:2021-09-03
  • 通讯作者: 黄瑞文 电子信箱:huangrw@yeah.net

Clinical characteristics of Crisponi syndrome caused by a compound heterozygous variation in CRLF1

LIU Yinzhi, LIAO Zhenyu, YANG Hui, YANG Zhiming, YE Hongqiu, ZHAN Caixia, HUANG Ruiwen   

  1. Neonatal Department, Hunan Children’s Hospital, Changsha 410007 , Hunan, China
  • Online:2021-09-15 Published:2021-09-03

摘要: 目的 报告1例CRLF 1基因新发复合杂合变异致Crisponi综合征(CS)的临床特征。方法 回顾分析1例 CS患儿的临床资料。结果 男性患儿,生后即出现张口困难、哭声小伴呼吸困难、吐沫;小下颌,手、足趾指细长,肘关 节及双手中指、无名指屈曲不能伸直;四肢肌张力增高;吸吮、觅食反射未引出。全外显子检测示CRLF1基因新发复合 杂合变异,c. 829 _ 847 del移码变异,来自父亲;c. 713 delC移码变异,来自母亲。经生物信息学分析判断为有害变异;根 据美国遗传学和基因组学会指南分别判断为I类致病变异和II类可能致病变异。最终确诊为CS。结论 CS的主要特点 是发热、屈指畸形、典型的面部特征、喂养和呼吸困难,可导致新生儿猝死。该例变异未见报道,扩展了CRLF 1致病变 异谱。

关键词: Crisponi综合征; CRLF1基因; 冷诱导出汗综合征

Abstract: Objective To explore the clinical characteristics of Crisponi syndrome (CS) caused by a novel compound heterozygous variation in CRLF1 gene. Methods The clinical data of CS in one child was analyzed retrospectively. Results A boy had difficulty in opening his mouth, crying softly with dyspnea and spitting after birth. The boy had a small jaw and the mouth could not be fully opened. His fingers of hands and toes were slender, and the elbow joint, the middle finger and the ring finger of both hands could not be straightened. He had increased muscle tension in the extremities. The sucking and foraging reflexes were not elicited. The whole exome sequencing showed a novel compound heterozygous variations in CRLF1 gene, among which the frameshift variation of c.829_847del was from the father and the frameshift variation of c.713delC was from the mother. The compound heterozygous variation in this child has not been reported, but was determined to be harmful by bioinformatics analysis. According to the guidelines of the American College of Medical Genetics and Genomics, it was identified as Class Ⅰ pathogenic variant and Class Ⅱ possible pathogenic variant. The patient was eventually diagnosed with CS. Conclusions The main characteristics of CS are fever, flexion deformity, typical facial features, feeding and breathing difficulties, which may lead to sudden neonatal death. This is the first case of CS in China and it expands the spectrum of CRLF1 pathogenic variants.

Key words: Crisponi syndrome; CRLF1 gene; cold induced sweating syndrome