临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (11): 805-.doi: 10.3969/j.issn.1000-3606.2021.11.002

• 遗传代谢疾病专栏 • 上一篇    下一篇

先天性糖基化障碍临床及遗传学分析

张思思 1,2, 江伟 1, 王献虎 1, 张明强 1,肖农 1   

  1. 1 .重庆医科大学附属儿童医院康复科 儿童发育疾病研究教育部重点实验室 国家儿童健康与疾病 临床医学研究中心 儿童发育重大疾病国家国际科技合作基地 儿科学重庆市重点实验室 (重庆 400014 );2 .陕西省汉中市中心医院儿科(陕西汉中 723000)
  • 发布日期:2021-11-19
  • 通讯作者: 江伟 电子信箱:18745297 @qq.com
  • 基金资助:
    重庆市技术创新与应用发展专项面上项目(No.cstc2019 jscx-msxmX 0197)

Analysis of clinical and pedigree genetics in eight cases with congenital disorders of glycosylation

ZHANG Sisi 1,2 , JIANG Wei1 , WANG Xianhu1 , ZHANG Mingqiang1 , XIAO Nong1   

  1. 1 .Department of Children Rehabilitation, Children’s Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing, 400014 , China; 2 .Department of Pediatrics, Hanzhong Central Hospital, Shaanxi Province, Hanzhong 723000, Shaanxi, China
  • Published:2021-11-19

摘要: 目的 探讨先天性糖基化障碍(CDG)的临床及遗传学特征。方法 回顾分析8例CDG患儿的临床资料。结 果 8例确诊CDG患儿共4种亚型,包括PMM 2 -CDG 5例(男2例、女3例),ALG 6 -CDG、SSR 4 -CDG、SLC 35 A 2 -CDG 型各1例(均为男性);平均起病年龄(5.6±1.8)月,平均就诊年龄(18.5±4.4)月,平均确诊时长(10.5±5.5)月。神经 系统最易受累,均以中、重度发育迟缓为主要或首发症状,均存在肌张力障碍,有特征性的骨盆上方和/或臀部脂肪垫及乳 头凹陷,头颅影像学多无特征性异常。ALG6-CDG及SSR4-CDG病例系国内首次报道。错义变异为CDG主要变异类型, 共6个位点为HGMD数据库尚未报道过的突变位点。结论 CDG是一类涉及多个基因、多个变异位点的疾病,临床表型 及基因型异质性强,早期诊断困难。

关键词: 先天性糖基化障碍; 发育迟缓; 肌张力障碍; 惊厥发作; 脂肪垫

Abstract: Objective To review and summarize the clinical and genetic characteristics of congenital disorders of glycosylation (CDG), and to help its early diagnosis and treatment. Methods To analyze retrospectively clinical characteristics, genotypes, family information, imaging and electrophysiological examinations, laboratory indicators and other related data of eight children with CDG diagnosed in our department in recent years. Results There were four subtypes in eight children with CDG, including five cases of PMM 2 -CDG (two males and three females), one case of ALG 6 -CDG (male), one case of SSR 4 -CDG (male), and one case of SLC 35 A 2 -CDG (male). The average age of onset was 5 . 6 ± 1 . 8 months, the average age of consultation is 18 . 5 ± 4 . 4 months, and the average duration of diagnosis was 10 . 5 ± 5 . 5 months. The nervous system were the most susceptible to be involved in CDG children, presented with moderate to severe developmental delay as the main or initial symptom. Dystonia was presented in all children, and characteristic upper pelvic and (or) buttocks fat pad and nipple depression were common phenotype. There were no characteristic abnormalities in brain imaging. PMM 2 -CDG was the most common CDG subtype, and the cases of ALG 6 -CDG and SSR 4 -CDG were reported for the first time in China. Missense mutation was the main type of CDG mutation. There were 6 sites in the article which have not been reported in the HGMD database. Conclusion CDG is a type of disease involving multiple genes and multiple site mutations. Therefore, the clinical phenotype and genotype are diverse, and early identification and diagnosis are difficult.

Key words: congenital disorders of glycosylation; developmental delay; dystonia; convulsions; fat pad