临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (12): 909-.doi: 10.3969/j.issn.1000-3606.2021.12.007

• 泌尿系统疾病专栏 • 上一篇    下一篇

胱氨酸病婴儿型(肾病型)1 例报告并文献复习

崔洁媛, 葛兰兰, 张东风, 刘玲, 韩佩桐, 袁晓颖   

  1. 河北省儿童医院肾脏免疫科(河北石家庄 050031)
  • 发布日期:2021-12-22
  • 基金资助:
    崔洁媛 电子信箱:cuijieyuan_0 @ 126 .com

Infantile cystinosis (nephropathy): a case report and literature review

CUI Jieyuan, GE Lanlan, ZHANG Dongfeng, LIU Ling, HAN Peitong, YUAN Xiaoying   

  1. Department of Nephrology and Immunology, Children’s Hospital of Hebei Province, Shijiazhuang 050031, Hebei, China
  • Published:2021-12-22

摘要: 目的 总结1例婴儿型胱氨酸病的临床特点,以提高临床医师对该病的认识。方法 回顾性分析1例婴儿型 胱氨酸病的临床特点。结果 患儿,男,2岁。因身高增长缓慢1年余,双下肢无力3个月收治入院。患儿临床主要表现为 体格发育落后、双下肢无力、佝偻病,辅助检查示代谢性酸中毒、低磷血症、糖尿、酮症、泛氨基酸尿、小分子蛋白尿及高钙 尿症,临床诊断为范可尼综合征,基因变异分析示CTNS基因复合杂合变异,一个为剪接变异c. 140+1 G>C(父源),另一 为错义变异c. 969C>G(p.N323 K,母源),明确诊断胱氨酸病(婴儿型)。结论 胱氨酸病以婴儿型多见,临床首发表现主 要为体格发育落后和尿检查异常,临床多诊断为范可尼综合征。

关键词: 胱氨酸病; 肾病; 婴儿型

Abstract: Objective To summarize the clinical characteristics of a case of infantile cystinosis in order to improve clinicians' understanding of the disease. Method The clinical features of one case of infantile cystinosis were retrospectively analyzed. Results A 2 -year-old boy was admitted to hospital due to growth retardation in height for more than 1 year and weakness of lower extremities for 3 months. The boy presented with physical development retardation, lower extremities weakness, rickets, metabolic acidosis, hypophosphatemia, glycosuria, ketonuria, aminoaciduria, low-molecular-weight proteinuria and hypercalciuria. Genetic variation analysis showed complex heterozygous variation of CTNS gene. One was a splicing variation of c.140 +1G>C from the father, and the other was a missense variation of c.969C>G (p.N323K) from the mother, and the child was diagnosed as cystinosis (infantile type). Conclusions Infantile cystinosis is more common in infant, and the first clinical manifestations are mainly physical retardation and abnormal urine examination. Clinically, it was often misdiagnosed as Fanconi syndrome.

Key words: cystinosis; nephropathy; infantile type