临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (11): 851-.doi: 10.3969/j.issn.1000-3606.2019.11.013

• 综合报道 • 上一篇    下一篇

Imerslund-Gräsbeck 综合征1 例临床和基因突变分析

刘俐兵,高晓洁,马颐姣,贾实磊, 陈冉冉, 李俊   

  1. 广东省深圳市儿童医院肾脏血液科(广东深圳 518000)
  • 出版日期:2019-11-15 发布日期:2020-02-03
  • 通讯作者: 高晓洁 电子信箱:gxj0824@hotmail.com

Clinical features and genetic analysis of Imerslund-Gräsbeck syndrome: a case report and literature review

LIU Libing, Gao Xiaojie, MA Yijiao, JIA Shilei, CHEN Ranran, LI Jun   

  1. Department of Nephrology, Shenzhen Children’s Hospital, Shenzhen 518000, Guangdong, China
  • Published:2019-11-15 Online:2020-02-03

摘要:  目的 探讨Imerslund-Gr?sbeck综合征(IGS)的临床特点、遗传机制。方法 回顾1例IGS患儿的临床资料, 并结合文献进行分析。结果 患儿,男, 3岁11个月,表现为营养不良、运动发育迟缓。实验室检查示血红蛋白 77 g/L,平 均红细胞体积 102.2 fl,平均红细胞血红蛋白含量 35.2 pg,平均红细胞血红蛋白浓度 344 g/L,血维生素B12 69 pg/mL,24 小时尿蛋白529.1 mg。基因测序结果显示患儿AMN基因存在c.742C>T(p.Q248*)纯合突变,Sanger测序验证患儿父母 均携带AMN基因c.742C>T(p.Q248*)杂合突变。明确诊断IGS。定期予维生素B12肌注治疗,监测血常规示三系正常,尿 蛋白-~++,大运动发育追赶至同龄儿。结论 对于巨幼红细胞性贫血合并轻中度良性蛋白尿的患儿,需考虑IGS可能, 基因检测有助明确诊断。

关键词: Imerslund-Gr?sbeck综合征; 巨幼红细胞性贫血1型; 维生素B12; 蛋白尿; AMN基因

Abstract: Objective To investigate the clinical characteristics and genetic mechanism of Imerslund-Gr?sbeck syndrome (IGS). Methods The clinical data and genetic test of a patient with IGS were collected and analyzed retrospectively. Related literatures were reviewed. Results The patient presented with malnutrition, exercise retardation, megaloblastic anemia, vitamin B12 deficiency, and mild-moderate benign proteinuria. Whole exome sequencing identified a homozygous c.742C>T(p.Q248*) mutation of the AMN gene in the patient. Sanger sequencing found both of his parents are heterozygous carriers. Conclusion For children with megaloblastic anemia complicated with mild to moderate benign proteinuria, the possibility of IGS should be considered.

Key words:  Imerslund-Gr?sbeck syndrome; megaloblastic anemia 1; selective vitamin B12 malabsorption with proteinuria; AMN genetic mutation