临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (4): 289-.doi: 10.3969/j.issn.1000-3606.2020.04.011

• 罕见病 疑难病 • 上一篇    下一篇

5 例低磷酸酯酶症患儿临床及遗传学分析

苏娜 1,2, 朱岷 1, 许珂 2, 张惠姣 1   

  1. 1.重庆医科大学附属儿童医院儿科研究所 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.电子科技大学医学院附属妇女儿童医院成都市妇女儿童中心医院儿童遗传 与内分泌代谢科(四川成都 610019)
  • 出版日期:2020-04-15 发布日期:2020-04-15
  • 通讯作者: 朱岷 电子信箱:15922915823 @163.com

Clinical and genetic analysis of hypophosphatasia in 5 children

 SU Na1,2, ZHU Min1, XU Ke2, ZHANG Huijiao1   

  1. 1. Department of Pediatric Research Institute, 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 Child Endocrinology and Genetic Metabolism, The Affiliated Hospital, School of Medicine, UESTC, Chengdu Women's and Children's Central Hospital, Chengdu 610019, Sichuan, China
  • Online:2020-04-15 Published:2020-04-15

摘要: 目的 总结低磷酸酯酶症(HPP)的临床及遗传学特点。方法 回顾分析5 例HPP患儿的临床资料,以及患 儿及其亲属的外周血高通量测序及Sanger验证结果。结果 5例患儿均有骨骼矿化不良以及血清碱性磷酸酶降低, 3例伴 有惊厥等神经系统症状。 5例HPP患儿高通量测序共发现ALPL6个突变位点,c.346G>A(p.A116T)、c.1097至c.1099del CCT复合杂合突变(p.T366_S367deli)、c.1014至c.1015ins G(p.H338fs)、c.1446C>A(p.482H>Q)复合杂合突变、c.920C>T (p.P307L)、c.883A>G(p.M295V),其中c.1014_c.1015ins G、c.1097_c.1099del CCT、c.1446C>A为首次报道,蛋白质结 构预测均为可能有害,ACMG评级为可能致病。结论 确诊5例HPP患儿,发现 3种新型突变,丰富了人类ALPL基因突变 数据库。

关键词: 低磷酸酯酶症; ALPL基因; 基因突变

Abstract: e To summarize the clinical and genetic characteristics of hypophosphatasia (HPP). Methods The clinical data and results of peripheral blood high-throughput sequencing in 5 children with HPP as well as Sanger verification of the children and their relatives were retrospectively analyzed. Results All 5 patients had poor bone mineralization and decreased serum alkaline phosphatase, and 3 patients had nervous system symptoms such as convulsion. Six mutation sites were identified in these 5 children by high-throughput sequencing, including c.346G>A (p.A116T), c.1097 to c.1099del CCT complex heterozygous mutation (p.T366_S367deli), c.1014 to c.1015ins G (p.H338fs), c.1446C>A (p.482H>Q) compound heterozygous mutations, c.920C>T (p.P307L) and c.883A>G (p.M295V). Among them, c.1014-c.1015ins g, c.1097-c.1099del CCT and c.1446c> A were reported for the first time. Protein structure was predicted to be potentially harmful, and ACMG rates them as possibly pathogenic. Conclusions Five children were diagnosed with HPP and three new mutations were found, which enriched the human ALPL gene mutation database.

Key words: hypophosphatasia; ALPL gene; gene mutation