临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (10): 785-.doi: 10.3969/j.issn.1000-3606.2020.10.016

• 罕见病 疑难病 • 上一篇    下一篇

GPI基因突变致葡萄糖磷酸异构酶缺乏症1例报告及文献复习

黄鹏 1,2, 唐黎 1,2, 汪爱平 1,2, 刘玲娟 1,2, 熊洁 1,2, 肖阳阳 1,2, 毛定安 1,2, 刘利群 1,2   

  1. 中南大学湘雅二医院1.儿科, 2. 儿童脑发育与脑损伤研究室(湖南长沙 410011)
  • 出版日期:2020-10-15 发布日期:2020-10-10
  • 通讯作者: 刘利群 电子信箱:liuliqun@csu.edu.cn
  • 基金资助:
    湖南省科技计划重点研发项目(No.2018SK2069);湖南省卫生健康委员会资助项目(No.B2018-0311)

Glucose-6-phosphate isomerase deficiency caused by GPI gene mutation: a case report and literature review

HUANG Peng1,2, TANG Li1,2, WANG Aiping1,2, LIU Lingjuan1,2, XIONG Jie1,2, XIAO Yangyang1,2, MAO Dingan1,2, LIU Liqun1,2   

  1. 1.Department of Pediatrics, 2. Children's Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
  • Online:2020-10-15 Published:2020-10-10

摘要: 目的 探讨葡萄糖磷酸异构酶(GPI)缺乏症的临床特点及致病基因。方法 回顾分析1例GPI缺乏症患儿的 临床资料,并复习相关文献。结果 患儿,男, 4岁3月龄。自出生起反复出现贫血、黄疸,伴有肝脾肿大、膝关节疼痛、大 运动发育落后;葡萄糖-6-磷酸脱氧酶、丙酮酸激酶、血红蛋白电泳、直接抗人球蛋白试验、红细胞脆性试验及骨髓细胞学 检查均未见异常;膝关节磁共振示双膝关节少量积液并滑膜炎。全外显子测序显示患儿GPI基因6号外显子存在纯合错 义变异c.553T>A(F185I),Sanger测序验证分别来自其父母,为未见报道的新发变异。该变异为致病性变异。结论? GPI 缺乏症为罕见的常染色体隐性遗传病,早期行基因检测可协助诊断。

关键词: 葡萄糖磷酸异构酶缺乏症; GPI基因; 溶血性贫血; 基因突变

Abstract: Objective To explore the clinical characteristics and pathogenic genes of glucose-6-phosphate isomerase (GPI)?deficiency.?Method? The?clinical?data?of?GPI?deficiency?in?a?child?was?retrospectively?analyzed,?and?the?related?literature? was?reviewed.?Results? A?4-year-?and?3-month-old?boy?suffered?from?repeated?anemia?and?jaundice?since?birth,?accompanied? by?hepatosplenomegaly,?knee?joint?pain?and?gross?motor?development?retardation.?No?abnormality?was?found?in?G6PD?enzyme,? pyruvate?kinase,?hemoglobin?electrophoresis,?direct?Coombs?test,?erythrocyte?fragility?and?bone?marrow?cytological?examination.? Knee?joint?MRI?showed?a?small?amount?of?fluid?and?synovitis?in?both?knee?joints.?Whole?exome?sequencing?showed?that?there?was? a?homozygous?missense?mutation,?c.553T>A?(F185I),?in?exon?6?of?the?GPI?gene.?Sanger?sequencing?verified?that?they?were?from? their?parents?and?it?was?a?new?mutation?not?reported?before.?The?mutation?was?pathogenic.?Conclusion? GPI?deficiency?is?a?rare? autosomal?recessive?genetic?disease,?and?early?genetic?testing?can?assist?in?the?diagnosis.

Key words:  glucose-6-phosphate?isomerase?deficiency;? GPI gene; hemolytic anemia; gene mutation