临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (8): 624-628.doi: 10.12372/jcp.2023.22e0486

• 综合报道 • 上一篇    下一篇

DHTKD1基因复合杂合变异致α-酮己二酸尿症1例报告

王红霞, 潘翔, 逯军()   

  1. 中南大学湘雅医学院附属海口医院(海南 海口 570208)
  • 收稿日期:2022-04-26 出版日期:2023-08-15 发布日期:2023-08-10
  • 通讯作者: 逯军 E-mail:Lu139762@163.com

Report a case of α-ketoadipic aciduria caused by compound heterozygous variant of DHTKD1 gene

WANG Hongxia, PAN Xiang, LU Jun()   

  1. The Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, Hainan, China
  • Received:2022-04-26 Online:2023-08-15 Published:2023-08-10
  • Contact: LU Jun E-mail:Lu139762@163.com

摘要:

α-酮己二酸尿症为赖氨酸、羟赖氨酸和色氨酸降解代谢紊乱所致的遗传代谢病,临床表现轻重不一,受累系统广泛,主要临床表现有生长发育迟缓、肌张力减退、癫痫、共济失调、小头畸形、行为异常等。本例患儿2岁8月龄,表现为抽搐和行为异常,尿有机酸分析示α-酮己二酸明显增高,基因遗传学检测发现DHTKD1基因存在致病复合杂合变异,结合患儿临床特征和遗传学特点,确诊为α-酮己二酸尿症。经低赖氨酸、低蛋白饮食和康复治疗等对症处理后,患儿病情有所改善。该病临床罕见,为国内医学数据库首例报道。本病例报道扩充了α-酮己二酸尿症基因谱,也为临床上该病的诊治提供借鉴与参考。

关键词: α-酮己二酸尿症, DHTKD1基因, 复合杂合变异, 儿童

Abstract:

Alpha-ketoadipic aciduria is a genetic metabolic disease caused by the disorder of lysine, hydroxylysine and tryptophan degradation metabolism. The clinical manifestations of the disease vary in severity and affect a wide range of systems. The main clinical manifestations include growth retardation, hypotonia, epilepsy, ataxia, microcephaly and abnormal behavior. The patient was 2 years and 8 months old and presented with convulsions and behavioral abnor malities. Urine organic acid analysis showed that α-ketoadipic acid was significantly increased. Genetic testing revealed that DHTKD1 gene had pathogenic compound heterozygous variation. Combined with the clinical and genetic characteristics of the child, the diagnosis of α-ketoadipic aciduria was confirmed. The patient's condition improved after symptomatic treatment with a low lysine and protein diet and rehabilitation. This is the first report of α-ketoadipic aciduria in Chinese medical database, which expands the genetic spectrum of α-ketoadipic aciduria and provides reference for clinical diagnosis and treatment of the disease.

Key words: α-ketoadipic aciduria, DHTKD1 gene, compound heterozygous variation, child