罕见病 疑难病

CTNS 基因突变导致幼儿胱氨酸肾病及角膜结晶

  • 马艳艳 ,
  • 刘玉鹏 ,
  • 丁圆 ,
  • 杨艳玲 ,
  • 李东晓 ,
  • 周玲 ,
  • 李溪远 ,
  • 沈延君 ,
  • 宋金青
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  • 1. 青海大学附属医院(青海西宁 810001); 2. 北京大学第一医院(北京 100034)

收稿日期: 2016-10-15

  网络出版日期: 2016-10-15

基金资助

国家自然科学基金(No.81471097);国家自然科学青年基金(No.81400939); 青海省应用基础研究基金(No. 2016-ZJ-730)

CTNS gene mutation leads to cysteine nephropathy combined with corneal crystal in young child

  • MA Yanyan ,
  • LIU Yupeng ,
  • DING Yuan ,
  • YANG Yanling ,
  • LI Dongxiao ,
  • ZHOU Ling ,
  • LI Xiyuan ,
  • SHEN Yanjun ,
  • SONG Jinqing
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  • 1. Qinghai University Affiliated Hospital, Xining 810001, Qinghai, China; 2. The First Hospital of Peking University, Beijing 100034, China

Received date: 2016-10-15

  Online published: 2016-10-15

摘要

目的 探讨胱氨酸病的诊断。方法 回顾性分析1例胱氨酸病患儿的临床、生化和基因检测资料。结果 患儿,女, 4岁。 2岁时出现畏光,眼科检查发现角膜结晶, 3岁发现双肾结石,伴体格发育落后、佝偻病。尿液气相色谱分析多 种氨基酸增加,尿糖、尿微量蛋白增高,符合范可尼综合征。血液游离肉碱降低,酯酰肉碱谱正常,赖氨酸、缬氨酸、精氨 酸等多种氨基酸降低。基因分析示CTNS基因存在纯合突变c.696C > G(p.323 N > K),为已知突变。患儿父母均为CTNS 基因c.696C > G杂合突变携带者。结论 对于主要表现为肾结石、肾损害,伴眼部、骨骼、甲状腺等多系统损害的患儿应 注意鉴别胱氨酸病。

本文引用格式

马艳艳 , 刘玉鹏 , 丁圆 , 杨艳玲 , 李东晓 , 周玲 , 李溪远 , 沈延君 , 宋金青 . CTNS 基因突变导致幼儿胱氨酸肾病及角膜结晶[J]. 临床儿科杂志, 2016 , 34(10) : 783 . DOI: 10.3969/j.issn.1000-3606.2016.10.017

Abstract

Objective To explore the diagnosis of cystinosis. Methods The clinical and biochemical information, and gene detection results in a child with cystinosis was retrospective analyzed. Results Four-year-old female presented with photophobia and corneal crystal was found by ophthalmic examination at 2 years old, bilateral kidney stone was found, accompanied by development delay and rickets at 3 years old. Gas chromatography analysis in urine showed that a variety of amino acids were increased, and urine sugar and urinary micro-protein were also increased, which were in accordance with fanconi syndrome. The blood free carnitine was decreased, ester acyl carnitine spectrum was normal, and multi-amino acids such as lysine, valine and arginine were decreased. Gene analysis showed a homozygous mutation of c.696C > G (p.323 N > K) in CTNS gene, which was a known mutation. Both her parents were carrier of heterozygous mutation of c.696C > G in CTNS gene. Conclusion Child with kidney stone, renal damage, combined by multi-system damage such as eyes, bone, and thyroid should be paid attention to identify the cystinosis.
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